1707NOTE: .
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
Subdivision Improvement Permit — Class III
DATE: 3/30/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Cat 651 Water Tanker From Dune Palms & Westward Ho —
Loaded on 9 axles. 1819"Wida,1419" High Northbound on Dune Palms —
95 overall Gross wt 238.345 Westbound on Miles — Northbound
DIMENSION OF INSTALLATION OR REMOVAL on Washington to Riverside County
Line & Return unladen.
SIZE OF EXCAVATION, IF NEEDED PILOT CAR REQUIRED
APPROXIMATE TIME WHEN WORK WILL BEGIN 3131 /93
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
t happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.
r 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.
gnature of Applican or Agent y
ti
E.L Yeager Const Co. Inc. P.O. Box 87 Riverside, ra Rnna 777_S3fin
Name of Applicant (please print) Business Address Telephone No.
SAME
Name of Contractor and Job Foreman Business Address Telephone No.
On File On Vila t.
Contractor's License No. City Business License No.
American International Co n117209167
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
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ 10.00
Received by Date
PERMIT NO
10 CAR P16TRNf."' 0.000
1 Inv f
PERMIT VALIDATION
1707
DATE APPROVED 3/30/93
EXPIRATION DATE 3/31/93
DATE ISSUED �3 ,'31- q3
By
-r 0 Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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