2189Ii0tE'f'%-.
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
Subdivision Improvement Permit — Class I II
DATE: 5-27-94 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION WASHINGTON & CALLE TAMPICO
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION TRANSPORT OVERSIZE LOAD
CAT 623 SCRAPER
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL 121W 14161H
65'L PURPLE WEIGHT
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 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:
Sketch (attach construction plans if appropriate)
HAUL ROUTE: CITY LIMITS ON
WASHINGTON SOUTH TO TAMPICO.
HAUL DATE: 5-27-94
L - 07 i ill, . CA
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.
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. _
ignature of Applicant or Agent
MARCO RENTALS 3636 WESTMINIST , SANTA ANA, CA (714) 554-5930
Name of Applicant (please print)
Name of Contractor and Job Foreman
Cal. 158746
Contractor's License No.
SEINGI—HANNON
Business Address
Business Address
Telephone No.
Telephone No.
City Business License No.
QB 85443771
Applicant's Insurance Company 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 �U
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
Recorded by
2189
PERMIT VALIDATION
PERMIT NO. 2189
DATE APPROVED
EXPIRATION DATE 5"'Z7 07
DATE ISS ED ��
By
Administrative Authority
TELEPHONE: (619) 564-2246
a
A4,aI0nV sARR"MMW
I AA
caml MCI
31WO N I.Mild"
-:�' a3AaaddV �.�Vq
NOIIVQI 1VA J.IWVld
"—.-,..AgPdAltaoe
'ON td!wsd i
� e1VSOl
psclna:,;t
Fuca Aiung•tsaads0 4u3
.d Mltusd
se:) iluuad
i slit u0pmarul
ilnpsyas psyotuo 9911 IAI I1210 — ilw,sd iuswsWtl W 1 aoulW
am 0914muWaa p4aulov;o %g tyuKulAadw! i39Alid
11140 UQIIZnnluoa potnullit 10 %2 sautulaeo,dwl nllgnd
lila —11.�ad
'MIT uoplw<aang cS89d
at4>'N ADIla %1rI'll 1illq'11 11319 Autdwop eous^ul i,ius*;Iday
1 '
'ON "URI e:suisnA 410
4141m 111""
,ON ltunl'1
out
FIN
.ON iuoydsisj nwppv ""Me 1julid "Old) iutollddv ;o al►latj
i►1o0V io i d to s,A11uft 7�
HW i0 4pVW 10 $t Au fj tuawnrlal. IauR111ppe Aua I01 Am at pue "mg r7
It An"* ty1 jA #++alas pua aKl�lfimra tlu►1sd 141 N+ 9o011tods pua $we& sot-MUOUIF00 A►13 rptdalldde P 14NM Apwo�
'Pa"rq IIVA ><►aM ua►um 6110 le uuteps 41 "OV sill JAMA UL'U U01 tt A1f+0y1WV W416 U1WPV t10 AJUON
'VOliagldOa 1110 01 Wlftn! PSiuu1 QWHd s1µ 4000 luxeurNn YOOM Aur 10 IjnW 04wulr04 a a 6ul,umpa .o Zulu mif
Auadad ,o tu03►9d m alawep ,a "ol 'tu.piaaa Aus ;a use Iu111,9 pus 401W 1MOo ,d n►+Rre wail 6wpinFW 6101 as eapplgh► 'ilgigued
Ila Ilea AUD UU106 PUW Umq iftKu" 'M AbIcIv r put s"mu@00404 '110aa 11W4ll ps"W a rf1 'MID nA #An two put;►P'1A71YUWPu1
,at 199.169 Aqugy iuni!tldg syi 'ilwlsd %%A ;o 6ul1uu6 a►p to uppt;OpliWoa 61
(sivow1Aottlwl 0luotids, m/pus 6uptlrlet8, tusutuu6d Iulstld pus uopm
-woo '6molljcpsq'alcgsp pug 'tlgMvj l 'uopMIMO lis ;o 1•A+Kuu 6ulWrl>wl}
(�rQ��rrrk vt=gin-ate i1� -W � sieouNOUDAWI$Noaall MISS
N01131imoo d0 asWU 91WOxoNd"
LW
6 %z/5 : �r�=�'��� 1► % 1 » /� I ogQnN di'N011VAVJX3 d0 321g
IVAOW811140 N01'11 'II d NTN WIQ
---A 21A2.1-
r�,N011,7f1N1$NOO dp N011diU0630
10111 &Wrll 11 1U4 aapsntisuoo 40RUO)1010 H 11J 1SH9O d 0 f1d
A '
%W= la (:Q!Stlltlata,o 116009 tN!'its
T r ' N0110nWiSN02 40 NOILY301
`�°"'�'"� A} Mfl� illWid tuaWSAO,dwl +OuIIN ;UvQ
II} IRMO — UQU1¢ %4"aWatiucl uolalAlPgM$ LZ /AV
SWISIAlclens Q;,AUUdAV PU* $1N3►N3AOMdY4I MONI19 Lmm Yoliasuuoo ul auKutAoJowl Wom 1011gw will 10th# pus
bill" 441m 'usmn 'sial bwi)pad 'sIllsmapfa 'siuwand '§AemtA!ap 'uglna 141AI,d co *!l4nd ;o' ualtarutiuo0 ty► ,od
UN3WHWOMON33 N0110171HION00 8xvoM onend-
liWWU U(M N0lLW011ddV
a1N1no vi jo Aim gsllnd wlulµebeaua
tAq 61" U406 umaj Mill
uoptpl!tW A�mm Y1�
'AXON
i
N3S
7 01cr.a0 bGa 01.1. «'lnILL1,L6l,9L WVLV:s : b6 -9Z-9 ; AZOL �6T4000161 x0aoy"As �
N
.. -rr_ .: � ^.�' •r''l� .! �l ..4�,r%'?1=yfi- . %a7s�','.°'�?t_�" .. ',"C... s7: "!^i.` _ �.�,
Tjht440"
S
REQUEST FOR INSPECTION
��MoF� or 24 HOUR ADVANCE NOTICE
7% DATE
PROJECT LOCATION
PERMIT NUMBER
CONTRACTORSNAMEPHONE
�L3SW
NUMBER
��1t
COMPACTION TEST
COMPACTION TEST
Subgade.................. ❑
Base ........................
❑
Grading ....................
0
Curb & Gutter .......... ❑
Drainage ..................
0
Formwork..................
0
Trenches ................ 0
Striping ....................
❑
Structural Steel ........
❑
Paving (Asphalt) ...... ❑
Signing ....................
❑
Backfill ......................
❑
Paving (Concrete) .. 0
Landscaping ............
❑
Excavation ................
0
Driveway Approach jq
Above
MONDAY
TU�Y--�' WEDNESDAY THURSDAY FRIDAY
78-105 CALLE'ESTADO • LA OUINTA, CALIFORNIA 92253 • (619) 564-2246