1263NdTE•� . ' �'.
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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
DATE: October 25, 1991
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION 950 E Loader
1.5' H x 9' W. Legal Weight
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 placin9 Permanent resurfacin and/or re lacin im rovements)
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV .
Sketch (attach construction plans if appropriate)
9 P 9 P
Y.
In consideration of the granting of this permit, the applicant hereby agrees to:
Haul Route: 52 at City Limits to
Bermudas and Durango
Haul Datee 10/25/91
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.
AA
Signature of Appl t 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.
a
On File
Contractor's License No.
On. File
City Business License No.
On File On File
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs 126-3
3
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
10.00
$ 10.00
Receipt No. .
Received by Date' E
Recorded by
PERMIT VALIDATION
PERMIT. NO. 1263
DATE APPROVED 10/25/91
EXPIRATION DATE 10/25/91
DAT Is. NS SUED 10/25/91
By.
�dmrative'Authority .
` TELEPHONE: (619) 564-2246
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NOTE,
this form wnrunnag an
onerinamfnam o"rt CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONMUCTION IEUCROACHMENT)
for the a0W^=,&n of "jC of p,r#Vt# CUrt4. dr1W
and other like "je *a,*; ip,0rVvffwM WDY1, P10"WM, li4roolko. posting Jou. www,'
. . In cOnnomOn with MINOR IMPROVEMENTS and APPFjovEO SUBDIVISIONS
BATE: 'eS — pomw — C40 III
MIrw Impr*wwww" P"11 frIlll IV
LOCATION OF CONSTRUCTION —
PURPOSE OF CONSnU`=ON Sketth I 12h Canxtruction plans if opwow,14I,
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01IRNSION OF INSTALLATION OR REMOVAL
;IZE OF EXCAVATION, IF NEEDED fill
ZROXIMATE
TIME YMEN wORj( WILL BEGIN —
;PPAO
4 IMATE TIME OF COMPLETION)
ESTIMATED CONSTRUCTION COST I
firoducling rt"ni at all aumutwn, ffir'd d*bht, Nckf i1firv, earn..
p4mon and Placing POr"awn Murtlm4l and/or mincing irnprovenw, 1 -160
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Name t ^001 ant 1pf tale arlmtv)
arne of Contractor Ifto Job Foramen 7— buishoss Adurvu
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Public immvo
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4AAWtiom Fee s-
10orrmit pip, ---------- PERMIT VALIDATION
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Bond GATE APPROVED
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TOTAL: EXPIRATION DATE
01"'01 No. DATE 1=[D
p■ellveo by �� fav
Recorw by Admin Av**M
r
NOTE: ^
With proper validationoC
this form constitutes an CITY OF LA QUINTA 1 U
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)G�oF`owsw
For the construction of public or private curbs, driveways, pavements, sidewalks, parking .lots, sewers, water mains
and other like public works imprdvernents in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: October 25, 1991
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 950 E Loader Haul Route: 52 at City Limits,to
15' H x 9' W. Legal we Eht Bermudas and Durango
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Haul Date: 10/25/91
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 ApphAt 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 III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs J
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
10.00
TOTAL: $ 10.00
Receipt No.
Received by
Recorded by
Date
PERMIT VALIDATION
PERMIT NO. 1263
DATE APPROVED 10/25/91
EXPIRATION DATE
10/25/91
DAT LIED10/25/91
By
ministrative Authority
TELEPHONE: (619) 564-2246
Oil