1364TOTE:
With proper validation -a -
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
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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
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Subdivision Improvement Permit — Class III
DATE: 2/21/92 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)
.44
DESCRIPTION OF CONSTRUCTION 623 Cat Scraper. 15' high, '
11'10" wide. 120.000 lips. Haul Route: Durango & Bermudas to 52
DIMENSION OF INSTALLATION OR REMOVAL to Washington & Noxth out of CityLimits.
SIZE OF EXCAVATION, IF NEEDED Haul Dart* 2/24/92
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APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION r
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 arisingout of an accident, loss or damage to persons or I
Y g p property Ih
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. I'
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started. i
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.
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Signature of App'h,.ajN or Agent I34a .-7
Tarmac California, Inc. P.O. Box 14050 Palm Desert, CA 92255 775•-8267
Name of Applicant (please print) Business Address Telephone No.
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Name of Contractor and Job Foreman Business Address Telephone No.
On Vile 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 I I 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 $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
10.00
$ 10.00
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 1364
DATE APPROVED 2/21/92
EXPIRATION DATE 2/24/92
DA E SSUED 2/21/92
By
74
Administrative Authority
TELEPHONE: (619) 564-2246
FESc.-2 1 —92 FR I 10 : 48 MAS P a 0]
NOTE:
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CITY OF LA OUINTA
f�t7'OOtTn'sNS pOrmrt
APPLICATION FOR PERMIT
PUSUC WORKS CONMUCTION OENCRQAC.HMENT)
For tnf oDnatrtirta;or o4 00160 Oyiirtiw",is
a9wralkf, ptM'uq lose, fttirvatt,
a+w Mor like ",crrotlif 1� In conne mon wom M114OR IMPROVEMENTS and APPROVED SU View�*
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Minor Imwv"ffwnl P rmat C6a III
LOC.AnON OF CONMUMON C{.ea IV
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PURPOSE OF CONSTRUC-nQN _ 3 •tw latwt:n
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DIMENSION OF INSTALLATION OR AEMOVAi
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512E OF 1EXC.AVATION.IF NEEDED .�..-...... �' �r
APPAOXIMATE TIME W EN WORK WILL BEGIN �i•1
APPROXIMATE TIME OF COMPLrnON
ESTIMATED CONSTRUMON COSTS
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PERMIT VALIDATION
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EXPIRATION DATA
TOTAL;
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TELEPHONE., 0111 B6.4 -224B