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AP
NOTE.
Withproper validation ` 4
this form constitutes an
TA,aF'
encroachment permit CITY.OF L A ' QUI N
APPLICATION FOR;,;P,E-RMIT f`r
=k' • r ' PUBLIC WORKS. CONSTRUCTION; (ENCROACHMENT) r.. c '""—n
ONE '.TRIP OVERSIZE .LOAD PERMIT 4 �` OF
A_ Forothe, construction of public or curbs, driveways, pavements, sidewalks, parking',)ots,.sewe'rs; water -mains
and other, Ilke public works improvements in connection with. MINOR IMPROVEMENTS_ and APPROVED SUBDIVISIONS
Subdivision Improvement Permit -Class II
DATE: 8/28/90 Minor Ir»provement l?ermit Class IV
.LOCATION OF CONSTRUCTION' MOVE EQUIPMENT
F (Street address or Description of Location)
,f ^ PURPOSE OF CONSTRUCTION - 't' Sketch (attach construction plans if+appropriate)'
DESCRIPTION OF CONSTRUCTION'L • HAUL 'ROUTE ! WASHINGTON `FROM N1
City Limits,. south to
3,,- ,= • Eisenhower, =Drive,. west• to 'Ave.
Fermando F
' 1DIMENSION OF INSTALLATION OR REMOVAL ;y M r
7rcaa M• n%yer-lnr�
PILOT -CARS ,REQUIRED(2)'Forward '
•�SIZE OF EXCAVATION'; IF NEEDEDI" t and aft Y
.MUST PROVIDE•FLAGGING,,AT TURNING
'APPROXIMAT&,TIME.WHEN WORK WILL BEGIN "INTERSECTIONS OF: WASHINGTON AT
ik;• Y EISENHOWER,, .AND' EISENHOWER' AT _
APPROXIMATE TIME OF COMPLETION
,,,AVENIDA FERNANDO
s�• ESTIMATED CONSTRUCTION COST $ r'
,` +r
' (Including,removal'of all'obstruction,"materials, and debris, backfilling, com- ONE DAY PERMITI'ONLY 8/28%90
paction and placing permanent resurfacing 'and/or,`replacing improvements) +=
* ..In consideration.of the granting of this permit, the applicant' hereby agrees to:
ii; emnify,•defend and:save.the.C,ity, its. authorized agents, officers, representatives and employees, harmless:.fro""m and against any and all
I penalties, Iiabilities.or loss `resulting from claims or court action and arising -out of any accident, loss or damage to pe'�sons'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'arid to pay for any additional replacement necessary as the result•of'this work.
rSignature of Applicant or. Agent f% t
Schwab' Sales 11;95 . ,WAine'r,. Chandler' ,AZ' 85225 '
Name of Applicant (please print) r , a. Business Address Telephone No
�` y v •,,
Name of Contractor and Job Foreman Business Address -Telephone No. .
On f ile . on. f ile ,-
' Contractor's License'No. < 'City. Business License No.''
- on file -t ' - `(('�05ig' b 0' 6-28-90 14
�' i.71� 1�17A1. i 50.00
Applicant's Insurance Company t Policy Number
• ' FEES: Subdivision Improvement Permit — Class l l l
Public improvements: 3% of,estirnated construction costs
- ,
Private improvements: 3% of estimated'c'costs X,2; '= = pp
Minor Improvement.Permit -- Class IV: See attached'schedule - - & q O 2 7
Inspection -Tee. $ . PERMIT, VALIDATION' ,' �.
Permit Fee 10.00 ` `
' _ {" PERMIT NO. 082%
Penalty :� 8[28/90
�rDATE APPROVED "
Cash Deposit -Surety Bond _
{ i
if. required
EXPIRATION DATE
'TOTAL:. $ 10.0+0
+ ' ,
DATE ISSUED �' 8/28/90
Receipt No.
By .
Received by Date - Administrative Authority
Recorded by ^� TELEPHONE: (619) 564-2246
..��
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NOTE:
With proper, validatio•n
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR,. PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OME TRIP OVERSIZE LOAD PERMIT.-
-For, the corstruction 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
DATE:,. 8/2090 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION MOVE EQUIPMENT
(Street addressor Description of Location)_
' 1
PURPOSE OF CONSTRUCTION Sketch (attach construction plans,if appropriate)
DE5CRIPTION.OF CONSTRUCTION HAUL ROUTE: 'WASHINGTON FROM NY
City Limits, south,to'
Eisenhower Drive, west to Aver
Fermando
DIMENSION OF INSTALLATION -OR REMOVAL
11 IRn -taT '191 lnnrT_' 191 r;m;ir nxiarhanrl
PILOT CARS REQUIRED (2) Forward
SIZE OF EXCAVATION, IF NEEDED and aft
MUST PROVIDE FLAGGING AT -TURNING
APPROXIMATE TIME WHEN WORK WILL BEGIN INTERSECTIONS OF WASHINGTON AT
EISENHOWER,. AND. EISENHOWER AT
APPROXIMATE TIME OF COMPLETION AVE,
FERNA14DO
ESTIMATED CONSTRUCTION COST $
(Including removal, of all obstruction, materials, and debris, backfilling, com ONE DAY PERMIT ONLY .8/28/90
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, yoff,icers,°representatives and employees, harmless from and against any and all
penalties, liabilities' or joss resulting from claims or court action and arising outof any ,accident, loss or damage io 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 beast 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. 1/
Signature of Applicant or Agent
r- Schwab Sales _ It95 WArner, Chandler, AZ' 85225
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 f QU i � •f 6't�'i1 �4 ;90-90 14
1o.4?0
$ f5
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
0827
Minor. Improvement Permit — Class IV: See attached schedule _N
Inspection Fee= $ , PERMIT VALIDATION'
Permit Fee , 10.00
Penalty
Cash Deposit -Surety Bond
If required
10.00
TOTAL: $
Receipt No.
Received by Date
Recorded by
PERMIT NO.
0827
8/28/90
DATE APPROVED
EXPIRATION DATE
8/28/90
DATE -ISSUED
8/28/90
By: /
J
Administrative Authority
TE.LEPHONE:.(619) 564-2246 +