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NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ONE TRIP OVERSIZE LOAD PH;U,7IT 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 I I DATE: June 5 i 1990 Minor Improvement Permit Class IV , LOCATION OF CONSTRUCTION t7OV2 LOUIPT iT (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTIO00F CONSTRUCTION Al Cry 1314" 12h 2x,000 and truck 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- d 1 ' t f ' d/ I t) Sketch (attach construction plans if appropriate)' pactlon an p aclnu permanen resur acing an or rep acing Improvemen s In consideration of the granting of this permit, the applicant hereby agrees to: PILOT CARE REQUIRED HAUL ROUTE: tIASINGTON SOUTH TO Avenue 52 1 mila cast on Avenue filovo on June 6, 1990,, --- pact — 990 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 lvz imyca isnaxnr grxnar i!;gii uounrry uiun Lj . i�;2KIRUaa uUXWE; L;A al�10-1 1 1, Name of Applicant (please print) Business Address Telephone No. Dalton Trucking 13560 vahittvan Fontana, CA 92235 Name of Contractor and Job Foreman Business Address Telephone No. on file on file Contractor's License No. City Business License No. Farmers Ins. Group 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 Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. j_n_00 Received by Date Recorded by PERMIT VALIDATION PERMIT NO. 0680 DATE APPROVED 6/5/90 EXPIRATION DATE 6/6/90 DATE ISSUED.,6/5/90 By— ~/ Administrative Authority TELEPHONE: (619) 564-2246 w • - - •„`�f�."s"s�(iv'.�%�'t.v'►�^.r ar .w `. r r .�..r.... � r 4 .a.•�'.f.. 4.-ira r w. ,N. iW .r�...�+ Csr-r.a,+a•.+..+ �.'.5. .w•v..-w r.w..w'w. p..r-...•r rv+-r v. a s' NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ONE TRIP OVESSIZE LOAD 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 :S,UBDIVISIONS DATE: June 5, 1990 LOCATION OF CONSTRUCTION MOVE EQUIPMENT (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION Q1 r%O 4-rAc-4-,nr 1314" 12h 26,000 and truck `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) Subdivision Improvement Permit— Class III 'Minor Improvement Permit Class IV Sketch (attach construction plans if appropriate)' In consideration of the granting of this permit, the applicant, hereby agrees to: PILOT CARE REQUIRED HAUL ROUTE: WASINGTON SOUTH TO Avenue 52.1 mileeyast on Avenue 52. P(����As�f '401116-p-111 .0. 00 14 Move on June 6,. 1990 �. 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 of 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. . Sighature of Applicant or Agent Neavo Engineering 79811 Country C1ub'Dr. Bermuda Dunes CA 345-1778 Name of Applicant (please print) Business.Address Telephone No. Dalton Trucking 13560 Whittvan Fontana, CA 92235 - Name of Contractor and Job Foreman Business Address Telephone No. on file on file Contractor's License No. City Business License No. Farmers Ins. Group 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 N 0.680 Inspection Fee $ Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL 10.00 $ 10.00 Receipt No. Received by Date Recorded by PERMIT VALIDATION PERMIT NO. 0680 DATE APPROVED 6/5/90 EXPIRATION -DATE 6/6/90 DATE ISSUEDX6/5/90 By Administrative Authority TELEPHONE: (619) 564-2246 NOTE:. With proper validation this form constitutes an CITY OF LA QUINTA, encroachment permit' APPLICATION ' FOR PERMIT PUBLIC •WORKS CONSTRUCTION (ENCROACHMENT) RUM 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 III — Ion 1 q DATE: Minor Improvement Permit Class IV LOCATION OF.CONSTRUCTION Ido-d. r (Street address or Description of Location) t PURPOSE-OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF�CONSTRUCTION G�SYIIv) PhISION OF INSTALLATION! O RE OVAL q I v "� x c a ,n U'Q ► c + -rr�, Cie • a: = -�- \�`n t 1-e� ' SIZE OF EXCAVATION, IF NEEDED eCl O n a— APPROXIMATE TIME.WHEIN WORK WILL BEGIN APPROXIMATE TIME OF .COMPLETION ESTIMATED CONSTRUCTION' COST $ (Including removal of all obstruction, materials, and deb: is, backfilling, com- paction om paction and :placing permanent resurfacing. and/or' replacing improvements) `' 1 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.a_nd against any and all, penalties, liabilities or loss resulting from claims or court actionand 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: -11 } Signature of Applicant or Agent' Name of Applicant ('please print) Business Address,. Telephone No. � an ' %Yl-Vi,0 qa a35 Name of Contractor and Job Foreman _ Business Address Teleph6ne No: Contractor's License No. City Business License No. Applicant's Insurance Company - Policy Number FEES: Subdivision Improvement Permit — Class I II Public improvements: 3% of estimated construction cosh Private improvements: 3% of estimated construction costs. ' N0 Minor Improvement Permit -Class IV: See attached.schedule ° Inspection Fee $ PERMIT .VALIDATION Permit Fee PERMIT N0. 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 �.