1318f 1 fir. �' •
liVithProper,.validation
-+
thr«.
is
1•' 'form;'constitiites 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
r
December 19, '1991 Subdivision Improvement Permit —Class III
DATE: _ • • I Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION :Move equipment
(Street address or,Description of Location)'
+
PURPOSE OF'CONSTRUCTION Ramatsu PC Backhoe 11.'_1011 wide Sketch (attach construction plans if appropriate)
15' high 130;000 - 140,000"wt.
DESCRIPTION OF/CONSTRUCTION - ROUTE: La Fonda and Washington to
52 to Bermudas, up to Sonora
and west to Obregon.
DIMENSION OF I NSTALLATION OR REMOVAL,
DATE: 12/20/91.
`SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
�APPROXIIVIATE TIME OF COMPLETION ?
'ESTIMATED CONSTRUCTION COST $
(Includingremoval of all obstruction, materials, and debris, backfilling, com �r
paction and placing permanent resurfacing and/or replacing improvements)
In consideratiori:of the' _n' 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 -applicabl'e' City'Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
f �,La Quintarand"to,,pay for any additional :replacement necessary as the result of this work. �•
Tina Graceq
Signature of Applicant.or Agent
Tarmac California.Inc. 775-8267
Name of Applicant (please print) • Business Address Telephone No.
P.O. Box 14050, Palm Desert, CA 92255
Name of Contractor and Job Foremanf. • Business Address Telephone No.
On file On file
Contractor's•License No. City Business License No.
i
Oa f ile f _.
z Applicant's Insurance Company . Policy Number
• ••
'FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs g Q
Private improvements: 3% of estimated construction costs + =i V
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
1318
PERMIT NO.
DATE APPROVED 12/19/91
EXPIRATION DATE 12/20/91
DATE ISSUED 12/19/91
By z6r�JZ4:20_4�
Administrative Authority
TELEPHONE: (619) 564-2246
s
DEG— 1 9-9 1 -r HU 1 4 :5 15 MAS 1- ell 1
NOTE.
1� wnh Prtxrsr ql
the form coft"Um, an
af+trO•tr+•rw�r oa,"n CITY OF LA OUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONMUCTION (ENCROAC8MEMT•)
For Ina oonryucuon of putmoc or pri"w Curb$. dr,yway+, PRvenw, , Lr
•nd otn•r I,k• 0uolft d•wolks• parking 104. Sow,
r„r�r 1$IrYr
wot" In w"Cl in donl+acaon w,m MINOR IMPROVEMENTS end APP{4QVED �BDIVISI®Iq
DATE r "R 5a+bglrviAronImprovrftrn!a
AVlnp.
LOCATION QF CONImp►&mvwn P.T, ciao IV
ST1iLIG1T(JN
Iiu..e popsy.r� ar p,.�,a w t�eonl
PURPOSE OF C0NSTRUM0N
SS a a, laas>rd� m al�rua+an pwm
da
0 RIFT NOF RU=O /^J //� J/ /j ig
DIMENSION OF INSTALLATION OR REMOVAL,
S!ZE OF EXCAVATION. IF NEEDEQ
APPROXIMATE TIME WHEN
IfIIORIt WILL BEGIN .-.—__.
APPROXIMATE TIME OF COMPLE C7'ON %���p cf�
ESTIMATED CONSTRUCTION COSTS t/'�'
11ndud,n9 r•mcp4l of so ots'Tnrm'n, m.flrr,alr, and , pa�ctill;
Paeoon and ploong parmarrn7 fr+•rur•fa ng' Carta
cg and/or npkang improvmsr.>sl r -
in �bnl,der•uon of tAa.�nt,ng of lha permit pro IPPI'znt Hereby agryh w;
?,Z
Ine.,r,f,,rv, e.�• aro M I$,1 Ra
CIIV, ISI Na,olrfq •*Ml, IIMRNy. Aow.nDl1wu MW erv�i+p,yp,,,40fnyn ,
f+f•M,rrv� IeADflrt»I aY yq MrNt hon I
aloft •r "wrl Halon WO 6"&R Of ler •� ase �v t1Al aN
Aa+o•►"'^o r ba°"'*'i w a P+tufrmtl• faun •f alw fon ano.rwrn urow I
A�wtae ��wq R""nr IM Wf�r+ iv �r�
Nmrry Int Aom, B,bftieurr p Int fla0+rrgw,
^ fw ,0*9"ry 0 Irr1 f+"++va•fur 1241 kern rt wvvnm of amt 6% sA»n pow VWI be am.".
C� dv tee, al lana ffv Oftlfrear,tw. tfa 1•rtnf ual wrd,rw+t •f
Lr G ,n 0
n ano is sav kr 9,w • norckrrrrl I+f al e,r Hoof R •Rtl �r ana l $yw &w ti'I�t 04 9l 0 dry a4
g+,.on.
r S "Tura of Aini aarit or Agarn
NAn►r r Agp„dnt Itltt C�rnti • .,r,_�/ % ~��jr .,
Liu na» Addy "^" No—�
T•IAIrwrw No,
NConlra�
amle r r .�'
Of oon d Fo •man
I Su$,nm Addrr$$ T•t No,
Contryctidr f L.Crnit/yy
lG o, /w OitV ®utfrstU L'r,Cenu No.
^�Pl,canl'1 1n1urA^p �'++lar+r
Policy Number
TEES; $uporvluon IMtro,, 4n Pr*mn -CtAu 111
Public Ifrlpmwfflwrb: at a oftui t" f r rtrun,on C*fu
Prlwla Imppw,vrrM: 1!( Ot •$¢Iny1lW CenrTrvetron Cvr19
M,nor Ifnorovtrrrr,i P"MIT -CIAa IV Sw atlscn
►d $tr•dulA No
IM01CTIon int S
ptrrnrl Frr I PERMIT VALIDATION
Perulty
1 4 ► 01MIl Sur$TV bond
It roow1w
TOTAL
pow of No
Rearnap a r Dam .�.
lA.ao,yao t�v
ae RMIT ::0,
DA`Z'E APPAOVEa
EXPIRATION DATE
DATE IMED
By
Atlnunaa�tvre A�,h,
TE LAA! PONE: Id 19! Badx�
f{ NO Is.
With Proper
chle }orm mr—ntit.itut.. og an CITY OP LA QUINTA
encroachmons Parmlt APPLICATION POR Pa Rimm
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
'
For the pon.tfuotlon pt F.cllo or p. Iva— urbe, driveway., pawmante. sidewalk., parking leve, a art, waterm.'
and other like public wcrka Improvements In connection with MINOR IMpROVSMHNT8 and APPROVED SUBDIV IBIONR
PAT61 Daootvber 19. '1991 Bu Ddly lslon Imprev.m.nt Pa rmlt — Cie.111
Miner Improvement Permit Cl.e. 1 V
' LOCATION OF CONSTRUCTION Moyu oQulpmonG
lBtr.et etldrau or 0....IF—. of Lo.......
P ISP HOP N UCT N 1Cnmrtats PC HnctcAoo 11,10" -:1 do Sk.toh (attach oone<ruotlon plan. If approprieto)
OBBCRIPNON OP CON87-RUCT ION SOUTIIt Ln Zc"d"` and Wnoh!--glen eo
' 92to Harmudnr lay to 6onorr
and tot ra
OIME.N uto ObBen.
810N OF INSTALLATION OR REMOVAL
DATBt 12/20/91.
SIZE OF HXCAVATION, IF NHHO&O ,
APPROXIMA"I-R TIME WN9N WORK WILL SBOIN
APPROXtMA'1-a TIME OP COMPLETION
EETIMATBD CONSTRUCTION C06T 8
j (InelVdlnQ r vel of ill pbaGuetlen, m oriel., and debrle, bapk11111ng, oem-
paotion and placing p.—,o —t recur}aping and/Cr replacing ImprovDMOnt.)
In eon.id.fallen of the orantlno of thle wrmlt, the ePPII.." hareby .once. to.
I InpemnHV,esfend one CI.V. 1[a .u[hirlettl .ee nt., p1t rap .......end ampteV.at, ne• a from Dnd a and II
Ileelll.laa er �ulclnp Irem el rt Pen and Ilna oe..an., lose mla a PPr.Dna P •ep.'rr.
' haDeanlni o ulna le • r me telt a wer4 vnd.rt.ken u r t . mit e d Pu rtuent d 1'a 1. ePPlle.elOn, r P
Notlly th. A m nt.tre Pvs A D e I a• ro r 17.) heura In ethr. neo o� the tl—Dnwhen wank wtll b. ate ...
Oemely with .I! applicable CIeyP OIC'nanPte t • e eonolPone o • PParmlt i pplleabla ful.a Dna ropulatlont Pt the Olty
aaer
L. Gulm. ane to pay for env addlt onel ropl...mant na ary at the raeule f tM1lt worn.
Tina 6rncev'
810netura of Appll—nil of Agent
TnrmaC Cr1lY etnnl� 2tto. 77 —8267
i Name el Applluent Cpl.... print) Business Addrew Telephon. No.
8.0. Ho: 14050 PaDeoart• CA 92255
I Name of Qentr. ator end
J. im b For.— 8-1— Addre.a Telephone No.
On talo Oa P11a
Contractor'. U..... No. City Bualnau Lloenaa No.
On Ys10
ANPllaenr'e insu ra nae Company Policy Number -
PESO: BubdlVla ion Imprevemun[ P.r—it — Oi.ss 111
f Public Im provem.nte: 396 pf .-I—ated Construction oe.2e 1318
Prlvete )MDr Ovomant.l 3% Of Ottl Toted o n.2ruatl on cP.te
Miner Imp!•ovemint P.rrnit — Cie- IV! Bae att.ahed .Oh.dW.
InePaetlen Pea 8 10.00 PBRMIT VA LIGATION
Perml< Pee
PERM IT NO. 1918
P..h OAT& APPROVED —12/19/91
Cash Depe.lt-Bur.ty Bend
If required EXPIRATION DATE 12/20/91 _
TOTAL: 8 10.00 12419/91
I DATE l8$/7E0.
Reo.IPS No.
Ijrl �.Ir
Rao.lvad Dy riata By Admin istr t va Authority
Recorded by TELEPHONE: (610) 864-2246
TRANSMISSION REPORT
THIS DOCUMENT (REDUCED SAMPLE ABOVE)
WAS SENT
*** SEND ***
COUNT
1 .
NO
REMOTE STATION I.D.
START
TIME
DURATION
#PAGES COMMENT �
1
6193427504
12-19-91
2:59PM
1'01"
1
TOTAL 0 01'01 1
XEROX TELECOPIER 7020
N
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit � S
APPLICATION FOR PERMIT Fg
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
• C�'�OF'1'f���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
December 19, 1991 Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Move equipment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Kamatsu PC Backhoe 11 10" wide Sketch (attach constructionif a lans
15' high 130,000 — 140,000 wt. p appropriate)
DESCRIPTION OF CONSTRUCTION ROUTE: La Fonda and Washington to
52 to Bermudas up to Sonora
and west to Obregon.
DIMENSION OF INSTALLATION OR REMOVAL
DATE: 12/20/91.
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.
Tina Gracey
Signature of Applicant or Agent
Tarmac California Inc. 775-8267
Name of Applicant (please print) Business Address Telephone No.
P.O. Box 14050 Palm Desert, CA 92255
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 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 $
10.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
1313
PERMIT VALIDATION
PERMIT NO. 1318
DATE APPROVED 12/19/91
EXPIRATION DATE 12/20/91
DATE IS UE0 9
12/19/91
By
Administrative Authority
TELEPHONE: (619) 564.2246