1311•. aR!tSTE: �
Mith proper validation 2
0
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT t#t
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: 12/16/91.
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION Kamatsu Backhoe,
11'10" wide, 15' high. Bonas Purple Weight
(13.0.000 lbs)
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
Haul Route: Highland Palms to
Washington and south to La Fonda
HHul Date: 12/i6 or 12/17 1 day only
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 Appkgja 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.
On File On File
Contractor's License No. City Business License No.
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 10.00
Penalty
Cash Deposit -Surety Bond
if required t.
10.00
TOTAL: $
Receipt No.
Received by Date
Recorded by
1,3'1 .
PERMIT VALIDATION
PERMIT NO. 1311
DATE APPROVED 12/16/91
EXPIRATION DATE 12/17/91
DATE ISSUED 1 6 91
By ..�
Administrative Authority
TELEPHONE: (619) 564-2246
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.'t
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e
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
r encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ms's
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 II
DATE: 12/16/91 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 Kamatsu Backhoe, Haul Route: Highland Palms to
11'10" wide. 15' high. Bonas Purple Weight Washington and south to La Fonda
_(130.000 lbs)
DIMENSION OF INSTALLATION OR REMOVAL Haul Date: 12/16 or 12/17. 1 day only
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.
Signature of Ap 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.
On File
Contractor's License No.
On File
On File
City Business License No. .
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs 1
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. 1311
DATE APPROVED 12/16/91
EXPIRATION DATE 12/17/91
DATESSUED
By
Administrative Authority
TELEPHONE: (619) 564.2246
DEC — 1 5— 9 1 MON 10:19 M Fa S. P-02
ear ..�. �. �.�. �—,.�.-�. .,.A �..� .� � ��.� •
NOTE:
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this tans ftrartnmw rr
.nprorcnrwt.nr o.n„" CITY OF LA OUINTA
APPLICATION FOR PERMIT
PUeL3C WORKS CONMUCTION (ENCROACMMFNTI
oil
For the cor,&V rrypn at Pubru Or p►rvrta wroe. OrtHrwan, Davamarrt:, I
and other tike Publk t>ro f<I t�+'v�rn in aonn.c>yon vvy n MINOR IMPROVEMEINTS end APP
ROVED SUBDIVISI t+IS
DATE: O " / Su6divilibn ImwovOrnrnr Pr►m
LOCATION QF CONST LCnON MInar Improtnrrwn pyemn Cks IV �
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PURPOSE OF CONMUCnON
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0 RIP7I �N f CONSTRU
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DIMENSION OF !N$TAU,ATION OR @LOVA
SIZE OF EXCAVATION, IF NEEDED 1►®� ( �U®�
APPROXIMATE TIME WWEN WCRX "LL BEGIN
APPROXIMATE TIME OF COMPLMON
ESTIMATED CONSTRUCTION COSTS v"4 L <2�'
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6 pont FVM re -able V +6d/dr replacing imprownrerrti,l
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IMM�pn ry, tb/nrd ow *`Q clip ON. fb tulmoued ap"u, rMpen, rfrbn w+trhvee red pryDrVvgy. /4h*s�o r+rrn ,
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r Aon,�n,etrN„w Aiet7r'arrry M ton fvF6"tV4wr Q41 Room 0t�nit% /V 7 b trig
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name or [ontrretoi ano +100 Foreman
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Al ..
Aobl t�nt't I(jWrrnd ComOen
V
i6ES:
Sirsitury of Aaplbont Or Atltnt
8ui,ne Addreta
/% Trlronar No.
i9uUnem AtldI�II
ale N0.
City Bullnesa L"Melar No.
Subtl�v�r,en Ilnae..r,a.rt pe,•.rrn g clay 111��_
I'ubllc rfnorovrrrwra: 3 7i o! •ronvted tnnmc1son Cora
prn4ti,mao+.rnenn: X%of rea,metee eenrvumcf, 40rta
M.nor Irrlvrovtmettt Pe+R+IT _ Cup tV;
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an,oeet,on Fee S
Otrrvtit Fee
Pttnr� tv
'1.9MIT %0,
O4I►.090-11•SurrN gond
It R'oulrto DATE APPROVED
TOTAL: EXPIRATION DATE .
Rac►-ot No DAT'C ISSUED
44+cetir0 by 6r
ata pvawv.,a by Adrrw— y" arty
'ML PHONL' 161f) 5644048
Polley Number
No
PERMIT VALIDATION