1964' --z sew=",�.-.'._` ; • R, _ ,
NOTE:
With 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 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 RANCW LA QUA
Subdivision Improvement Permit = Class III
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIPMNT Sketch (attach construction plans if appropriate)
DESCRIP,II OF CQN TRUCTION �' TMM
12 9, 13 8 , 90,000 LBS HAUL ROM: WASHING' TO NO=
CITY LAMS
DIMENSION OF INSTALLATION OR REMOVAL HADy DATE:;,11/8/93
SIZE OF EXCAVATION, IF NEEDED PUM CAB REQM3= D
APPROXIMATE TIME WHEN WORK WILL BEGIN NOV 08 15993
r w
APPROXIMATE TIME OF COMPLETION I By
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 aigenifs;4officers, representatives and employees, harmless from and agains/t any and all 4,,v
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persocis or property y^
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
CNANNEL & MARLOW LOWBED 8466 B. AMBEIWWOOD ST.., ANAHEIM, CA (714) 921-8440
Name of Applicant (please print) �� Business Address Telephone No.
SAAB
Name of Contractor and Job Foreman Business Address Telephone No.
ON FILE
Contractor's License No.
ON FM
City Business License No.
ON FILE OR PILE
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10
Receipt No.
Received by Date
_RiTcorded by
196
PERMIT VALIDATION
PERMIT NO. 1964
DATE APPROVED 11/8/93
EXPIRATION DATE J/- `93
DATE ISSUED —
By
Administrative Authority
TELEPHONE: (619) 564-2246
it �4
f ��
8-93 MON 1 5: 1 0 NUEVO ENG I NEER I NG
NOTE:
With proper validation
this form Cohstitutes an
encroachment permli
CITY OF LA OUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P . 0:3
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like pubilc works Improvements in connection with MiNOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision improvement Permit -- Class IIi
DATE:— Minot Improvement Permit Class IV
LOCATION OF CONSTRUCTION Rancho La Quinta
IStreat address or Description of t_ow!onl
PURPOSE OF CONSTRUCTION Move Equipment;
DESCRIPTION QF S N$TPUCTIIOON DdL D oo Dozer
DIMENSION OF INSTALLATION OR REMOVAL
Sketch (attach construction plans if appropriate)
TE, ljo27t,6
HAUL ROUTE: Washington, --P�F4
G k-t:k-t Li H.. T -S
HAUL DATE: 11-8-93
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL OF -GIN
APPROXIMATE TIMi= OF COMPLETION
ESTIMATED CONSTRUCTION COSTS �.----- --- - - - ,
(including removal of all obstruction, materials, and deb:•fs, backfilling, com-
paction and placing permanent resurfacing grid/or replacing improvements)
in consideration of the granting of this permit, the applicant hereby agrees to:
Indemnity, defend and -ave the City, its Iuthorlzed agents, officers, representatives Ind employees, harmless from and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, toss or damage to persons or property
happening or oceurring as a proximate result' of any work undertaken under the permit granted pursuant to this sppllptlon.
Notify the Administrative Authority at least twenty-four 1241 hours In advance of the tittle when work will be started.
Comply with IiI soplicabte City Ordinances, the terms and condition$ of the permit and all applicable rules and regulations of the City of
t.e Quinn and to pay for any additional replacement necessary a$ the result of this worts.
Signature of Applicant or Agent
Channel & Marlow Lowbed 8466 E. Amberws$od St.' Anaheim, CA (714) 921-8440
'Name of Applicant (please printf 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
FEES• S b ' I I
U div Von Improvement Permit — Class til
Public Improvements: 3% of estimated construction costs
Prlvaf• Imnrnvonwnre. 'Ift •t ...1...._J __,_._..__.__ _ -
I-T�
�,PILPrivate Improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
nspection Fee Z
Permit Fee — %b
Penalty
,ash Depostt-Surety Bond
I required
TOTAL:
secelpt No.
tecetved by Date
tecorded by - - - -- -
Extended Page 3.1
N�
PERMIT VALIDATION
PERMIT NO,
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By —,.._.
Administrative Authority
TELEPHONE: (6191664-2240
U
l