1349�;•
With proper
validation �4 2
this form -constitutes an
encroachment permit CITY OF LA. QUINTA ,
APPLICATION FOR PERMIT •'
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curb's,, driveways, pavements, sidewalks,. parking lots, sewers, water mains
and other like public works improvements in.connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
f
DATE:.'January 28, 1992
'LOCATION OF CONSTRUCTION'
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate) -
DESCRIPTION OF CONSTRUCTION Namatsu PC 400, 15' 'high
11,11011 wide, 160,000 lbs gain Route:' Obispo and Washington to
52 to Durango and to Velasco
;DIMENSION OF INSTALLATIOWOR REMOVAL
Haul Date: 1/29/92
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ , •t
-.(Including removal of all obstruction, materials; and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements) ^ }
In consider`ation'of tfie granting of thisrpermit, the applicant hereby agrees to: r
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
'I La Quinta and to pay -for any additional replacement, necessary as the result of this work. '
•F ` ' O'
Signatu,e 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.
Name of Contractor and Job Foreman Business Address Telephone No.
On File On File
Contractor's License No. ^ City Business License No.
On File ;_ On File ;
r ' Applicant's. Insurance Company _ Policy Number
r
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
FEES: Subdivision Improvement Permit ---:'Class I II
Public improvements: 3% of estimated construction costs
Private improvements:'3% of estimated construction costs 1,349
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 Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 1349
DATE APPROVED 1/28/92 r
EXPIRATION DATE 1/29/92
DATE ISSUED 1/2-8192
By
Administrative Authority
TELEPHONE: (619) 564-2246
..TAN -28-92 TUE 14:19 MAS
i�
NOTE:
Wnf% tlroaur valad u.,
iT a f° — m n}et�pp� r1
a�ooaa++.,crn o.�+nR CITY OF LA CUINTA
APPLICATION FOR PERMIT /
PUBLIC WORKS CONST UC'TION (ENCROACIjmk T)
For tris cor4v!u= on of puwK of Prpvvtd Opt,», df,v"vj, povamrrftp. Etdawallta, pw%l,4 bt0, {thy ty �
arW outer like t%ubld eeo�9e fn a�eofrR sft conna=0n w101 MINOR IMPROVEMENTS and APPROVED t1BpIV,S,b S
P . 0
DATE:-
Impmvernee t pa mly —CIft1ti
LOCATION OF CONSTTIU=ON
mIncw Imgrowwr'm po mft '
,
IStrrn scar.,, a pp,cr,a,ei s+ Laovw+i
PURPOSE OF CONMLX- oN
D 1PT10N OF=ON
NST
i
$kers+ lertst�t auvrm,94ch pups d a
DIMENSION OF INSPALL,A71Otd OR REMOVAL
(,Z Slez/,X9
;IZE OF EXCAVATION, IF NEEDED
✓
APPRgXJWAT'E
/t's L �
TIME "EN ftRK WILL BEGIN
APPPDXIMATE TIME OF COMPLETION
i
9571MATED CONSTRUCTION COST S
pndvd nS mp onl of all obor",n. mPtanou. ens W�
dctrrn, tt1Ni
p+eC°ah anC piaonp �arniahrfR fattitry n9. COftr
BOW/or
rttptaOnq 1m0rOvR't+t►rtta)
In eon{rderr♦twn of ptv �t,� dp tfta �nftrt. tht
t, . !/ (I�'/ �.►
`
600+rtunt hertov a g''ae�a to:
OoMul ahs mae the C rv, ft ava+VVW ttp fn, *Morn, fee Ott �
°s''a't� tab.,nav or bm nosMVteva sae Oa' .001,
fHw, ho hvm
ON
1 avw r�1 aus � � aer�eene. Ida � �
w r,s� & tm„n aetwn wv a b Parva
any ,tuft ares" lomw ass
ow -me triHhtt 0vmvAm to the awarvm+t,
yoe h tM ,wn+*e.o Av Aa`'eY >t ta,rdt t ,vaaur 1261 Min A aDva+f,a Ot iM My Man was tr41OQ ME
fbnav en.m:a;r �,r;ri Orovu+a+ra pM er•,�,1 aae °onals
ii Cha
i R ,.wC , mW+adi nprb- OM roMr+vr� A') a@ Dry OfLA
'ng'f,rm W asv b •^y pao,t,o,v rsp..p,�*1 n.wu�y sr ens Iiwnt ....
pa
°�� °pi��,IOltab ot•tntl
Name op C6ntracwt an Job Oratnan
C°ntrano L.tlnk kp /
S. wn of—"��'''
IJ^a App, nt 0r Agttm
Adtlfau
fy0.
tpu{rrt0all AdCnea �'"` TI
Gty 6u{,ntfd Ltorner Np, �'�
AoDirt:ant'f IRtura�ttr Ce-toanv
iel,ey Numtoer
FEES.ITprp.r... Pev,•tn
Cr'llI ,
d'v9; a ofmwo,"t"m: 3% 01 ut.o mneVvtl,on mro
P,rvata rmprovu,ra,rp� y%mf ai$pmated ConnrrucZl°n C*rr*u .
1�
t C1en IV Sol etmrnv° tcnwavra s0
tn{oeet,bn P*e s ,
hs,m,t Fre I PERMIT VAUDATIDN.
Poverty ocRMI T %0.
CAM o.00711 Safery Eo„° DATA APPgQVEO
it fogy„ad
TOTAL EXPIRATION DAT'T
Olaa,°t t4° DATt I=JED
�K77f10 Ov �v
Lira
T_ Ad'nmavvv” AutAgrwy
TTLEI►fCNE: f01@I 48