1287J �4 � •
_-NOTE'-'7 -
Withro er validation
P P this form constitutes an
.encroachment permit.
fS
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
'C DATE: November, 18, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or DescriptioQRf Location)
PURPOSE OF CONSTRUCTION MQVequpttlent Sketch (attach construction plans if appropriate)
DESCRIPTION OF.CONSTRUCTION Grinder, 10' wide.. Haul Routes Bermudas & Durango to
_green weight, all else legal 52 to Washington and North to City
Limits.
DIMENSION OF INSTALLATION OR REMOVAL
Raul -Date: 11/18/91
S12E-0F EXCAVATION, IF NEEDED
APPROXIMATE,.TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME TIME OF COMPLETION '
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, I' com-
paction and placing Permanent resurfacing and/or replacing improvements)
•I
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 andyall ; f: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 buinta andtopay for any additional replacement necessary as the result of this work.
Signature of Applica•t or Agent$ Tracey-
TARMC CALIFORNIA P.O. Boas 14050 Yalta 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 On File
Contractor's License No. City Business License No.
On File On File,
Applicant's'lnsurance Company Policy Number
FEES: Subdivision Improvement Permit—, Class III .
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 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by
Recorded by
Date
PERMIT VALIDATION
PERMIT NO. 1287
11/18/91 r l�
DATE APPROVED
EXPIRATION DATE 11/18/91
DATE ISSUED 11/18/91
By
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE: �
With proper validation
this fo�mconstitutes an CITY OF LA QUINTA
encroachment permit v
APPLICATION FOR PERMIT s
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
C`�f1OF
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:—November. 18, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Grinder, 10' wide,
green weight, all else legal
Haul Route: Bermudas & Durango to
52 to Washington and North to City
Limits.
DIMENSION OF INSTALLATION OR REMOVAL
Haul Date: 11/18/91
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.
f i�A2Acxv
Signature of Applica t or Agent Tina Gracey
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 G V
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 1287
' PERMIT N0.
Penalty 11/18/91
Cash Deposit -Surety Bond DATE APPROVED
if required EXPIRATION DATE 11/18/91
10.00
t TOTAL: $ DATE ISSUED 11/18/91
Receipt No.
By
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
h3�ew— 1 S—"9 1 MON 05 MFRS P _ 0 1
NOTE_
Wh9+ otoew Vol
talo ierT eenr-Lnw an
ehvora,m.nt Dahr1R CITY OF LA QUINTA
APPLICATION FOR PERMIT
PV8UC WORKS CONMUCTION 4ENCROACJiMENTI
For the eche vcuon of public a prrvaea cvrol, tlnvtr vevt•
end otna► tike pupla at e i is �parking
�".
�0In oornemonwrdMINOR IMPROVEMENTS adAPqVEDS18b1M
DATE: Subdivision Imomvw"m Parmn .
CW III
LOCATION OF CONM=nON Minor Improv PymR cIw IV •~,�,�
SS+rees earn.. a. p�� «, t.ocsoe,r, t
PURPOSE OF CONST;wc 10N
Sketch (atom :on ward Na
41DRIP271ON CONSTAUC17ON FON OF INSTALLATION OR REMOVAL-
SIZE
EMOVAL `��
SIZE OF EXCAVATION. IF NEEDED �� � /' �✓
APPROXIMATE TIME 11MEN µ/DKK WILL BEGIN /
APPA-0XIMATE TIME OF COMPLrnON /
ESTIMATED CONSTAKnO N COST tOwuding rin"I of 411
Oecbon 0o pteo obefft ' ntourvll, and debrn, beocfilling, mfn
n$ palrrle/t/r}t htur v" And/or npleang irnProvottanpl
in Gbnutlrra4on lef M4 f r&m"ng of th" PaRnrt, the aoolrant hereoy agrees td:
Ind+''nn.N, artw w Oro JM she tjty. rO auth"ad ayrnti. aMatn, raonr�ptryy N,p r+r.+rev..., Ira ,
Wnrnwt, heWrnMrt w roe rtn ovule ftm *sow er 1Wuh man long arwrr>f wut M
ndwM"q « m arm eMrter awr arse all
kpt,ti ms aWwt*t1 q • Mwnrwa rtiun Sf btr reo+k Y^erroetln trnowr WW P�+rt Anrep lana n er 1* 006" tp 0r� « pimm,
^wu+try AutharRy q y„t ��ey,khrF 0241 hours N W . WWI Mw ft0o�orum.
C cooly vwar all oamm eu Gtv O'"Wmrrw• cower a+ the crow tra+ea M smrwd.
V Ourne a.e OD oeti b erg it" SRO cone trON of the
awrra! and atl tr�pme ry,q e� Muatra+w � she Oh H a,
•°`fmu.°' reoceoramrrh necuo�y et rhr n,wt e/tf,q rw+u• J ..._.
Name orV
Wntrarzor and j
p
enuh
Cont►aRor I L40 it No.
AoPi�clnl't Inlvr7npt Conow
Flits:
Signatyn Of Mpl+canl Qr Agent —.—
'%
.Eusinall Atltl 22. P'
Telatstate No.
Butrneu AdarRll
Taleonorte
CatV BuHneu LIornW No, —"
alloeivifion Imora..ngryt Prrrnn _
Ctati 111
Public arrp vvrnw ts: e�ruttrd tOnet►uR:On t>,ra
Or,nte rtna0ra*nanb: 3% of NUIrnotad oonotr mon c om
Knot tmotaytrh •nt Prim
rs See attecnea 10"Vle
tMo•ctlon Fee S
Prtnrrt Frr
Penalty oc RMIT ;;0
PofrtV NUmt"
PERMIT VALIDATION
C"a Deco+ t'Svr.IV 80ro
if reevrrra DATE APPROVED
TOTAL: EXPIRATION DATE
1`160,01 Na DATE ISSUED
A.prypO by 19r
Data
R►ewad by Adn+rntaa�r, qe�
TEUYHONE- 16191 6edZ48
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