0576NOTE:
With proper validation }
this form constitutes an
CITY OF LA QUINTA
encroachment permit, ,,- ,
APPLICATION FOR PERMIT,
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) . .
r
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: At)ril 12, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION OVERSIZE LOAD
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if.appropriate)
s.
DESCRIPTION OF CONSTRUCTION HAUL ROUTE: FRED WARING South
to AVENUE 52 - 1 Mile East on
AVENUE 52 -
DIMENSION OF INSTALLATION OR REMOVAL Cat 623 B Serapeer
I n I i, 12' w. 119 .x..38 lbs _CW_ - REQUIRES TRAFFIC CONTROL •
SIZE OF'EXCAVATION, IF NEEDED
y
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/13/90
A)OT loC
REQUIRES COUNTY PERMIT
U—J.yU�6'
APPROXIMATE TIME OF COMPLETION 4/13/90
ESTIMATED'GONSTRUCTION COST $ MOVE ON: April 113, 1990 i•
(Including reriioval of all obstruction, materials, and debris, backfilling, com-
paction
om 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.
' c
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
LajQuinta and to pay for any additional replacement necessary as the result of this work.
} Signature of Applicant or Agent ".
CAL . PERMITS INC': P.O. Box 799. San Bernardino, CA "(80011-344 1,911
Name of Applicant (please print) Business'Address Telephone No.
PICONI TROCKING 39723 Old Carriage Rd., Murrieta, CA'92362
Name of Contractor and Job Foreman Business Address Telephone No. `
Contractor's License No. r City Business License No. '
Farmers,Insurance Group 600221517`
Applicant's Insurance Company Policy Number
. t .
FEES: Subdivision Improvement Permit - Class III
Public improvements: 3% of estimated construction costsl0� l;A H 1 41 �T 4 1 2-90 J. �).DOio
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule o' 6
Inspection, Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
10.00
$ 10.00
Received by Date
Recorded by
PERMIT VALIDATION
s
PERMIT NO: 0576
DATE APPROVED 4/12/90
4/13/90
r EXPIRATION DATE
DATE,,I'SSUED ••4/12/90
By
`'. 6etry D. COf e(f,/d6Administrative Authority
TELEPHONE: (619) 564-2246
NOTE:
With proper.validation t 4 2
this form constitutes an.
encroachment permit CITY OF LA QU-INTA
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
Subdivision Improvement Permit — Class I
DATE: April 12, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION OVERSIZE LOAD
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION HAUL ROUTE: FRED WARING South
to AVENUE 52 - 1 Mile East on
AVENUE 52
DIMENSION OF INSTALLATION OR REMOVAL Cat 623 B Scraper r
n1eu. 12' w. 119,138 lbs GW REQUIRES TRAFFIC CONTROL:
-- --
SIZE. OF EXCAVATION, IF NEEDED V�]�.C�.6•-+C®d77VIZ/
1A�a
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/13/90 REQUIRES COUNTY ERMIT 9 _
0-190-6
APPROXIMATE TIME OF COMPLETION 4/13/90
ESTIMATED`CONSTRUCTION COST $ MOVE ON:. April 13, 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:
-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. '
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.
PICON1 TRECKING 39723 Old Carriage Rd., Murrieta, CA 92362
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 II 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.
10.00
10.00
Received by Date
Recorded by
25181A_1
8 341LT6A -12-90 .?).0()10
NAt�576
PERMIT VALIDATION
0576
PERMIT NO.
DATE APPROVED 4/12/90
4/13/90`
EXPIRATION DATE
DATE ISSUEDBy
,Jea�ry D. Coffey/d3Administrative Authority.
TELEPHONE: (619) 564-2246
'From the desk of"
Frank Reynolds
City Engineer (7
G� .
9