1487NOr�/ /
With proper validation
�K this form"co'nstitutes ai
encroachment permit
i
CITY OF LA QUINTA
PUBLIC WORKS CONSTR
FOR PERN
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
July 13, 1992
Subdivision Improvement Permit - Class I I I
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION - La Quinta, Washington & Hwy 111
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION - Move equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Cat 623 Scraper ROUTE: South on Washington to
Avenida La Fonda.
DIMENSION OF INSTALLATION OR REMOVAL 14' 6' histh
12' wide, 65' long
SIZE OF EXCAVATION, IF NEEDED ,-
APPROXIMATE TIME WHEN WORK WILL BEGIN 7/13/9
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 Applicant or Ag/_eAf
Standon Co.. Inc. (714) 877-2126
Name of Applicant (please print) Business Address Telephone No.
rranite Const.
Name of Contractor and Job Foreman ' Business Address Telephone No.
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit - Class 111 rM,,
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
07
PERMIT VALIDATION
PERMIT NO. 1487
DATE APPROVED 7/13/92
EXPIRATION DATE 7/13/9
DATE IS 7/13/92
By
Administrative Authority
TELEPHONE: (619) 564-2246
",r—" .Ir r ynZ-
CLEC 26
0 NaTF:
r With "repair validetien
this form fYhnstltutm an
encroachment oermit
'92 192-39 0E0VQI041z,�30a0%0E0�0H0 F01
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
r nr ttip construction of punlic or private curbs, drfvt-dvs, pavements, sidewalks, parking lets, saw.►s. .,,er.r rrmj, ,
)rd other like public world improvements In conneWon with MINOR IMPROVEMENTS and APPROVED SUI3DIVfSlONq
Subdivision Imprvtrcment Permit -- Cla.t III -
DATE!
llDATE! /✓ W � Minor improvement Permit C1111 IV
LOCATION OF 1 ONSTRUCTION
• r
fstrimt redrew of Ca -e rtotfen of Legation)
PURPOSE OF CONSTRUCTION rg g2rk. i Sketch (attach construction Otani if arvilw" rhttol
DESCRIPTION OF CONStRUCTION f r�r U ZI '14" -AMS AoV r-)+ viu a%'+'S H I N6r0 luf
-To A ✓o 14 roN v R
DIMENSION OF INSTALLATION OR REMOVAL If 4
is " ',') 1 1, g - 4-s:'y
,
SIZE OF EXCAVATION, IF NEEDiEO
APPROXIMATE TIME WHEN WORK WILL BEGIN z 13 ' 2
APPROXIMATI' TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST !
(trlciudlnq removal of all obttruetlon, materials, and debris, bedtfilling, cam-
vacdon Ind placing permanent resurfseing and/or replacing Improvements)
in consideration of the granting of this permit, the applicant herobtf agrees to:
Indltnnifv. defend hid save the City, Its autheritad agemi, afflcars, ripretentstiva and emplove", harmless from and opimit any a" all
0 --heel, liabllltiat or lou resulting from claims or court action and irlalna out of any accident, lost or darns" to pertons or coft"ih
*sdoenfnq or orrurrinq as 1 proximate result of env work undartakin mnder the Permit granted pursuant to this soolttytion.
Notify the Adminktnttw Authority It least twentvfnur 1211 hodri In ed"Mill of the tines schen tverk will be tiarted.
Cemnly woth all soolleabte City Ordinances, the harem end conditions of the permit Ind III saPlkable rules end regulations or the Cltv of
U Ouinta end to oey for any eddnionel realacerttant necYWry III th1 nwit of thla work.
/� ve --)WIT enc tpleaR mil tsutlnets moor@%% rel►nhone Nn.
t-��f}��� ��1��
Flame of Contrecter and Job Foreman Business Address telephone! Nei,
Contreeter't License No. City Business License No.
AoPUeent's Insurance Company Policy Number ^
FE1511- Subd!vlslon Imofavemant Permit — Class ail
P;iblie impfovemants: 30,6 of estimated construction costs
Private Ifmxevamantt: 3% of estimated construction eoets
Mlno! Irrtorovement Permit — Class IV, Sen attached schedu,l9 !y l�
lntneenen F.e 8 1 PERMIT t
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