1331�NOTE.•_•x, a '
With prop6r validation h ( r Q
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` thisco'n'stitutesan
encroachment permit ` --CITY OF LA CUINTA, -----�►--••.-•.'.�.-`•"""--.-'-•.-=� �
••• � �
APPLICATION �FORt PERMIT g
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OF
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 tl
DATE: January 14, 1992 Subdivision Improvement Permit — Class III
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 EL 300. 151 high x 1112" 'Haul Route:, Washington at 111 South
wide. 110.000 lbs to La Fonda
DIMENSION OF INSTALLATION OR REMOVAL Raul Date: 1/14•/92
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN ,y
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,
o: t,
Indemnify,•defend and save the City, its authorized agents, officers representatives and employees, harmIess•from:and against any and all c
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 an work undertaken under the permit ranted ;
Y p g pursuant to this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work•will be staried. ' t'
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. ,
h
Signature of Applicant or Agent
Tarmac California P.O. Box 14050
Palm Desert, CA 92255 775-8267
Name of Applicant (please print)
Business Address Telephone No.' .,
i Name of Contractor and Job Foreman'
Business Address 'Telephone No.
'On File
On File,
Contractor's License No.
i
City Business License No.
On File
On Pile
Applicant's Insurance Company
I '
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 VALIDATION
Permit Fee 10.00
PERMIT NO. 1331
i Penalty
1/14/92
Cash Deposit -Surety Bond
DATE APPROVED
if required
EXPIRATION DATE 1/14/92
TOTAL: $ 10.00
1/14/92
DATE ISSUED
Receipt No.
Received by Date
Bystt,t,�
Administrative Authority
Recorded by
TELEPHONE: (619) 564-2246
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NOTE:
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fnDneD rrMKr oe•,r,a CITY Of LA OUINTA
APPLICATION FOR PERMIT
IPUBUC WORKS COI+IMUCTION IENCROACHMENTI
For tnf ODnrvua+on of puOrec or pfrou Curti. drrwvvsvt, pavemorro, trdrroviii le, parfcnaq bu,
4104Vt
n0 owr like ",Cj ,f��� to conne,mon wvd+ MINOR IMPAOVEM$N•TS and APPROVED SUBDIV Wish
(tlgNs
DATE; /A/— Subdlritron Improrrmon9 permit pw Itt
Mllnca Imprpvwnwrrl pirvmft C" iV `
LOCATION QF CONMU SON
isww W*vw er Qwcnor Of Loqupn,
PURPOSE OF CONSTRUCn(pi
!wall fJ OF CO �R fZ10N
DIMENSION OF INbTAI CATION OR ADMOVAL
SIZE OF EXCAVATION, IF NEEDED
NrPpO WATE TIME "EN WORK WILL BEGIN
$ketm (arcedf mn 7UC216n plarg A
70U/L,0 l,Uiz 57/7 r,!, J�
/4L
APPROXIMATE TIME OF COMPLE-11014
ESTIMATED CONSTRUCMON COSTS
{Indud,r,v nrr+owt of etl oerg ctiam. nntun",, AV down, ba.%filli
picaon Ino pteGhq MrrrYhrrt n0,
r"urfs
� Incl/or feDLaanQ ,mcrovtarnevrtal 1.eo
In trnc drt"On Of the twinq of the porno„ 1, the spAlrOnt hcrvby pgrwri Lo'
Ira.w ►v e+rhno M+o ft" w+r civv. 0 9-w+wvto &PRO. *"mws, fwq wmwrww wa o"O'Cre". Ah—40 frwn ewn *OWN nay '
Ow ,w. aW0 rnwv w fea rvydy„ y fftm down, or anwn enah am or" 0,,R of Nfr 6w,", Mcg 4111wn ton w fi°nr"N M sw�
" ^�^I r «r vrry d f flror.a,rve aof Wv vwr. ,.Krra.rn Yw.r IN fliwvnry oft Amo ovm% nt or broom,"
to tine efror,bgpl,
Npt ry Me Vr*,nv,rnwr Aun,wrrr M hen hra"Ir�IDvn 1Z/1 anw,rf n ar►v of leu trine w,rr+ v.DrM WWII M erartoa,
�aw'+ar -0 eel aov—tm flvv C.orrrem ,na vrn,w Mrd co"alimm of ow bw"vw OW oft
La nr,na Mo ft p. la rwr fed�erf rv�rr Mw "h+rrwr,.,f M GM N "_+e
•°'°'rte`" r`we.^�*n nrp,4ry o, t*o Iv�utr of a,n wnn, .r ..,.
AoDup►nt tpiafe tannt)
o+ Canuector fl^D .k�D Foremen
ContreRor ! Lhnu Np
="11Can,, rn,urf^d Catv—,r
Sigrwturp of ADpi.ant or Agum
/ .
ufrnetb Addreq
Gtr 8u94eu Licamw Nn
Www No.
elepr+pr* No.
Polr�y Numprr `�
FEES, SoDa•.rarar tmp�ppari++n _
CLc Ifl
public 1rhom v" W": of
►starvnftfb co*tei'rVctrpn OC+rO
Prlvotil ImppFyrh�d. 3% of e' `rutW cohrtrurr,on cpm
IA,np, IrWavrmimm Prnnrr
SM etper,etf fOrroule 1�{ �.
*nap" Ilion fro S .
otrmrt F ff i PERMIT VALIDATION
--------------
Penally ,
rash Doomtl Su env BDno
If ave„pD
TOTAL,
Ria of No
Aoo.Nfo by
11•�,n,,,o try
7CRMtY ::0.
DATE APPAOVED
WIRATION DATE
OATS IWED
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NOTE:
With proper validation
i
this form constitutes an CITY OF LA QUINTA`�
encroachment permit
APPLICATION' FOR PERMIT 83
PUBLIC WORKS CONSTRU_ CTION (ENCROACHMENT) t m- w4R
•
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: January 14, 1992
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION _E • 300, 15' high x 11'2" Haul Route: Washington at 111 South
wide. 110.000 lbs to La Fonda
DIMENSION OF INSTALLATION OR REMOVAL Haul Date: 1/14/92
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 rsult of this work.
Signature�P=Ag nt
Tarmac California P.O. Box 14050 Palm Desert, CA 92255 775-8267
Name of Applicant (please print) Business Address Telephone No.
rvame or Lontractor ano Job I-oreman Business Address Telephone No.
On File -
On File
Contractor's License No.
City Business License No.
On File
I--1
ne
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
1 v J I
costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
PERMIT VALIDATION
Permit Fee 10.00
PERMIT NO. 1331
Penalty
Cash Deposit -Surety Bond
DATE APPROVED '1/14/92
if required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
EXPIRATION DATE 1/14/92
D ISSUED 1/14/92
By
Administrative Authority
TELEPHONE: (619) 564-2246