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0560NOTE: �. •. � .. -• ,� .- . _ . With pr.operzvalidation this form constitutes an nt permit r CITY' OF LA QUINTA encroach APPLICATION FOR PERMIT w PUBLIC WORKS CONSTRUCTION, (ENCROACHMENT) '. ONE TRIP OVERSIZE .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 ,April 5, 1990 Subdivision Improvement Permit — Class III DATE: Minor Improvement'Permit Class IV LOCATION OF CONSTRUCTION MOVE EQUIPMENT (Street address or Description of Location) t PURPOSE OF CONSTRUCTION. Gama (,iiImA marhi nimSketch (attach icon struction plans if appropriate) . 10"A" Wide, ]P(ja1 hAiaht-NPirrht, DESCRIPTION OF CONSTRUCTION _ HAUL ROUTE: EISENHOWER' AT COLINIA TO WASHINGTON. TO'FRED.WARING DRIVE + DIMENSION OF INSTALLATION OR REMOVAL 4 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,_backfilli,ng, com paction'and,placing.permanent resurfacing and/or replacing improvemerits) 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 fromand against any and all penalties, liabilities or loss resultirig from claims or court action andarising out of any accident, loss r 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. SignatureApplican or Agent , MASSEY SAND AND ROCK CO PO Box 1.767 Indio; CA 92202' Name of Applicant (please print) Business Address 'Telephone -No.. Name of Contractor and Job Foreman + Business Address Telephone No. on, file on file Contractor's License No. City Business License No. -on file Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I II t 5ggo 0 5 U Q Q4— 5-90 Public improvements: 3% of estimated construction costs . NN FTOTAL 3.Q.o0 Private improvements: 3% of,estimated construction costs Minor Improvement Permit —'Class IV: See attached schedule N6 056 ' Inspection Fee $ t PERMIT VALIDATION Permit Fee ]'n' DD PERMIT NO, ! nRr, n " Penalty ' DATE.APPROVED 4/5/9,0 Cash Deposit -Surety Bond if required EXPIRATION DATE 4/,6/90 TOTAL: $ 10.00 '. 4/5�9� r DATE ISSUED t No. • / Receipt By / (, t. p y Received by Date Administrative Authority Recorded by TELEPHONE: (619) 564-2246 NOTE: With proper validation this form constitutes an encroachment permit CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ONE TRIP OVERSIZE PERMIT For ithe 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 April 51 1990 Subdivision Improvement P-7ermit Cla'ss I II DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION MOVE EQUIPMENT (Street address or Description of Location) PURPOSE OF CONSTRUCTION Gomaco cnbb machine- Sketch (attach construction plans if appropriate) 1016" wide, leaal height/weiaht DESCRIPTION OF CONSTRUCTION HAUL ROUTE: EISENHOWER AT COLIMA TO WASHINGTON TO FRED WARING DRIVE DIMENSION OF INSTALLATION OR REMOVAL 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: 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 MASSEY SAND AND ROCK CO PO Box 1767 Indio, CA 92202 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. on file on file Contractor's License No. City Business License No. on file Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I I I 51I3'►. 2gp p4__�0 f•0 Public improvements: 3% of estimated construction costs � A ^ TOT. L 1.0•00 Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule 2 0560 Inspection Fee $ Permit Fee 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 f Receipt No. Received by Date Recorded by a PERMIT VALIDATION PERMIT NO. 0560 DATE APPROVED 4/5/90 EXPIRATION DATE 4/6/9,0 DATE ISSUED 4/5/90 By Administrative Authority TELEPHONE: (619) 564-2246 -NOTE: ,�• With' proper validation • " ' N — . this form constitutes am - 'f encroachment permit CITY. OF 'LA',QUINTA APPLICATION',; FOR" PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)' For the construction of public*or driveways,, pavements, sidewalks; parking lots, sewers, water mains p private curbs,, drivewa and other like public works improvements in connection with. MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS ' Subdivision Improvement Permit — Class III i DATE: / ��` Q. Minor Improvement Permit Class.IV LOCATION OF CONSTRUCTION ,,(Street addressor Description of Location) , c PURPOSE,.OF CONSTRUCTION Sketc0attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED f ` APPROXIMATE TIME WHEN WORK WILL BEGIN a APPROXIMATE TIME.OF COMPLETION^ ESTIMATED CONSTRUCTION COST $ f (Including removal of al; obstruction, materials, and debris; backfillingj'com-t. paction and placing permanent resurfacing and/or replacing improvements). In consideration of the granting', of `this permit, the applicant hereby agrees to: ' Indemnify, -defend andsavethe City, its authorized agents, off icers,.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 topersons or property happening or occurring as a proximate result of ,any work undertaken under•the permit granted pursuant to this application. y , ?.Notify the Administrative Authority at least twenty-four (24) hours in'advence of the time when work will be started. y w. Comply with all applicable City Ordinances, the .terms and, conditions of the permit and all applicable rules and regulations of the City of La Ouinta and to pay for any additional replacement necessary as the result of this work. ` y.. 'Signature of plicanto Agent•. Name of Appli (please print) "';Business Address Telephone No: Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No, d City Business License No. + Applicant's Insurance Company .F a Policy Number FEES: Subdivision'(mprovement Permit —Class I • Public. improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit - Class IV: See attached schedule N'U' Inspection Fee• $ PERMIT VALIDATION Permit Fee PERMIT NO. ` ". Penalty DATE APPROVED .' Cash Deposit -Surety Bond ` if required. EXPIRATION DATE TOTAL: $ DATE ISSUED Receipt No. By., Received by'.' Date Administrative Authority Recorded by - TELEPHONE: (619) 564-2246 .