1919461m:_
With proper validation
thi4form 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
10/11/93
LOCATION OF CONSTRUCTION BEHELDAS AND SINALOA
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MVM EQUIAM Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 233 CAT
HAUL ROUTS: FM WARING TO
12• W, 80' L, WASHINGTOR TO TAMPICO TO
DIMENSION OF INSTALLATION OR REMOVAL BIAS TO SINALOA
14' R, 90,000 LBS
SIZE OF EXCAVATION, IF NEEDED #HApi, DATE: 10/11/93
APPROXIMATE TIME WHEN WORK WILL BEGIN 10/11/93 Q
10/11/93 D
APPROXIMATE TIME OF COMPLETION OCT3 .
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements) I By
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, defend and save the City, its authorized agents, officers, representatives andemployees, ha mless 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
JOBS: BROTHERS CONSTRUCTION 85989 AVEM 52, COACHELLA, CA 347-2291
Name of Applicant (please print) Business Address Telephone No.
SAME
Name of Contractor and Job Foreman
172092
Contractor's License No.
Business Address Telephone No.
153
City Business License No.
SITING & HANNON ON FILE
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
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: $ 10.00
Receipt No.
Received by 'Date '
Recorded by
a
91 9
PERMIT VALIDATION
PERMIT NO. 1919
DATE APPROVED 10/11/93
EXPIRATION DATE 10/11/93
DATE ISSUED $0/11/93
B �A'
r
Y t
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE:
4ith proper validation
this form constitutes an
encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lou, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
'%JM
GATE �� �� 93 Subdivision Improvement Permit — Class III
• Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Oeseription of Location)
PURPOSE OF CONSTRUCTION �/��/ - �1� "' ✓� Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION e4 -f
I
DIMENSION OF INSTALLATION OR REMOVAL
w
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
(InNuding removal9 a obstruction, materials, and debris, backfilling, com. lQ��, / I �"
Paetion and platin permanent resurfacing and/or replacing improvements) 1 g.
Wos1,1-PJ4Qf'
M 00/0'5
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, defend and save the City, its authorized agarms, officers. representatives and employees. harmless from and against any and all
penalties, liabilities or loo resulting from claims or court action and arising out of env aecident...loss or damage to persona orpro
happening or ooeurring as a proximate rasun of any worts undertaken under the permit granted pursuant to this application. perty
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 appliable rules and regulations of the City of
La Ouints and to pay for env additional replacement necessary as the result of this
Signature of A nt or Agent
0 72 /J _ ., - - - - -
Name of Applicant (please print)
Business Address
Telephone No
Name of Contractor and Job Foreman Business Address Telephone No.
9
Contractor's License No.
Applicant's Instdance Company
ism
City Business License No.
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
13086
DATE APPROVED 9-3
EXPIRATION DATE 3
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246