1419NOTE:
With roper 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••likp_public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision.lmprovement Permit — Class II I
DATE:.
April 14, 1992'^ •�� -
Minor Improvement Permit Class PV
LOCATION OF CONSTRUCTION — Bermudas & Durango
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Protiler
ROUTE: North on Washington to
outer City limit at Fred
DIMENSION OF INSTALLATION OR REMOVAL 14' high, 14' T-74de Waring...
SIZE OF EXCAVATION, IF NEEDED I
APPROXIMATE TIME WHEN WORK WILL BEGIN4714792 PILOT CAR REQUIRED. •
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, -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 (274) 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.
F,y Y
P''Signature of Applicant Sr Agent
Standon Co. Inc. P.O. Box 903 Colton, CA 92324 (714) 877-2126
Name of Applicant (please print) Business Address Telephone No.
Pavement Recycling
Name of Contractor and Job Foreman Business Address Telephone No..
On file On f ile
Contractor's License No. City Business License No.
On file
Applicant's Insurance Company Policy Number
r
141
FEES: Subdivision Improvement Permit — Class I II
Public improvements: 3% of estimated construction costs 0051820
910 4-14-9 10
Private improvements: 3% of estimated construction costs i0 CAH i TOT(1L 1 10,.00
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
PERMIT VALIDATION c
PERMIT NO. 1419
DATE APPROVED 4/14/92
4/14/92
EXPIRATION DATE _
DATE ISS ED 4/14/92
By:
Administrative Authority .
Recorded by `�� 11 TELEPHONE: (619) 564=2246
,' C;
SEF 27 ' 92 16: 5E 0E0VO I 0 + 1z,�s0' 0%0E0�OHG P01.
NOTE:
With araper velldetlett
this forst constituto an CITY OF LA aUINTA
eneroaeflrtent permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSRUCTION (ENCROACHMENT)
For the eansnruction o{ public or private curbs, driveways, pavements. sidewalks, parking lots, sewers, VVetff maim
and other like public works improvements In connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISION$
4 Subdivialen Imnt
preveent Permit — Class 111
DATE: _ '441u DAS Mlnor Improvement Permit Clan IV
LOCATION OF CONSTRUCTION
19ttnet eddreq er Casratptiae of Laotian)
PURPOSE OF CONSTRUCTION 1 911EGam) r100&.E JZ
�•�v Sketch (attach CORstrUctlen plans if appal
DESCRIPTION OF CONSTRUCTION - A/ngv* oN k),45ff ,4JG—roW- - 'TG
a vT� J2 C� IT -'r r�-i' f a r /
DIMENSION OF INSTALLATION OR REMOVAL. J ta)A & N6 17,E
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN -
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST =
(including removal of all vbttruotion, materials, and debris, backfilling, corn- ----77
Psce lon and placing permanent resurteeing and/or replacing improvarientsl - *'f t,or (20 .9 TeQy r Pe 0
In comideration of the granting of this permit, the applicant hereby agrees to:
lndammfv. tlafand ■rid uvo the Clivting it, authoroe"Gitaganta, officers, repmmntatiwt and emaloyas, hartttieq from and eeamrt anb end all
hsovei i Iiabllitie■ or leq swills$ from chime at court action and arising out of any {LcidMt, Itlta or damage to persons or aropmN
h■aoan�rrq or omurrina Is a proaimlite naeult of anY work undertaken under the oerrnit granted Gursuaet to this atnsll ation.
Netifv the AdministretiN Authority at least tw'enw-faur 1241 hours in agv4rroa of the tints when work will be started,
Cer•+e1V w,th all epolit:able City Ordinaries, the terms and conditions of the permit end all appiicabie rui" and regulations of the City of
lJ Qu(nts and to pav for any addiflen4l r0olaceneent nalissary es the raait of this work,
Name of Aooucant I
Name of Cpntraetor and Job Foreman
Slyn!lure of Applicant or Agent
Business Address
Business Address
Telephone No.
Contractor -1 Licrrtse No. City Business License No.
Aaaucant't Insurance Company
Policy Number
FEES: Subdivision improvement Permit - Clasa III
Public Improvements: 3% of estimated construction tests
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