1432r
NOTE:
With proper validation r� 2
0
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
1.
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
^ "• A^ w ,;ztc;j,gSubdiivisionn Improvement — Class III
DATE: May 14, 1992 Minor Improvement Permit Class IVV
LOCATION OF CONSTRUCTION
r
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move eauiument T Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Trimmer — 11110" wide
115, k1110-;, 111110.000 lbs. ROUTE: Durango from Montezuma to
52 and Washington.
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED '
MOVE DATE: NAY4'15, 1992.
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
,ESTIMATED CONSTRUCTION COST $ a "
(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. 4_
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 Applicant or Agent
_Tarmac California Inc. 775-8
Name of Applicant (please print) Business Address Telephone No.
_P.O. Box 14050 Palm Desert, CA
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 ,
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. (ate
Penalty
Cash Deposit -Surety Bonc
if required
TOTAL:
Receipt No.
Received by Date
00BO' CAATTRAG4192 120.48
1432
PERMIT VALIDATION
PERMIT NO. 1432
DATE APPROVED
5/14/92
EXPIRATION DATE 51115149- r
DATE ISSUED 5/14/92 —
By
Aministrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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