1696"NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
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 like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: 3/18/93
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment
DESCRIPTION OF CONSTRUCTION 633 Tractor/Scrapar
DIMENSION OF INSTALLATION OR REMOVALLoaded on 9 axles
13-9 wide 14-9 high 99-10 overall 218.518 lbs
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 3/18/93
APPROXIMATE TIME OF COMPLETION 3/24/93
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
In consideration of the granting of this permit, the applicant hereby agrees to:
From Westward Ho & Dune palms
North on Dune Palms - West
on Miles - North on Washington
to Riverside County Line &
Return unladen
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.
re of Applicant or Agent
E.L. YEAGER CONST CO INC PO BOB 87 RIVERSIDE, CA (800) 222-5360
Name of Applicant (please print) Business Address Telephone No.
SAME
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.
City Business License No.
AMERICAN INTERNATIONAL CO BE7702162
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
ti
' Permit Fee
� Penalty.
Cash Deposit -Surety Bond
if`Cequired
s.3 TOTAL:
Receipt No
Received by
$ /0
Date
H5'BWA 1BT��--�a-93 10.0010
1 696
PERMIT VALIDATION
PERMIT NO. Ile 96
DATE APPROVED -Fl o —7-3
EXPIRATION DATE �— �8 —n73
DATE IS UED f %�
gy Jl
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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