0570NOTE:
With proper validation
this form constitutes an
encroachment permit
Y
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
April 10, 1990 Subdivision Improvement Permit — Class III
DATE: i Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 52nd Ave. between JEFFERSON AND Washington
(Street address or Description of Location)
r .
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 623S,L_r=�Gr REQUIRES TRAFFIC CONTROL:
14' H, 12' W >. 2 Pilot vehicles per California
v Vehicle Code
SIZE OF EXCAVATION, IF NEEDED 4
REQUIRES COUNTY PERMIT
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/1111/90 0-190-6
APPROXIMATE TIME'OF COMPLETION A 96 MOVE ON: April 11, 199.0
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.Ouinta and to pay for any additional replacement necessary as the result
`offtthis
�work.
Signature of Applicant or Agent
CAL PERMITS INC. P.O. .Box 799r', San Bernardino, CA (800) 344-1911,
Name of Applicant (please print) Business Address. Telephone No.
PICONI TRUCKING 39723 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 III
i0
i0.00
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 '
Recorded by
Date
0 SiCA H i OTAL 10-y0
0 570
PERMIT VALIDATION -
PERMIT NO. 0570
DATE APPROVEDaT4: n
EXPIRATION DATE 4/11/90
DATE ISSUED 4/10/90 '
Ce6wr �D . Cof f e
�/ 6r v GA(dmi'nistrative Authority
TELEPHONE: (619) 564-2246
y; dA. w mi X1.3. i� ie �r. i►....:.. ' „_.. a� .W.' d. r.lr. vp•m .�_ _ _. .._ ' .r:.r -_ ---
NOTE:
_
NOTES
"With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
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
April 10, 1990 y Subdivision Improvement Permit — Class I I I
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
DIME ISI �N OF 11ST ALLATION OR REMOVAL r, 23 enra»ter
v
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/10/90
REQUIRES TRAFFIC CONTROL:
2 Pilot vehicles per California
Vehicle Code
REQUIRES COUNTY PERMIT
0-190-6
,.APPROXIMATE TIME OF COMPLETION A /1 /n n MOVE ON: April 11, 1990
ESTIMATED CONSTRUCTION COST $ _ J
(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: '
r
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.
L. ---
,,Signature of Applicant or Agent
CAL PERMITS INC. P.O. Box 799; San Bernardino, CA (800) 344-1911
Name of Applicant (please print) Business Address. Telephone No.
PICONT TRUCKING 39723 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
o5iV_ n 3392 04-0-90 t0
Public improvements: 3% of estimated construction costs $ CAR i TUTAL. i io+ oo
Private improvements: 3% of estimated construction costs leo 0
70
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee $10.00 0570
PERMIT NO.
Penalty •
Cash Deposit -Surety Bond DATE APPROVED A /7 n /q(1
if required EXPIRATION DATE 4/11/90
TOTAL: $ $10.00 y DATE—ISSUED 4/10/90 J
Receipt No. j B ( / A
Received by Date L7erry /ll. corxey-`�A"dministrative Authority
Recorded by TELEPHONE: (619) 564-2246
NOTE:. .
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit r
"APPLICATION FOR PERMIT 83
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
y _
Forthe construction of public or private curbs, driveways, pavements, ".sidewalks, parking lots, sewers, water mains
and other like public works improvements in'connection witti.MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision.lmprovement Permit — Class III
DATE: t J ' Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
_(Street address or Description of Location) t
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIP� /'L JL
DIMENSION1=A�1
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, co^—
f
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 an•d'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. ,t`'
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. r
r
Signature of Applicant or Agent
i e_�o A,) l / e lJCK!/i C- -I 3.1 7 2.. 3 ®G` i7
ame 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 III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs NO
Minor Improvement Permit — Class IV: See attached schedule
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