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05691 NOTE: With proper validation, SNthis form constitutes an encroachmentipermit _V _ " CITY OF LA QUINTA +r r APPLICATION FOR `PERMIT PUBLIC WORKS 'CONSTRUCTION (ENCROACHMENT) y 1, 7 • <, r For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains r and other like,public works improvements in connection with MINOR IMPROVEMENTS and'APPROVED SUBDIVISIONS April 10 1990 Subdivision 'Improvement Permit — Class III , DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 52nd Ave. between Jefferson and Washington, (Street address or Description of Location) ' PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION Oversize Load HAUL ROUTE: 52nd to WASHINGTON to MILES AVENUE DIMENSION OF INSTALLATION OR REMOVAL Farm Tractor REQUIRES TRAFFIC CONTRO: 14' W 2 Pilot Vehicles per California 'Vehicle Code SIZE OF EXCAVATION,'IF NEEDED REQUIRES COUNTY PERMIT APPROXIMATE TIME WHEN WORK WILL BEGIN 4/11/90 '.0-.-90-6 APPROXIMATE TIME OF COMPLETION 4/11/90 ESTIMATED CONSTRUCTION COST $• MOVE ON: April 11, 1990 .(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, y 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.4. ignature of Applicant 'or Agent CAL PERMITS INC. P.O. Box 9, San Bernardino,.CA (800),344-1911 Name of Applicant (please print) Business Address Telephone No. PICONI TRUCKING 33723 Old Carriage Rd., Murietta,, CA Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business License No. Farmers Insuiance•Group 600221517 Applicant's Insurance Company Policy Number e. FEES: Subdivision Improvement Permit — Class Public. improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs.0051?AL. i , 04 -i0 -y0 10 �I�Mtff (; 10.'00 Minor Improvement Permit — Class IV' See attached schedule �- Inspection Fee $ PERMIT VALIDATION f - Permit Fee $10.00 Penalty Cash Deposit -Surety Bond if .required TOTAL: $ $10.00 Receipt No. Received by Date Recorded.by • F 0569 PERMIT'NO: DATE APPROVED 4/10/90 EXPIRATION DATE 411/9n DATE ISSUED (�j ,4//10/90 Gc7er . Cotfey/Adm-inistrative Authority 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) 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 April 10, 1990 LOCATION OF CONSTRUCTION Subdivision Improvement Permit — Class I II Minor Improvement Permit Class IV 52nd Ave. between Jefferson and Washington (Street address or Description of Location)" PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION Oversize Load DIMENSION OF INSTALLATION OR REMOVAL Farm Tractor 14' W SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 4/11/90 Sketch (attach construction plans if appropriate) HAUL ROUTE: 52nd to WASHINGTON to MILES AVENUE REQUIRES TRAFFIC CONTRO: 2 Pilot Vehicles per California Vehicle Code REQUIRES COUNTY PERMIT 03-90-6 APPROXIMATE TIME OF COMPLETION 4/11/90 ESTIMATED CONSTRUCTION COST $ MOVE ON: (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: April 11, 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 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 LaQuinta and to pay for any additional replacement necessary as the result of this work. �//S"ignature of Applicant or Agent ;3 CAL PERMITS INC. P.O. Box 9, San Bernardino, CA (800)344-1911 Name of Applicant (please print) Business Address Telephone No. PICONI TRUCKING 3@723 Old Carriage Rd., Murietta, CA 'Name of Contractor'and Job Foreman Business Address Telephone No.. Contractor's License No. City Business License No. Farmers Insurance Group 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 Date Recorded by $10.00 $10.00 Al, °_��° o io.00 PERMIT VALIDATION 0569 - PERMIT. -NO.. DATE APPROVED 4/10/90 EXPIRATION DATE 4/11/90 DATE ISSUED /�4//10/90By f ,! er ry/'r�. CorreyAdministrative Authority TELEPHONE: (619) 564-2246 0 With proper validation. ; this form constitutes an CITY'OF LA .QUINTA encroachment permit ` - APPLicAT,10W FOR PERMIT;, f . PUBLIC.�WORKS CONSTRUCTION- :•(ENCROACHMENT)• 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 DATE: ell Minor I m:;prAvemerAt Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONST RUCTIONt DESCRIPTION _4���i 7 '.k7_,5LC_7 R DIMENSION L /41 1Z4-) - SIZE OF EXCAVATION, IF NEEDED Sketch (attach construction'plans if appropriate) APPROXIMATE TIME WHEN WORK WILL BEGIN ]•'�� L APPROXIMATE TIME OF COMPLETION ' ESTIMATED CONSTRUCTION COST $ (Inc! --ding removal of all obstruction, materials, and debris, backfilling, com ` paction.and placing permanent resurfacing and/or replacing improvements) In consideration of the granting ofthis permit, the. applicant hereby agrees to: Indemnify,defend and save the, 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 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 �3 l 7a<_3 oz_2�, /Y1b, l CrTIr.114 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. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class.( l l Public. improvements: 3% of estimated construction costs ' k Private improvements: 3% of estimated construction costs N O' Minor Improvement Permit — Class IV: See attached schedule . { Inspection Fee $ Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: ” $ Receipt No. Received by Date Recorded by < PERMIT VALIDATION PERMITNO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: (619) 564-2246•