1963Ai-NOTE:-
With
i"NOTE:With proper validation
this form constitutes an
•encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
,x
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
11/8/93
LOCATION OF CONSTRUCTION RAI= &A Q14M
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOPE BQUIPKMT Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 637 AUGER
1318"R. 13% 114,325 LBS
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
HAUL ROUTE= WASHINGTON TO NORTH
CITY L an
HAUL DATE:,:.. 11/9/93
PIIAT CA8` mqum
D
NOV 0 S 1993
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:"4
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees,,harmless from andaga nst 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
CHARM 4 MARLOW LOWBED 8466 E. AMBEMMOD ST.. ANAHEIM. CA (714) 921-9440 I
Name of Applicant (please print) Business Address Telephone No.
SAM.01
Name of Contractor and Job Foreman Business Address Telephone No.
ON FM ON FILE
Contractor's License No. City Business License No.
ON FILE ON PII.B
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III i
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule 1963
Inspection Fee $
Permit Fee
10
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10
Receipt No.
Received by
Recorded by
Date
PERMIT NO.
PERMIT VALIDATION
1963
DATE APPROVED 11/8/93
EXPIRATION DATE
DATE ISSUED
By
Ad istrative Authority
TELEPHONE: (619) 564-2246
,:C'n =F 67-...Av
f Is
a
Nc�,/—'i8-93 MON 15 :09 NUEVO ENGINE a R I NG P _ 02
NOTE:
With proper validation
this form constitutes in
encroachment permit
CITY OF LA OUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewal' s, parking lots, sewers, water malas
and other like public, works Improvements in connection with MINOR IMPROVEMENTS and APPROVE%D SUBDIVISIONS
DATE: .,.,.�.�Nov. 8_71993
Subdivision Improvement Permit -- Class I I I
Minor- improvement Permit Class IV _
LOCATION OF CONSTRUCTION. -Rancho LA Quint ,
ISt�eet address or Douriptlon of Location)
PURPOSE OF CONSTRUCTION Move Equipment
DESCRIPTION QF CONSTRUCTION
131`8 1H. 131`W, 114
er
DIMENSION OF INSTALLATION OR McMOVAL'
SIZE OF EXCAVATION,.IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(including removal of all obstruction, materials, and deb; -is, backfilling, tom•
paction. and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Sketch (attach construction plans If appropriate)
HAUL ROUTE: Washington to
G �{ L_(WL TS
HAUL DATE: 11-9-93
{ZCA11'%_te-F,10
indemnify, defend arca save the City, its euthorlted agents, officers, repretentetives and employees, harmless from and against any end all
Penalties, liabilities or lost resulting from claims or court action and arising out of any accident, lot$ or damage to pertOnt or properly
happening or occurring es IN proximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at last% twenty-four 4241 hours In advenee of the time when work will be stansid,
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
LA Quints and to pay for any additional replacement namssary of the remit of this work,
Channel & Marlow Lowbed
Name of Applicant (please print)
Signature of Applicant or Agent
8466 E. Amberwood St. Ahaheim, CA (714) 921-8440
Business Address �~ Telephone No.
(Name of Contractor and Job Foreman Business Address telephone No.
(Contractor's License No.
City Business License No.
Applicant's insurance Company Policy Number
ES:
Subdivision Improvoment Permit — Class 11
Public improvements: 3% of estimated construction costs
Private Improvements: 3% of estimAtod mnetrl,Minn
J
'rrnva a improvements: 396 oT estinlsited, construction costs
Minor Improvement Permit — Class IV: See ettacheQ schedule
nspection Fee
°ermit Fee
'enalty
° sh Deposit -Surety gond
required
TOTAL: S
ecelpt No.
ecelved by Date
ecorded by
r • ���i sato
0
Extended Page 2.1
�p
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED // — g 70t 3
EXPIRATION DATE
DATE ISSUED
ey
Administrative Authority
TELEPHONE: (619) 664.2246
� '1
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