1519-NOTE:
With 'roper,'alidation
this'form constitutes an,
'^"'encroachment permit, CITY ,OF LA. QUINTA • `
. } '
APPLICATION.. FOR PERMIT
• PUBLIC -WORKS 'CONSTRUCTION( (ENCROACHMENT) •
For the. constructiori ;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
Y Subdivision Improvement Permit — Class II
DATE: August 24, 1992. Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location) i
PURPOSE OF CONSTRUCTION Move equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION D9 W/ blade attached ROUTE: From Riverside Co ntq line
south on Was agtOn - east
on Miles, ® uth on Dune Palms
DIMENSION OF INSTALLATION OR REMOVAL Loaded on 9 axles to Westwar Ho and return
106" wide, Legal height 99-10 overall gross weight unladen.
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 8/25/92
APPROXIMATE'TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
it % ,�,r^ nAq- t�
(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
4
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 Agp,9t
B.L. Yeager'Const. Co, P.O. Bou 87 Riverside, CA (800)222-5360
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No..
Ameridan International Co. BE 7702162
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 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
$ 10.00
Date
arTs-s2 10,00
1.
15,19 C
PERMIT. VALIDATION
PERMIT NO. 1519
DATE APPROVED 824/92
EXPIRATION DATE 8/25/92
.DATE (ISSUED 8/24/92
By /�
Administrative Authority
TELEPHONE: (619) 564-2246
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