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1958OTE: `With proper validation lis 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 lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit — Class III DATE: 11/5/93 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION RMCHtI LA QUMA (Street address or Description of Location) PURPOSE OF CONSTRUCTION MOOS EQUIPMENT DESCRIPTION OF CONSTRUCTION D6 DOZER AND SH S FOOT 101H, 11'10"W, 40,000 LBS DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attach construction plans if appropriate) HAUL ROUYE: 48TH WEST TO ii�SHINGI'ON, NORTH TO 1-10 ,,I,HAUL DATE: 11/8/93 Q � A NOV 0 5 1993 APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ By (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. ;l 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 ApolicankoN Agent JOHNSON TRUC=G P.O. BOX 1618, FALLBROOB, CA 92028 723-8257 Name of Applicant (please print) Business Address Telephone No. NUEDO III- FLUNG, INC. 79-811 COUNTRY CLUB DB., BERMA DUAES, CA 345-1778 Name of Contractor and Job Foreman Business Address Telephone No. ON FM Contractor's License No. ON FILE City Business License No. OA FILE ON FILE 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 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 ' M Receipt No. Received by Date Recorded by 1958 PERMIT VALIDATION PERMIT NO. 1958 DATE APPROVED 11/5/93 EXPIRATION DATE 11/8/93 DATE ISSUED 11/5/93 By Administrative Authority TELEPHONE: (619) 564-2246 NOV— 5-93 111Pitth proper validation this form constitutes an `ie tcroadlrttettt pelntit finr rltn ,nr,5t,rutrnn nl rNrhlir, r1t Itriv�ta rurht, rlrivew7Ys, t,ivcrnPntt, sidewalks, parkEnq lots, tr,Whrs w ter tnaEr+t end rylhur lil n t,irlrii, w,+,ks inrptov.r�enent: in ennt+r!ction Wille MIN011 IMMOVEMENTS anti APPI10VEI) S1111U1VISIt7NS FRI 13:51 N U E V-0 ENGINEERING CiTY OF LA GUINTA APPLiCATION FOR PERMIT PUBLIC WORKS CONSTpUCTiON (ENCROACFIMENT) P. 02 DATE; 11-5-93 Subdivision Improvement Permit — Class 111 _ ,__... "--� Minor Improvement Permit Class IV �-- LOCATION OF CONSTRUCTION Rancho La Quinta --�—�. IStreet eddresa Or D@scrlption of t.ocatlon) PURPOSE OF CONSTRUCTION Move Equipment DESCRIPTION o i�q���� N D oxer s ee s of �,0 lbs. DiMENSION Or: INSTALLATION OR REMOVAL. SIZE OF EXCAVATION, IF NEEDED ' APPROXIMATE TIME; WHEN WORK WILL. BEGIN _ A*PPROXIMATE TIME OF COMPLETION ' ESTiMAT15D CONSTRUCTIONCOST S (Including removal of all obstruction. meterlals, and deb. -is, backfilling, corn- paction and placing permanent resurfacing and/or repiacinq improvements) In consideration of the granting of this permit, the applicant hereby agrees to: Sketch tattach construction plans Tproprlate) HAUL ROUTE: 48tb,✓Washington, 11,04' to 1-10 HAUL DATE: 11-8-93 tndeel, Iiebilitles ,defend and penaftlnietLave the City, Itt suthOrlted ap@nts, officers, representatives ant (t d employees, hartnietorn ar,d egrllryt any end all OF toss retulling from clalins of court action and othing out of any ateident. IOtt or danta" to persons or property happening or occurring as I prOttimete result of any work undertakers under the permit granted purtuant to this 4PPllcatlon. Notify the Administrative Authority at 1@811 twentyiou► 4241 hours in advance of the limp when work will be Started. Consply wlth an eoollcable City Qrdinencet, the terms and condltions of the permit and all epplleable rules and regulellohs of the Ci La flulnta $r,d to pay for shy additional replacementee nefsary at the result of this work, ty or _ Johnson Trucking Name of Applicarst (please printl 1131tte of Contractor and Job Foreman Utl ii'l.lc _ Contrar:tor's License No� Signature of Applicant or Agent P.O. Box 1618 Fallbrook, CA 92028 (619) 7238257 Ousittess Address Telephone No, Business Address — -. - Telephone No. On File City Business License No, Applicant's Insurance Company Policy Number FE:FS: Subdivision Irnproveatent Pertnit Class Public Improvements: 3% of estimated construction costs Private Irnproverrlentt: 39A of •.rl...,._�-__.... r < <<.o�: mlNrovernentt: 396; Of estlrttated Construction costs J Minor Improvement P rmlt — Class IV; See attached Schedule nsn¢Vlon Fee 'erMit Fee rliAtty telt benoslt•Surety Bond required TO tAL.- � LD .'ecelpt No. ircelved ieeorded by 0 Extended Page 2,1 �0 PERMIT VALWATION PEnMIT NO. DATE APPROVED EXPIRATION DATE �— 3 DATE ISSUED By Adrninistiative Auttiorlty TELEPHONE; 18191664.2748 I y + f