496v
NOTE: i..
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TIME OVERLOAD PERMIT
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: 1/2/90
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 42th Aventte and Washinaton
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL 917 Srram_ t?r.
7 F 1 7 11 1, , KH l 1 1 Q II rn; A n O A l err
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 1/2/90
Sketch (attach construction plans if appropriate)
HAUL ROUTE: 30th Avenue, Laundau
to Vista Chino, Date Palm to I-10
south on Washington to Avenue 49
and return unladen
REQUIRES TRAFFIC CONTROL -2 pilot
vehicles per California Vehicle
Code
APPROXIMATE TIME OF COMPLETION 1/2/90
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:
Requires County permit
0-1-90-6
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.
Signature of Applicant or Agent"
On, D..,-.,; p4z4 Tr% tin n^,�r Q Qan A=rnarAi nn _ ('A 99AQ7 1 —Ann-144-19I
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.
Farmers Ins. Group
City Business License No.
600221517
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
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
1Q.00
$ 10,00
Date
PERMIT NO.
PERMIT VALIDATION
496
DATE APPROVED 1/2/90
EXPIRATION DATE 1/2/90
DATE ISSU•E'D' ///1`/ 2 / 9 9
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
TAM '!l+.�i �Yti P�4 N.�w 4.w �� s.+. W� eft M� —�� �.� �� we— w+.. +.�. �.. w+.�. w..+ wi1� w �� r •ram �r �� r �— +�� �.. �.�. ter„
4
NOTE: .'
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TIHE OVERLOAD PEW-1IT
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: 112190
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 43th Avenue and Washincston
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL F;37 4;crginer
_Iona
r
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 1/2122
Sketch (attach construction plans if appropriate)
HAUL ROUTE: 30th Avenue, Laundau
to Vista Chino, Date Palm to 1-10
south on '{Iashington to Avcnu� ,,8
and return unladen
REQUIRES TRAPFIt.' CONTROL -2 rilot
veh:-cles per California Vehicle
Code
Requires Count, permit
APPROXIMATE TIME OF COMPLETION 1/2/19L 0`1`90-6
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 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.
J F h
Signature of Applicant or Agent
P,- -x-mi +-c-- True- Pn Pnac 79q Ann 14PrnFxr1i.:no . ' CA 02402 1-800-344--191I
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Farmers Ins. Grout 600221517
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. Lao
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
Receipt No.
Received by
Recorded by
$ 10.00
Date
PERMIT VALIDATION
49G
PERMIT NO.
DATE APPROVED 1/2/90
EXPIRATION DATE 1/?/90
DATE ISSUED' //1/2/90
By —
Administrative Authority
TELEPHONE: (619) 564-2246
- -- -
`;
NOTE:
WithnpropeNvalidation
this form constitutes an
CITY OF .LA OUINTX, v
encroachment permit ,.
' APPLICATION FOR PERMIT.''
PUBLIC WORKS CONSTRUCTION,
(ENCROACHMENT) 6�7
It ,_ _• ; _ �•• i. .I - ..
For the ;construction of public or • private curbs, •,driveways, pavements, sidewalks, *parking-' 'I sewers, water mains
and other like public -Works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
~• Subdivision Improvement Permit — Class 111.
t ,• / j99D
DATE:S�LQ`L1 • ` - - / ..Minor Irriprove,ment Permit Class IV
LOCATION OF CONSTRUCTION ✓e
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
30 /Qd2 '7
DESCRIPTION OF CONSTRUCTION -
DIMENSION OFNS ALL_ ATION OR RE OVAL�17 -s bn-dam // ,� % /0 7•O
SIZE OF EXCAVATION, IF NEEDED S/ �/�e
APPROXIMATE TIME WHEN WORK WILL BEGIN/ A• `
APPROXIMATE TIME -OF COMPLETION
ESTIMATED CONSTRUCTION COST $
' (Including removal of all obstruction, materials, and debiis, 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, harmlessfrom 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 a_s the result of, this, work. F
w. f Signature of Applicant Agent i
h'e;;hd i ay.C��z Oz / 8eo 2 �giZ
Name of Applicant (please print) : . ' Business Address - + Telephone No.
Name of Contractor and Job Foreman - Business Address Telephone No.° r
r + Contractor's License No. City Business License No:
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 Uu
Minor Improvement Permit — Class IV: See attached schedule
Inspection_F.ee $ ' ` PERMIT VALIDATION ,
Permit Fee I I PERMIT NO.
Penalty 4
Cash Deposit- Surety Bond , DATE APPROVEDr, r.
if required EXPIRATION DATE
TOTAL: $ DATE ISSUED '
Receipt No.. �z� ` ' F•
Received by Date _, Administrative Authority
4 Recorded by TELEPHONE: (619) 564-2246