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1262N", With proper validation 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 Subdivision Improvement Permit— Class III DATE: October 25, 1991 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION EL 300 Excavator, 15l H x 1112" Wide. 100,000 lbs DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attach construction plans if appropriate) L 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: Washington and Hwy 111 to La Fonda Haul Date: 10/28/91 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. Signature of Applic or Agent Tarmac California P.O. Box 14050 Palm Desert, CA 92265 775-8267 Name of Applicant (please print) Business Address Telephone No. On 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 1262 Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ 10,.00. Permit Fee t Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date '0 Recorded by PERMIT VALIDATION PERMIT NO. 1262 DATE APPROVED, 10/25/81 EXPIRATION DATE 10/28/91 DAT ISSUED 10 25 91 By _ Administrative Authority ''TELEPHONE: (619) 564-2246 J) J N f r i NK i AI ."A A4 OMMpOU ...................................... An CWAI 31110 NOI1Vb1dX3--------------------- — — PUQq AIII yn* •0': Imusc ollippy ................. ............ A4'#Utd jo %C mumI O#Iftkqap 10 u : 7 D 4outimsul I'lumal1w 77�)17= L�7 ............ .............. ON III I,or awn No hulto o— v 10 At* 60 A OAW,*, 0,,q W '4 "'""1 l"— —0— A- 4; AM a MINI .344M r, If Iualroutlo PW W`h" rA -MM-PI A10 V III lAW* Aftmo 10 W" Ittl lr4oAAwmU A AV UAONANN"WL40I MW AplaN MUL" "a AINI WO"Womn WOM ANN if UANNU jRMWMI 11 0 WWAI AD aq 66 woo sw" a" u4nas wmQ* a —90 —4 6wup%m 10 rM hio were au* NMW MMI -141 Mg om"UmMaW '"I 'tLuWl* 04twI lb *410 444 polzilddl ip4; IluAj40 $114 119 5U,9 WRA &4 ;0 U011244PIly L4SUSAII14010 5UMlqd pt4c uowgd • &MXUUq* III JO J6ACKU4J bUipMoUl) 3 -.S03 Nou.onllZNOD Q3jVjjjjS3 NOU3101100 do qrjjj 3,vf V1, XoUody NI933nLA4)jWoM N3HM 3Vyll 3LVVIX04 ddY 03033N dl •NOIIVAVOX3 :10 BIZIS '� !�i'r�� ll f lVAIDIIII UO NOUVMVISNI 40 NOISNUI 0 nu 0 A N61 HIM0 N0U.,.)n=NO3 :10 3 SOdund Alm* N0LjI;DnWN03 dO NOlIV301 LUIWSA04WI UotpAlp4"S :31y0 ;MI!UAIQon$ 03A01jddV 949 &1N3Fi3A0W4iqI VON104 'Almok wo=wouLjd* ul c""m*AI 41, J# 'gnaw -nol X-400 NPI a 1110 Mv by!W" '9A4~14p -jCWn2 InL-14 M 3ymnd jo u A cc su3 god Ow • Jum tumo !lN31NWJY0U:)N3) Nomonusrmo smom o'nou iWi3d 401 N0liV3IlJdV 'Wino vi io AAto UUAAQ wrWraroaw ut qwumua* WAI 9149 131ON T 0 cl S t;l W G : T T I ZH --A 9 :3 o N011Y011YA kly—olija j3qwnN A.,Jjod ollippy ................. ............ A4'#Utd jo %C mumI O#Iftkqap 10 u : 7 D 4outimsul I'lumal1w 77�)17= L�7 ............ .............. ON III I,or awn No hulto o— v 10 At* 60 A OAW,*, 0,,q W '4 "'""1 l"— —0— A- 4; AM a MINI .344M r, If Iualroutlo PW W`h" rA -MM-PI A10 V III lAW* Aftmo 10 W" Ittl lr4oAAwmU A AV UAONANN"WL40I MW AplaN MUL" "a AINI WO"Womn WOM ANN if UANNU jRMWMI 11 0 WWAI AD aq 66 woo sw" a" u4nas wmQ* a —90 —4 6wup%m 10 rM hio were au* NMW MMI -141 Mg om"UmMaW '"I 'tLuWl* 04twI lb *410 444 polzilddl ip4; IluAj40 $114 119 5U,9 WRA &4 ;0 U011244PIly L4SUSAII14010 5UMlqd pt4c uowgd • &MXUUq* III JO J6ACKU4J bUipMoUl) 3 -.S03 Nou.onllZNOD Q3jVjjjjS3 NOU3101100 do qrjjj 3,vf V1, XoUody NI933nLA4)jWoM N3HM 3Vyll 3LVVIX04 ddY 03033N dl •NOIIVAVOX3 :10 BIZIS '� !�i'r�� ll f lVAIDIIII UO NOUVMVISNI 40 NOISNUI 0 nu 0 A N61 HIM0 N0U.,.)n=NO3 :10 3 SOdund Alm* N0LjI;DnWN03 dO NOlIV301 LUIWSA04WI UotpAlp4"S :31y0 ;MI!UAIQon$ 03A01jddV 949 &1N3Fi3A0W4iqI VON104 'Almok wo=wouLjd* ul c""m*AI 41, J# 'gnaw -nol X-400 NPI a 1110 Mv by!W" '9A4~14p -jCWn2 InL-14 M 3ymnd jo u A cc su3 god Ow • Jum tumo !lN31NWJY0U:)N3) Nomonusrmo smom o'nou iWi3d 401 N0liV3IlJdV 'Wino vi io AAto UUAAQ wrWraroaw ut qwumua* WAI 9149 131ON T 0 cl S t;l W G : T T I ZH --A 9 :3 o ;J NOTE: With proper validation p4 this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ' w4 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: October 25, 1991 LOCATION OF CONSTRUCTION Subdivision Improvement Permit — Class I I I Minor Improvement Permit Class IV (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION EL 300 Excavator, 15' H x 11'2" Wide 100.000 lbs Route: Washington and Hwy 111 to La Fonda DIMENSION OF INSTALLATION OR REMOVAL Haul Date: 10/28/91 -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 andsave 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 Applicuxlpr 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 III Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs 'r li 2— Minor Improvement Permit — Class IV: See attached schedule Inspectidn Fee $ 10.00 Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date Recorded by PERMIT VALIDATION PERMIT NO. 1262 DATE APPROVED 10/25/91 EXPIRATION DATE 10/28/91 DATkPSUED 10 25/91 By Administrative Authority TELEPHONE: (619) 564.2246