1337NOTE'1r '
With proper validation
thls form constitutes an
4. ,. .
-.encroachment permit
�?�.-.-w-*r•.�..,•`-
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
Janusz 2 Subdivision Improvement Permit— Class III
DATE: Y ®; 1992 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 . CMI Trimmer, 12' wide, Haul Route: Washington at Fred '
100,000 lbs, all`else legal Waring South to Highland Palms
DIMENSION,OF INSTALLATION OR REMOVAL • Haul Date: 1/21/92
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME'OF COMPLETIONESTIMATED-CONSTRUCTION COST $
(Including removal sof all obstruction, materials, and debris, backfilling, com=�-4'.- ;
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 Cityits 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 Authorityat least .twenty-four (24) hours in advance of the time when work will be started. r
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 pays for any additional replacement necessary as the result of this work. d
i Signature of Ap f nt or Age t
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 w 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 (II
I
'Public improvements: 3% of estimated construction costs
'Private' improvements: 3% of estimated construction costs ) 3
Minor Improvement Permit — Class IV: See attached schedule
,Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
PERMIT N.C. 1337
DATE APPROVED 1/2$/92
EXPIRATION DATE 1.491,499
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246
.T 2 1 —92 TUE
r
0
9: 1 1 M A S
NOTE:
wvl proper "Iasit",
Ma foam 1vr°vW, to
/n CrOrl to n* ,.r p� rt
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUSLIC WORKS CONSTRUCTION (ENCAOACHMENT)
P 0t1
ta
A For ma CDN.V-I" of putrl-c o► prrvtn� C.M" drrvrwovo, vavom-vu. A+d"4kt, para" no ONrr Irks "Ic I ram ftn"MOM wto, MINOR IMPROVEMENTS Irld APpRL &-", r''egt►' _
OVED s at),viElom
/�
BATE: / �/ /,moi' Subdlrh�on ImDrowmr►re I.rmR •.
Mirw Im �
i.QC+1T10N OF CONSTAULTION "�"'t Pernrrf txawV
I
ism—
PURPOSE OF CONs717R"-noN
Slrrt�r�, (irtaah ow,,Ucron plans A a
d 5AN
NSTRUCnQN ill CIMENALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WpRK pryLL BEGIN
APPROXIMATE TIME OF COMPLETION
ES`rIMATED CONSTpL", ONCOSTS
(In"IrIq rornon, of Ali
p�rnon And p4tin fin' h+rtanau, Dnd drrbrR, b+=thiliN, wm•
4 Prrtrgrrns fv atoWyq i+W/br nplaanq lmarov+rr+rrml` "a /—�;�
In int+drrytron of the t�i,46 of Cho Orrrnrt, tt�e AGAl+ant APn:®y agrvei to:
I� h. ti m. aMo Wit fati, w wrr orveo +M�w, ■Ngrtt, hvrrw+r�rr+w ono Ano�evon. a
a'y'r+h IMb+nrh i0p rewlb" lown Coy w Yr mun rngn �.Arrrr+e dH1 N tray uayM+rl. 11■t M tiWSsA Io
rvco.,,,,p v 6m,' P 1 • Orad 0 marl of &�v rru+lw Yrlo■nrW/n Y �+� hosn rhsy� « tloa W
Nrri+h tr+a Aare, now — 00, rvmrw wnwr„ to a■ onwsr n, ~'�°�
nviLvIl Ave+o�+ry rt ban. tsrsnerllp+r 1711 Iwvn rn ypwrct of ft►w tsryr anon ftv.
p.l1 tM ey06P
4 (Limb pat to M► tv OV,,
1 *1 Lqu oontl+rgry Of O10 09A in MO SII OpiP 4C1 • : • ,•j.�
sdpn,d.� nsasal.rrnr rto�vv tr The rt of b,n a,orr, o W4r ens
�. two of 1q cry d" .•. .
f �. Slfl*+an,re O) APPI+dnL Or Aprrt1
Nrn.r r AOP +ant Ip w orrntl �- r,
�v ✓Lrr B%+rw>ts Advv t
N�rrw or ComraRor dna Je For than
C'J tet`'$ Lof i Tltlrananr No.
Sutlncf, Adurea
j
TIP It �yf
C+ontrI1001 t L.tlntr ko Z
IleBut+ntit L�anta No,
AoCIIGntY Int ro,tq Ca wolr „
PoI+tY Numprr '�'�
iEI $, $�Dp r+1+p� Imp+On•nrn Pr,mn
CLa ill
PybI'c rmpro.t,rwr,o j96 of b terutoC to
P�wtu rm ngvc'tlon Cora
aX of o3s,rtyrra tonnrvRion e&rj
M,�o, trnc�prr^Mrt Prrrn,I _ Ctais
b Ib' 5-9 elmp+r0Icr+routr
Intarcuan Oft i
Ptrrh,r F,, I PERMIT VALIDATION
Penalty 1 2!RMtT';O,
DAM,eoDAM,5ur.fy
If t9oy+r®o„o DArE APPROVED
If h�
70TAL EXPIRATION OATt
Apop o, No DATE I=J[D
0100,v to e,0
Rte, br Ad num
TTLblst E: tOisI s64.,UW