1274NOTE:
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 31, 1991 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 __235 Excavator, 11'6" wide
150,000 lbs., lexal height. Haul Route: Washington and Fred
Waring to 52 and Bermudas to Sonora
DIMENSION OF INSTALLATION OR REMOVAL to Herrera.
Haul Date: 10/31/91
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 propety
happening or occurring as a proximate result of any work undertaken unde'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 F
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 1274
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
PERMIT VALIDATION
PERMIT NO. 1274
DATE APPROVED 10/31/91
I EXPIRATION DATE 10/31/91
DATE ISSUED \10/31/91
Administrative Authority
TELEPHONE: (619) 564-2246
OCT -3 1 —9 1
THU I I :24—m -As p la:
NOTE.
this form mnwvuftg I.,
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSMUCTION (ENCROACHMENT)
For thi ft
""y of Public of OrNm Wrlis. dri
and OlAor like ";C "1 1 vtw*yl, PO4mmV, sidewalks. parking IOU WWw. OW.
Yn� in ammmon wiv, MINOR IMPROVEMENTS and ArpR
;VED SubbjV
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Minor ImPrwmnwn
LOCA N OF CONSTRUCTION
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PURPOSE OF CONMUcTiON Sketch
fetescn I
0 PIP ION OF ksT;IU 0 Corwtruggibm Plans if
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"ON OF �aT"U
DIMENSION OF INSTALLATION OR
REMOVAL — -
SIZE OF EXCAVATION, IF NEEDED
"PROXIMATE TIME WHEN um
APP (IMATE TIME OF COMPLE-noN
WIMATED CONSTRUCTION COST S
lIncluding rom"I at to Obrtrwtlo",e
mrtlemill, and d*OM, baCkfil0mg, Gorr,
P&COon Ind Placing plmement ftful`11812nil Ind/or mplacinj irnpmvwwml
In tonuderaluon of !ht "
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PERMIT VALIDATION
Penury #
Cash OSMIT-Suraty Bono
if FlIftirm DATE APPROVED
TOTAL: EXPIRATION DATE
D
plem,01 No, ATE ISSUED
P'Mvvtc by By
Aft*,%w by aur—A-i,"'
TrLLEN4ONE;- 16191 5U.Z46
APPROXIMAT&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:
r
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 Applicah4r 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% bf estimated construction costs
Private improvements: 3% of estimated construction costs ; l
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 (I1274
PERMIT NO.
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by
Recorded by.
Date
DATE APPROVED 10/31/91
EXPIRATION DATE 10/31/91
DATE ISSUED 0/31/91
By
dministrative Authority
TELEPHONE: (619) 564.2246
3ya_�so�f
I NOTE:
' With
proper validation
this form constitutes an
encroachment permit CITY OF
LA QUINTA
APPLICATION
FOR PERMIT 93
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) - 4
0
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: October 31': 1991
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 _235 Excavator. 11'6"
wide
150.000 lbs.. 1 g_a1 height
Haul Route: Washington and Fred
Waring to 52 and Bermudas to Sonora
DIMENSION OF INSTALLATION OR REMOVAL
to Herrera.
—
Haul Date: 10/31/91
SIZE OF EXCAVATION, IF NEI,DED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMAT&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:
r
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 Applicah4r 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% bf estimated construction costs
Private improvements: 3% of estimated construction costs ; l
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 (I1274
PERMIT NO.
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by
Recorded by.
Date
DATE APPROVED 10/31/91
EXPIRATION DATE 10/31/91
DATE ISSUED 0/31/91
By
dministrative Authority
TELEPHONE: (619) 564.2246