0577NOTE: rs
With proper validation
this form constitutes an
encroachment permit CITY OF 'LA QUINTA
' 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 II I
DATE: Abri 1. 12,. 1990 Minor Improvement Permit Class1V
LOCATION OF CONSTRUCTION OVERSIZE LOAD
r
(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 rAT 1 hti Al adc,
121 w. 11'9., 1384 GW REQUIRES 92AFFIC CONTROL:
SIZE OF EXCAVATION, IF NEEDED V>ti.hkele ^ede
APPROXIMATE TIME WHEN WORK WILL BEGIN 4 /13/90 REQUIRES COUNT PERMIT 3 a
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:
1
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all 4�
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. r
Si nature of Applicant or Agent
CAT, PERMTTS TNC_ P.O. Box 799., San Bernardino, CA, 1800) 344-1911,.
Name of Applicant (please print) Busiriess Address Telephone No.
. PICONI TRUCKING 39723 .Old Carriage Rd., Murrietta,,CA
Name of Contractor and Job Foreman,,r Business Address Telephone'No.
Contractor's License No. City Business License No.
Farmers Insuuance Group 600221517
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit— Class I I I
Public improvements: 3% of estimated construction costs 005i.8 10 344 04 -•i? -9i 0 10
Private improvements: 3% of estimated construction costs i0o ASH i TOTAL i i.10.00
Minor Improvement Permit — Class IV: See attached schedule,. O
577
Inspection Fee $
10.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00,
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 0577
DATE APPROVED 4/12/90
EXPIRATION DATE 411 3i99
o T�
DAT ISSUED r 4/12/90
klev
v
(/Jerry D � C fey/&dministrative Authority
TELEPHONE: (619)(564-2246
NOTE:
With proper validation
this form constitutes an
encroachment permit
.�,_," r.. o.. r..q" w.: c -an^.a
CITY OF LA QUINTA
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: 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 166 )Made
`. 1 Q 1 C" H; 12' W. 119, 1384 GW REQUIRES TZAFFIC CONTROL:
r 2aP.ae oxnia
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/13/90 REQUIRES COUNT PE ' 1.3 /9 Z)
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:
Indemnify', -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and4l,_
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 appli'cati'on.
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.
PICONI TRUCKING 39723 Old Carriage Rd., Murrietta, CA
Name of Contractor and Job Foreman . Business Address Telephone No.
Contractor's License No. City Business License No
Farmers Insuvance 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 $
10.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No
Received by
Recorded by
Date
45i8�U 4 T4�TAL4.ii2_'i0.00'0
,'3E� iUsUfi i0
577
.. J
PERMIT VALIDATION
0577
PERMIT NO.
DATE APPROVED 4/12/90
EXPIRATION DATE A/7 -A IQn
DATE ISS/UED/ 4/12/90
Jerry D 'Cof�ey/dAdministrative Authority
(-
TELEPHONE: (619) 564-2246