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%hlth�proper validationthis form constitutes an
en oachment permit
S.. c.. _ _ - _ - ..�
Y CITY, OF LA QUI;NTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction ofublic or
p private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
}and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
January 8, 1992 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 Move equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Move Cat PR 000 PavementROD?B: Wash ton Street uth
and Profiles to Aveni onda
to Cal _ south to
DIMENSIONrO�r INSTALLATION OR REMOVAL 15'2 ig ' te.
wide, 99 6 long. �.
SIZE OF EXCAVATION, `F NEEDED * Pilot car required.
APPROXIMATE TIME WHEN WORK WILL BEGIN 1/14/92 REVISED ROUTE:
}, Avenida Bermudas to Calle
APPROXIMATE TIME OF COMPLETION Durango — Calle Durango up
1, to Washington to Hiay'� 111.
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction andi placing permanent resurfacing and/or replacing improvements),e
In consideration of the granting of this permit, the applicant here�by";ag s 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 ermit•and�all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as t u f 1his work. i
Signature of Applicant or Agent
Standon Company Inc: P.O. Box 903 Colton, CA 92324 (714) 877-2126
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address '" Telephone No.
Contractor's License No. City Business License,No.
Transignal Insurance Brokers f TRK-04-201CG E -
Applicant's Insurance Company r Policy Number
p 1040 CSHOi bTQTAL01108-90.00 10
FEES: Subdivision Improvement Permit —Class II I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee - M $
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
i 326
PERMIT VALIDATION 4, �^
PERMIT NO. 1326
DATE APPROVED 1 2 1/14/92
EXPIRATION DATE %1/15/92
DATE ISSU D 1/8/92
2.
13y
Administrative Authority
TELEPHONE: (619) 564-2246
JUN 22 ? 92 17:29, 060VO,I041,z-lr.O? 0%060�OHO P01
iN (y�M�uNC! WITH YOUR REMVgT
NOTE:
vmrlaer validation -
this form constitutes an CITY OF LA QUINTA
encroachment permit ca
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
January 8, 1992 Subdivision Improvement Permit — Class II I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION hove equipment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move equipment Sketch
(attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Move Cat PR 1000 Pavement
and Profiles ROUTE: Wash ton Stree uth
to Aveni onda
g to Cal south to
DIMENSI?9
N 6 INSTALLATION OR REMOVAL s te.
wide, 99'6' long. fel
SIZE OF EXCAVATION, IF NEEDED * Pilot car required.
APPROXIMATE TIME WHEN WORK WILL BEGIN 1/14/92 REVISED ROUTE:
Avenida Bermudas to Calle
APPROXIMATE TIME OF COMPLETION Durango — Calle Durango up
ESTIMATED CONSTRUCTION COST $ to Washington to Hwy. 111.
(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 1241 hours in advance of the time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions of emit and all applicable rules and regulations of the City of
La Quints and to pay for any additional replacement necessary as
� an f his work.
Signature of Applicant or Agent
Standon Company Inc. P.O. Box 903 Colton, CA 92324 (714) 877-2126
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Transignal Insurance Brokers TRK-04-201CG
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III 1000525'1016519AL011 08-930.00 SO
Public improvements: 3% of estimated construction costs A lHi TOT
Private improvements: 3% of estimated construction costs 1 326
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 1326
PERMIT N0.
Penalty
Cash Deposit -Surety Bond DATE APPROVED 1 1 14 92
if required EXPIRATION DATE 1/15/92
TOTAL: $ 10.00 1/8/92
DATE ISSU D
Receipt No.
Received by Date
Recorded by
administrative Authority
TELEPHONE: (619) 564.2246
v.•l r' —it ` Qulnco, CA 922-53 Phon (619),-3454-2246
P.O. 0— 1904 76-103 C�Ito 8asetlo Ia C
PA7C:'
<6 19) 964-961'7
'Tot =Z:Z=
Attentions
vara 1 or r
Comments: . L/i .3rC�0 t�E?2sJ�7 i
TRANSMISSION
TRANSMISSION REPORT
THIS DOCUMENT (REDUCED.SAMPLE ABOVE)
WAS SENT
** COUNT
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REMOTE STATION I.D.
START TIME
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17146774727
1-14-92 4:30PM
1'49"
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TOTAL 0:01'49" 2.
XEROX TELECOPIER 7020