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0890•i:r ti, a �; ,,�,iy rn,. f 'ay vyy i' 1", t: j,K uw i it: zlof '��",�yl`�•�} 41 NOTE: With proper validation x k °• f ' , - Q this form constitutes an CITY, OF -1A` QUINTA' encroachiment.permit' , •,, ' APPLICATION, FOR PERMIT' . " - . ti "PUBLIC. WORKS CONSTRUCTION (ENCROACHMENT). ONE TRIP OVERSIZE LOAD PERMIT c�'�OFT���S 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 11.1 - DATE: Mr trcarnhaar .7 1.99(1 Minor Improvement Permit Class IV LOCATION OF' CONSTRUCTION _; move ,ectuibment , (Street address or Description of. Location) 5 L • PURPOSE OF CONSTRUCTION ? 966, loader - • - Sketch (attach'construction plans if appropriate) 15!h,-. 9' V' wide, •.legal length and'- wei&ht < i -'DESCRIPTION OF CONSTRUCTION, '--HAUL ROUTE: Nogales and :;Bermudas to Avenue 52 to -Washington north to Hwy 111 DIMENSION OF INSTALLATION,OR REMOVAL ' Haul' date: 11/3/90 SIZE OF EXCAVATION; IF'NEEDED1 APPROXIMALLTt TIME WHEN WORK WILL BEGIN < r�APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ l (Including removal of all obstruction;, materials; and debris;'backfillmg com ' paction and.placing permanent resurfacing and/or. replacing improvements) ' In consideration of. the .granting of this permit, the applicarif hereby agrees, to: - Indertinify,'clef end and save.the'City, its.authohzed 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 L 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 ;a La Quinta and to pay' for, any additional replacement necessary, as the'result of� this work. ' 'Signature of Applicant or Agent Ilk 4rnimnut r' :Capri" anis- .. nk ' Name of Applicant (please print) `` .Business Address Telephone No. Name of+Contractor and:Job Foreman Business Address Telephone.No. on , f ill ,Contractor's License No. City Business License No. , Jon file`ie - �A Applicant's' Insurance Company t . " Policy Number FEES:. Subdivisi.on'lmprovetment`Permit —:Class III Public improvements: 3% of estimated constructioncosts . 0 9 0 %v IV. VV Private improvements: 3% of estimated construction costs Minor Improvement Permit,— Class IV: See attached schedule N 0 r Inspection Fee ,$ " PERMIT VALIDATION • �h Permit Fee 10.00 DR9D PERMIT NO. Penalty Cash Deposit Surety Bond , DATE APPROVED- if required EXPIRATION DATE TOTAL: '$ 10.00 DATE ISSUED; m /9'/QD Receipt No.. ` BY Received by Date Administrative Authority' Recorded by TELEPHONE:.(619) 564-2246 L, t . ,�-r.q^,= s: sw► wr .a .s neee� .► .�...-.�. .c. �.ys+-�k•e.,.r��. a�. e�.w:. o,.:!w .r_� sem•-�+y �c .w .�,+.J�.s..... w.-w.:iw w.:�•.+i� ...�. � w...u. w., ....w .o.. oi. � rr NOTE: With proper validation this form constitutes an encroachment permit CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ONE TRIP OVERSIZE 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 SUBDIVISIONS DATE: RSr%v�tnhPr 1 f 1 Aon LOCATION OF CONSTRUCTION move equipment (Street address or Description of Location) PURPOSE OF CONSTRUCTION 966 loader 15'h', 916" wide, legal length and weight DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME. WHEN WORK WILL BEGIN Subdivision Improvement Permit — Class I I I Minor Improvement Permit Class IV Sketch (attach construction plans -if appropriate) 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: HAUL ROUTE: Nogales and Bermudas to Avenue 52 to Washington north to Hwy -111 Haul date: 11/3/90 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. Name of Applicant (please print) re of Appficant or Agent Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. t 3A 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 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 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date Recorded by —`00--t82 C�SEf�15 O L0I-90 ,V.vvv 1° 0n PERMIT VALIDATION PERMIT NO. 0890 DATE APPROVED 11/2/90 EXPIRATION DATE DATE ISSUED_ la/2/90 By Administrative Authority TELEPHONE: (619) NOTE: With proper validation i !7.777 this form constitutes an CITY OF 11.A QUINTA encroachment permit APPLICATION FOR, PERMIT PUBLIC. WORKS CONSTRUCTION (ENCROACHMENT) . oA TRIs� 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 111 DATE: 24z�:_R 9L9'r;; : ' Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESC IPT) ON OF ON RUCTION ` DAENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED Sketch (attach construction plans if appropriate) APPROXIMATE TIME WHEN WORK WILL BEGIN �-A APPROXIMATE TIME OF COMPLEl'It)N 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 124) hours In advance of the time when work will be started. I 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: SignatWa of Ap icant or Agent Name of Applicant/please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Te ephone No. Contractor's Licen,eCitNo.y Business License No. Applicant'sInsurance Company Policy Number FEES: Subdivision Improvement. Permit — Class I I I Public improvements: 3% of estimated construction costs ~" Private improvements: 3979 of estimated construction coots No Minor Improvement Permit — Class IV: See attached schedule ?" lv Inspection Fee $ } :' %` I PERMIT VALIDATION Permit Fee PERMIT NO. Cash Deposit -Surety Bond if required TQTA61 ' 91 : receipt tJo.• � , �, ` ��•. DATE APPROVED EXPIRATION DATE ©ATE I55U99 gy AdMinlssrolive Authtafity Recorded by — i II TELEPHQNE, (519) 504.2240