1505_NOTE:
With proper validation
this form constitutes an
encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT
r PUBLIC WORKS, CONSTRUCTION (ENCROACHMENT)
ole `rx%j 0VER,,,5Wt10 T,,, LDAI> ` 59JA I r"' c� OF
4 For the construction of public or -private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
andkother like public works improvements in connection with MINORIMPROVEMENTS and APPROVED SUBDIVISIONS
t i
Subdivision Improvement Permit — Class I II
DATE!".August 5• -1992 , Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
• (Street address or, Description of Location) r
Hove ,051# E"lat P appropriate)
PURPOSE OF CONSTRUCTION Sketch (attach construction tans if
DESCRIPTION OF CONSTRUCTION CAT $51 Water banker ROUTEt ' Prom .Riverfide County line
• South, on Washington east
on Miles south an Dune Palms
DIMENSION OF INSTALLATION OR REMOVAL Loaded on 9 axeles, to Westward Ho 'and; return
13-9 wide.• 14+-10 wide3 14-10 high 95 overall' Bross unladen.
r 410t 238, 345.
SIZE OF EXCAVATION, IF NEEDED AQ5iAM 14AA-An fo.00
f4,
r
APPROXIMATE TIME WHEN WORK WILL BEGIN 8/7/92
-No Sat. or sun. move. 43/7. OK $/lto) AY DNL-Y
APPROXIMATE TIME OF COMPLETION 8�1Ki�92
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 Agent
B.-. L. +Yeagalr Const. Cd.* InO. P.0. Box 87 RiiVer#ida, CA (800)222-5360
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
f
Contractor's License No. City Business License No.
American International Co. B37702162
Applicant's Insurance Company ti 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 1.,50
Inspection Fee $ 10.gii PERMIT VALIDATION
t Permit Fee ,10'00PERMIT NO. 1505
Penalty 8/5/92
Cash Deposit -Surety, Bond DATE APPROVED
if required ," EXPIRATION DATE 8/7'/92
TOTAL: $ 10.00 DATE IS• U D 8/5/92
Receipt No. B /1Z)r
Y
Received by Date % Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
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