1163NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit —Class I I I
DATE: July 26, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION HAVE EQ111PHW Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 161 BARBER GREEN 11016"
WTDP CRF,FN WFTMM At t R7.51A. T.FO,AT,
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
ROUTE;
MONTEREY AND MONTEZUMA
BERMUDA 52 OUT OF CITY LIMITS
DATE 7-26-91
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this work.
BECKY PHILLIPS
Signature of Applicant or Agent
TARMAC CALIFORNIA 0.0. BOR_ 140550 PALM DFRFRT CA 42955 775-8200
Name of Applicant (please print) Business Address Telephone No.
ONFILE
Name of Contractor and Job Foreman Business Address Telephone No.
ON FILE
Contractor's License No.
City Business License No.
—1— 1 '1
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No
Received by
Date
1163
PERMIT VALIDATION
PERMIT NO. 1163
DATE APPROVED 7-26-91
EXPIRATION DATE 7-26-9I
DATE
,L
ISSUED 7-26-91 A
By 2
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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NOTE:
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Whh ptOpv
thb farm comuwm an
encroeehnum O rtmt CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBUC WORXS CONSMUCTION (ENCROACHMENT}
For tna aonruuc,on of public or Prrrata curbs. driven ye. paven►mm, a}d9mlks.
and othar Ilko puotie Morar improve"Wrty In oonnacpOn with MINOR IMPROVEMENTS g tau. APPROVED e. �� wow
SI180IVIS14NS
.
DATE:-,,�/ Subdlrieionimorovernrrnptmr, ..
R Ctaae lI I
LOCATION QF CONMUCTION Mlrtor fmat0►rtrtr►am PeeMa C IV
ISMwt .oa'oer a o.,e��,e„ or t�vonl
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PURPOSE OF CONSTHUCnON / ' L
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Sketch 4aeueh
�.� oaneovaien pLrta R
R RIP ION OF CONSTR 6N
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1
DIMENSION OF INSTALL.ATIO OR REMOVAL • ' ' o�� 7L c „ d�L�.y�
SIZE OF EXCAVATION, IF t
'
APPROXIMATE TIME YMEN WORK WILL BEGIN '
APPROXIMATE TIME pF COMPLETION
:• '
ESTIMATED CONSTRUCTION COST S
, ,
Uncludinq renrowl of all obnrtruccion�Oaeon
f*�etanals, and debris, backfilling, eara
and placing eraent fen"lemg and/at replacing tnprowl
In Consideration
''•..
of tha grantlnq of this Permit, tha applicant fufrebv agrees to:
Indamnlfv, eelerq arov the W�f Y `_
rv, m oymo tied @"nta, affic". rep�e
mroe W4 e�+aafvm. Mammon f- aN
pw*ly . W41111in Of tear ►eWrtwq hem anion Or comm acuon wee arw
h�nMN
5.:�, �` • `;
end If" out of any eoewsnt, baa ersr w
w covirrom M • Dmi real rmrn of nay wale MRaera " wow the eD BweorM pump"
NOUN the Adm,hwrrnh f�errrlR ftt^wd summon to thio aoolovoo4
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........_ �,.,....._ Comae wyel all trro►►N a< b.eit o++Mvaow.flal �eurt
... , .. aoo� G '• of the stens
'� N.Om�. "�',;:,.••�•� .•1....c.,. � wr.an ewes wul be errtwf, ,
�':;. .., �. ,.... ... •.._._....i - oil OormK Ond aI1 : ,.. • ; ;• ,,
J.....Y.. _ I.a she t0 caw , e:..; the
!Or env '+de+tieiii' !N!wi
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.na!ia!nw�t .•rs�uliyo,r ."r"'.;
" 1 of thw+t.
: c .
re of Appnant or A ns
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Name ai Aooudnt laleau tants
Business Addreu To 11"WN No.
Noma
at Contractor aha Jo For. an Suuness Address
..� 1 T cal► No,
Contractors L.cente No,
City Suunau Lipnu No.
A00cant's Insuranca Cwnpyr
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POliev Nurnsw
FEES: Subdivision Imoro.ernom Perrnrt Coss If!
Public improvrments: 3tG of esvrnated
,
cor+smretion torn
Privets rmtarorrrnents. 3% of aW
r4ted eonatructron eons
Minor Ifiprovem►nt Permit — Class IV: See otacneNO,
schedule lr O
lntbettlah Fee $
Ottm,t Fee PERMIT VALIDATION
G+I+ Ceaosit•SureN Bond
if rwouired DATE APPROVED
,
TOTAL: EXPIRATION DATE
,
A-1it No. DATE ISSUED
140(i typo by DataBy
--
Reaoneo tYv Admmmrtitm AuvxwM
�fLEPHONE 18181 Wd."AA
;i+'ACSfiMIIL� TItANSMI'I'TAL 1
Peg®a of �
Time Sent: )q ?a S 6� • ►'71
Oper®tora i —moi hj -L
Additional Corrianentaa
TRANSMISSION REPORT
THIS DOCUMENT (REDUCED SAMPLE ABOVE)
WAS SENT-
*** SEND ***
COUNT
2
NO
REMOTE STATION I.D.
START TIME
P.O. Box 1704 75-103 Cello —sa4c LA Quin%^. CA 9;737 Phono, (619) 564-1146
#PAGES
(619) $64-3617
;i+'ACSfiMIIL� TItANSMI'I'TAL 1
Peg®a of �
Time Sent: )q ?a S 6� • ►'71
Oper®tora i —moi hj -L
Additional Corrianentaa
TRANSMISSION REPORT
THIS DOCUMENT (REDUCED SAMPLE ABOVE)
WAS SENT-
*** SEND ***
COUNT
2
NO
REMOTE STATION I.D.
START TIME
DURATION
#PAGES
COMMENT
1
6193427504
7-26-91 9:37AM
1'33"
2
TOTAL 0:01'33" 2
XEROX TELECOPIER 7020
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OF X04
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: July 96- 1991
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MQUE EQUIMENT Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 265 BARBER GFJiEN 101611 ROUTE;
WTnF. rRF.FN WRTGAT AT.T. FT q17 T.Fr_AT MONTEREY AND MONTEZUMA
BERMUDA 52 OUT OF CITY LIMITS
DIMENSION OF INSTALLATION OR REMOVAL
DATE 7-26-91
i SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons 'or property
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Ouinta and to pay for any additional replacement necessary as the result of this work.
BECKY PHILLIPS
Signature of Applicant or Agent
TARMAC CAT.TFORNTA P -n- RnX 14OSO PALM TIRRFRT m 92255 775-8200
Name of Applicant (please print) Business Address Telephone No.
ONFTT.F.
Name of Contractor and Job Foreman Business Address Telephone No.
ON FIT.F.
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs 1 1 CV 3
Private improvements: 3% of estimated construction costs I I
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee 1000 PERMIT NO. 1163
Penalty 7-26-91
Cash Deposit -Surety Bond DATE APPROVED
if required EXPIRATION DATE
TOTAL: $ DATE ISSUED 7-26-91
Receipt
— —
Receipt No. By
Received by Date ' Administrative Authority
Recorded by TELEPHONE: (619) 564.2246
i