1257',N'OTE:Owl
With proper validation rt 2
`this form constitutes an
encroachment permit CITY OF LA QUINTA
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
s'.„1..✓3`^1{f:�.ii•..w1L.i'�... Nhe'WJt'.�Iwr.'SDl{iy:�,lFwµf�r ..N:w.rw_ w.-.. u. •1 ,.. «wr. 4. - �.r
Subdivision Improvement Permit — Class II I
DATE: October 17, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
/.8
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION `', • t Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Badger 4450 Crane, 10' wide
green weight, all else legal Haul Route: Washington and 111
to La Fonda
DIMENSION OF INSTALLATION OR REMOVAL
...” Haul Date: 10/18/91
SIZE-OFwEXCAVATION, IF NEEDED
� r M
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�his 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
i� 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 ofthiswork.
2 Signature of Applicant or Agent
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
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.
10.00
$ 10.00
Received by Date
Recorded by
125-7
PERMIT VALIDATION
PERMIT NO. 1257
DATE APPROVED 10/17/91
EXPIRATION DATE 10/18/91
DA SSUED 10/17/91
By
Administrative Authority
TELEPHONE: (619) 564-2246
OCT -17-91 T H U 9:43 MAS P.01
NOTE:
'
wrth 0'w-tralid�taprl
o
the loan tenrmna u a.,
•neroeelmant C•rmrt
CITY OF LA OUINTA
APPLICATION FOR PERMIT
• '
PUSUC WORKS CONMUCtION
IENCROACHMENT)
For the commuc'?+on of Public Or Arrvtlte
And
atrl•r like turbt, d"wrmy', pavfthertw, sid"okl,
R"�'� • inrRrdvllrranq in oonnae�on wlct, MINOA IMPA �mi� late,
OVEMENTS and APPROVEIjw ' maitr'
S[JBOtY151pt�S
Subdivision Itnpfnvernern Perm
Minor a "
i.QCATION Im 9 CONSTI; ON Plov.Rw'et P•nrrn
Cee•■ ty
PURPOSE OF CONSTRUCTION
Sketch fattsch t�rarn'ttQien
SC�IPT1,ON C"m if
.�L aFcgNS'I'N �p �
DIMENSION OF INSTAW,TIQh9
OR AEMOVAL
SIZE OF EXCAVATION, IF NEEDED
i
APPROXIMATE TIME "EN WORK WILL BEGIN
APPRQX►MATE TIME OF COMPLE7tON
ESTIMATED CON STRUCnON COSTS
flndud'ng remnval of ell
p•eann Ind 0laGn t►et+on, no— Alk and d•brn, badefilling, to
g Mrltl•rrrrl h'surl"mv •ndlor replacing ImarovemartaI
In t onsiderauon of the
ty+trrt:ng Of the Otrnr+lt, the aRRt+Ont hereby aqm" to.
►�ewrrnth, tlefanp
mp a" 09 CIM, ab aHlr+Ahlea ewno, Orr�Oars, a Alps, him �
10h1t 1� lniee a r a V~ a„erl tfa+rr M blurt Mmn
t} �•��• .
N&4
•+!tl aM.rfe ►�W allow OW •wl •o
a M M�+^rM rPyM of yrh vrwlr Nnobob an Ynou ern f►er+fra er�mo PUNK." 1pe f � to mer g
Narlry ele IAprrrryy�a AY rwafn A t!+■ Krum.
tleaeUt/r elt (ar•1 @w _k'00ur
'' •
1141 Noun M
CoR+av «ren 1, nw N U!a t■ns IYprM 1,01 adrm,
�M ~
U d++n6 a" � n� Gh Ororr,�. �M �**+rr and oenelltlew
C'
Af o+o
�Y lar pry � .P�t'MR't rte014/�1 of rhe mw Q h Irplri l 4Wrhe MOM •n0 hra+rra'Nent N � ati of0:�'
j,
f.'R�virR'Ytl
5i
sure of ApplKent r Agent
�^
1
Name Aoo ant 1R14130arin 111010,
":' •'''
Name of Contractor
eno sob oreman
d Sus+neu Adtiml
0,0
Tole
Contractor t :,unm
N0. �'/
:K,.. �.�. •!^y�„_3: 1n :L r� '.y.. ;G.• •Q'�!� viL':;.�..•�” .� ciry
_ ":}„ :,�:' — e9 ail ,tis;......_:,.,...,,.:•,; :,::.• t.tcen.e No;' :; �
. ... ....... .,...n .. e..y;. •:A: :. :1...
�,••'
.., ,. . .•
;AODlitant'llnrurynnrangoey
,i£E$: .Subdlvltionfm or+
. .•h. - ,a,i: _ Pr�r*Nnt PlY1f1n ...--•Y=:�' _ ;'r :.'a.:., E
.+brie 3% of oonmuelton
Private lrnornvntarq; 3% bfeTin'llited bora
•=n+tiRi Conrrumon
Carl
Minor lmordvtn+ent P"" _ 24d IV. $068113ts,e4 lor,•aula No
Infne CUpn ire ti
Pfrmlt Fre i PERMIT VALIDATION
Penalty °.AM1UT::Q.
Cuh Deoos+t•Sur•ty Bond
if retlunao DATE APPROVED
TOTAL, �..EXPIRATION OATS
Aenetat No. DATE 153UED
Datil
�eopn0ia by
�Or"
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TELEPW ME (0191 564.Z" • '