1413N.
/NOTE:
With proper validation
this form constitutes an
encroachment permit
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
DATE: April 7. 3992
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
PURPOSE OF CONSTRUCTION- Move Equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION -Mitsubishi Backhoe
_12' 6" Wide. 99' 6" Long, 14' 6" high
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Haul Route: North on Eisenhower to
Washington, North on Washington to Highway
111 to City Limits
Pilot Car Required: Haul Date $/7/92
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 result of this
work.
Signature of Applica t or Agent
4
_S_tandon Co., Inc.. P.O. Box 903 Colton, CA 92324 '(714) 877-2129
Name of Applicant (please print) Business Address Telephone No.
Tarmac Califounia P.O. Box 14050 Palm Desert, CA 92255
Name of Contractor and Job Foreman Business Address Telephone No.
On File
Contractor's License No.
On File
City Business License No
On File On File
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111
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.
Received by
Recorded by
10.00
$ 10.00
Date
1413
PERMIT VALIDATION
PERMIT NO. 1413
DATE APPROVED 4/7/92
EXPIRATION DATE 4/7/92
DATE ISSUED j92
By �OJ\,.?
f+ Administrative Authority
TELEPHONE: (619) 564-2246
w
SEP 20 a92 17:17 060V0i041-,1s0�0%060-,*,0N0 Pai��
"Elm
NOTE:
With ompar vaildetjM
this form constivalle an
encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the Construction of pubile or private curet, driveways, pavements, sidewalks, parking lou, sewers, w41W MISI g
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISION
DATE:
LOCATION OF CONSTRUMON
istraat sadmoa esti 0atorrlttion of Low"")
Subdlviabn Improvotrtarrt'amtlt _ t:Ian III
Minor Improwmern Permit Class IV
PURPOSE OF CONSTRUCTION a 4 Sk_`(attaoh 00nslrfUction plans if a
+anis
DESCRIPTION OF CONSTRUCTION = 1440 Rocy' A10rM
�,pj if"i s� h�v�.Ee To crJ�Sr>t��'�-tea
DIMENSION OF,INSTAI.LATION OR REMVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN )YORK !NILE. BEGIN
,66 k—r tf 0-'U LL)f S 41 fjG-r-ti r
APPROXIMATE TIME OF COMPLETION T ' L 07' C.4
ESTIMATED CONSTRUCTION COST S
(Including removal of all obstr=j0n, materials, and debris, biccfilling, cam.
Paction and placing permanent Murfseing and/or replacing improverrlanui
In eontlder■tion of the granting of this permit, the applicant hereby agrees to:
Indearcnity, dotano and taw the Clty. III autnor!zed aee . offiears. rprapnestiyat and artfplOvssas, narrralasr from and ,� a
penaattW, liapilitlat or lost resulting trans cl ' of cour4 action and arning out or and
accident. ION eW air da � M and all
happening or o=urring as a Prtsalfftata result of any work ur4oactionakan under the � to persons asr w*PW y
Notify rhe Adnlincstretiw Authorny at lust twantvfour 1241 hairs in Wes Permit grsr+tad pursuant ll this applianen.
Ca MON with all amlk*ft City Ofdinancn, the terms and eonditbm Of the
of the time rtAan work (Mill be ttaRad.
V Quints and to oav for any oddhbnel molson Mat n COMMofhis end all apolieable ftilaft and fsoatleatt of the Cky of
eeetaafer at tree result of ehh worst.
Name of AOAlacant (Please print)
' L
ContraCtw Lmense No.
PAI F
Slgnature of Appileent of Agent
Business Address
tiu3lness Address
Telephone No.
City BUi1n/11 License No.
Anotrcant`s Insurance Company -vI f Le
Poliey Number
FEES: Subdivision Irnwevomern permit — Class 11!
Public improvements; 3% of estimated construction oasts