1228� d
'NOTE:.
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 III
DATE: September 25, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
r
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION Grinder, 101 wide, green
Weight, All else legal
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if�appropriate)
Haul Route: Durango and Bermudas
to Highland and Washington and
Return.
Haul Date: .9/26/91
Return Date; 9/30/91
ti
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com- 05 2 10 gq 09-25-~91_ 14
i6 RSH i QTAL i` 130.04
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 Quinta and to pay for any additional replacement necessary as the result of this work.
ka
Signature of Applicant or Agent Tina Gracey
TARMAC CALIFORNIA P.O. Bos 14050 'Palm Desert,.CA`92255 775-8267
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
On File On File ,..
Contractor's License No. City BusinessLicense No.
r•
On File On File
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
,r
Inspection Fee' $
Permit Fee - 130.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 130.00
Receipt No.
Received by Date ,
PERMIT VALIDATION
PERMIT NO. 1228
DATE APPROVED 9/25/91 „
EXPIRATION DATE 9/30/91
DATE ISS ED 9/25/91
Bnory
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
i
NOTE: i
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OF 7i$�
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:
September 25, 1991
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _
DESCRIPTION OF CONSTRUCTION Grinder, 10' wide, green
Weight, All else legal
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit —Class I I I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
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:
Haul.Route: Durango and Bermudas
to Highland and Washington and
Return.
Haul Date: 9/26/91
Return Date; 9/30/91
i0O5 CASHOi4TOTAL09125-90.00 14
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities o. 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 124) 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 Quints and to pay for any additional replacement necessary as the result of this work.
Sage -.ter
Signature of Applicant or Agent Tina Gracey
TARMAC CALIFORNIA P.O. Box 14050 Palm Desert, CA 92255 775-8267
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
On File On File
Contractor's License No. City Business License No.
On File On File
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111
Public improvements: 3% of estimated construction costs 1228
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee 130.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 140.00
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
1228
DATE APPROVED
9/25/91
EXPIRATION DATE
9/30/91
9/2 /91
DATE ISSdED
By
Administrative Authority
TELEPHONE: (619) 564.2246
J
A
148" of Avoitcan, It-leaw orint) - . z
1? 1-- — — ' __; - — BusinessAddress
-N810 Or Contractor ono J
,po F prorrian
y1,1 Z,
CcintraLjor-s L.censo No
Business Address
Private imbrow, ast"l-Ifu construction corn
rrrffa: 3% Of Osbrrmlec construction Co.
ts
Minor irmorovenw.? p..,,
Can IV, See arocrito scmedui,
#n2bection i:ee S
Perf"ll Ft.,
NOTE:
Whh proper
th a form cOrtlicumas an
onemaMrneriT oWMff CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For tris consrucuon of Pu
and Other like Public mo, I public i6r, Private curbs. driveways, Pann'"mm. sidewalks. Parking lots, tW ffatipw.
RIM"irrverms in connection with MINOR IMPROVEMENTS and APPROVED
SuBDIVISION3
•j
DATE: Subdivision Improvernent Parini, CLm
Minor Improverram pwmlt Cas IV
LOCATION OF CONSTRUCT70N
PURPOSE OF CONSTRUCTION
Sketcm f8rlach corMM c2trans if
DESCRIPTION k' nr "U
0
OESCRIPrT1 NDF ONSTRUCTION eon-
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L
7.
4_,al /
6
DIMENSION OF INSTALLATIObp
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FIREMOVAL
01
Ue5zj"1'fz/ - . C I
SIZE 0 749
EXCAVATION, IF NEEDED
APPROXIMATE
TIME WHEN WORK WILL BEGIN
I —
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S ----------------
'Including removal Of Ill Obstruction,
r"ItOnsis.8riddebrit, —*filli,
ngcorn-
Paction and Placing be Perrn*norn nalurf'SCIV4 and/or ravlacing impromrwTal
In Consideration of the granting of thi Plfmlt. the OPPlicant Hereby sqrftl to:
'no—ltv- ont-W am a" me cl
lab'I'ti" or JmMO
ma"t"'o. smo"Wm- ha—ess tnwn mo
ftm clAw" or court action and onit" owt of a" ammoom. Now= eery No am
*r 00"Ar"m " 8 Omm"arm Soma or 68"W"
mmn of givy wm* uno wftow me p"
Pdvtltv via Auvmwwv as ben twm" ortmun ft Shia aMeram. or prom"
,our 124, hou on WWWC*
Of She twif When wore rml ift
COMINY "m all mogmicat" Cjtv 0,0 wunm. the tens/
LA Quints am to eav ter o"notto"a *f th& 001 SM all MMCMU* rWWS Orld MolAftlar•n of a@ C3
acartumw FWDL&Cvrrwm naommuv as T"s V"Lm t of IV
Sign"IADt Appitcan, or Agent
148" of Avoitcan, It-leaw orint) - . z
1? 1-- — — ' __; - — BusinessAddress
-N810 Or Contractor ono J
,po F prorrian
y1,1 Z,
CcintraLjor-s L.censo No
Business Address
Private imbrow, ast"l-Ifu construction corn
rrrffa: 3% Of Osbrrmlec construction Co.
ts
Minor irmorovenw.? p..,,
Can IV, See arocrito scmedui,
#n2bection i:ee S
Perf"ll Ft.,
-1p
011CY Nurroer'
'Vg �4
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= t E17-
7,07W0 51
PERMIT VALIDATION
Penury 'ERMIT ';0.
Cash C40-It-Surery Bona DATE APPROVED
----------------
if OVED
TOTAL: EXPIRATION DATE
F1000101 No. DATE ISSUED
1400111VOO by By
Data
Reawom Dv Atimmisulm"
A410.10mv
Toloorm" No.
Tole N
-1p
011CY Nurroer'
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= t E17-
7,07W0 51
PERMIT VALIDATION
Penury 'ERMIT ';0.
Cash C40-It-Surery Bona DATE APPROVED
----------------
if OVED
TOTAL: EXPIRATION DATE
F1000101 No. DATE ISSUED
1400111VOO by By
Data
Reawom Dv Atimmisulm"
A410.10mv