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1246NOTE:.. • I With.proper validation this form constitutes an ; CITY OF' LA QUINTA encroachment permit APPLICATION FOR `PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) r 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: 10/8/91 t, LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Subdivision Improvement Permit— Class III j Minor Improvement Permit Class IV DESCRIPTION OF CONSTRUCTION __Johnson 966 Loader, Green Weight. All Else Legal DIMENSION OF INSTALLATION OR REMOVAL Sketch (attach construction plans if appropriate) Haul Route: Washington at Fred Waring to 52 to Bermudas and Durango Haul Date: 10/9/91 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION' t ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, com- paction avid 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. Signature of Applicant or Agent Tina Gracey Tarmac California P.O. Box 14050 Palm Desert, CA 92260 775-8267•' Name of Applicant (please print) r Business Address Telephone No. , Name of Contractor and Job Foreman Business Address ► Telephone No. iOnnFile 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 III Public improvements: 3% of estimated construction costs i Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection. Fee $ Permit Fee 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL:. $ 10.00 ' Receipt No. Received by Date . Recorded by 124 'PERMIT VALIDATION PERMIT NO. 1246 DATE APPROVED 10/8/91 EXPIRATION DATE 1049/91 10/8/91 DAT I • LIED By Administrative Authority TELEPHONE: (619) 564-2246 4 '. � r "� � �� ..� _ - - 0 C T.— S— 9 1 T U E 1 3 S 1 M A S P 0 1 NOTE: ' t mh tern eensmsrm in *11" ,nem fsfrmr< CITY OF LA OUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ar� paverom. s' Fotlr the }»nstruc::on of PwOfic to prmu curox, arlre"v, otn•r like pypl.c +!caro f +h+sxnwrre« Ih conn•eeoh with Mt QA l (ji Mks, artd AP O�arfting Io40, PROVEDSUgrjWSt&a ; OAT'E: � SP+frdirition I,Mfsrovertre -- y. •;;,' ' nt Pent, Clam I ll LOCATION dF CONS HU=ON AAint+r lenp vv�, D R i !!/ ~' < fSM•eE •r10h7 � �'" . PURPOSE OFr ' CONMUCTiOfV , Sketch feruch C to -cru 0 PT ON OFC 'NS'I'RUfdT1 sign/ptttra H ENSIGN OF INS?ALLATI Orr OR REMOVAL StzE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHFN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COSTS (Including retnaval of all pwroen Intl p4�n ren' mals, line aebm. unkfiltinil, cortr In �nt:dr 4 pernYrrrt ►otl�fatavg end/or replacing improetKr rtef nt+on of the gr.n1:n9 of 011,, permit, the OFA++rant he /a •' fn0e,enih, det•a0 •qe M the rtov Ogre" t0. f+eno t+a, I,ao ltt,•f er arm _Gh. ori cutnlgNre R '^"e r • t>"n" #own d•.Mr M gown acvon Am ara,n f m 0f ern, bamsemr, ow ow a"mw awe N 4 mean of �++}. teas er r' N•tlh tll► Aa,n,h,r„m,a Au e�si tl�orM Yr4rRk•n urger 1M i�rR Qr•nr�e 1w � � M �+tr ,•''t .-.: , . e/ teem �t 10 04 a w Comsxv w.n ail t"Je"rvfiour ta47 lwur n wn.,er eA the Hmr wn M �r+n, 1.r Aulnm •+�o qty Ords..a�st, dw ra+m wre conartwd 0} els t►vw�+f erKt t waee ar+s rap%..,r„ i n V er Mr MOM 0 d n r,o,r �o°°atsr0f• n+Pr are? ►•"setup of tw ON N 0 0 punt to as. onnrl But stun 4f Applr int or Agent I Adarest 'j"; TN•Ps Ne. : •mf enn e F rorr►an / r.. q.:... Sustnctt Addressr �Otc,,Qmmmof Ttle Y?. ,; ,. �: ? • ,'; ?' .v.' . ;;r,:max:.. City Butintu,LIcent/ is fn' Conroxfl r ;F•; � ',r. ::>',' q ..��. .... _ �: ' :;--'s 'i;; ,.M,. Pchcy Nurnper. , •'.y'. ;r'. :.,.!FEES: :�UbCm ion n .,:.,, •'+ r is ••:), , '''.,�•'� - 1r+1ot'Oyw'rnrrt e.. C�W fll� �'!7t�baysAw•:eew.x;. no. - �). .... .. . PI,C mot 3% S9G 8f Prlvetf Irn P7rOve w-ft:au Of oateLMffLn ted cananvice:pn AOe>s r'' , ItW ConOtivchOn corp Minor IrnPr�t vrmMt Pfrmlt — CI•n IV; Se• ar4�fe0 tcl+edute� +nte•CLon icr S . Pfrm.t Frf PERMIT VALIDATION �ehalty o°RMIT *,0, ' C'e+A be0os�t•5urrry 8ontl � . it rt+auirfa DATE APPROVED TOTAL: EXPIRATION DATE Rwe,ot No, DATE ISSUED 49"rvea by bats g� `' ReO-aw by � � Admmsttrey1e TtLEPHONL jejgl 68a.��ut NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT )g PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) OP 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: 10/8/91 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION Johnson 966 Loader, Green Weight. All Else Legal Haul Route: Washington at Fred Waring to 52 to Bermudas and Durango DIMENSION OF INSTALLATION OR REMOVAL Haul Date: 10/9/91 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 Quinta and to pay for any additional replacement necessary as the result of this work. Signature of Applicant or Agent Tina Gracey Tarmac California P.O. Box 14050 Palm Desert, CA 92260 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 III Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs h `_ Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ PERMIT VALIDATION Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by Recorded by 10.00 $ 10.00 Date PERMIT NO. 1246 DATE APPROVED 10/8/91 EXPIRATION DATE 10/9/91 DAT I UED 10/8/91 By. Administrative Authority TELEPHONE: (619) 564.2246