The URL can be used to link to this page

0640la , NOTE: With proper validation this form constitutes an encroachment permit CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) '#f I ,f f , 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: , �/ Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location�l�� PURPOSE OF CONSTRUCTION Ala Sketch (attach const uction plans if appropriate) DESCRIPTION OF CONSTRUCTION ��= DIMENSIO OF INSTALLATI OR REMOVAL 9P�'�' . O'd 6SIZE OF EXCAVATION, IF NEEDED. APPROXIMATE TIME WHEN WORK WILL BEGIN _ "A/ 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: 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. ,Ignyaturreejof Applicant or Agent of ApplicOt (please print) Telephone No'. Name of Contractor and Job Fob n Business Address epho No. Contractor's License City Business Lice se No. Applicant's InsuranceAompany Policy Number FEES: 'Subdivision Improvement Permit — Class III Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs 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 _ .. ._._ _ .-•r ,..... .� . _. �.� _ _ A PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TEMPHQNEI (919) 5944249 ?dV �.`_. y.�4....r. - w ei..-...i"r s.M.....•w, .....+v., r.....rv+.rr�....`n.•-- -w ..,.�,n--..� ..:..m-�.,,,F'.-�.+ti. -- .:.'C'p."tiwc: ^;""fir =-.�..#c-" .` `.awe.ss.ti'9�+•f=.=e.�e+"►c+"o.-�-a..-�r,.:.,.�va.-....�. • ,.�•ti ... , -.:...w. ............a.�.�..,�,:� ... Ka.,w� w •. r-o:.1�.�......a ..�... +�•�cw.,.� '...�, �......��... �.. ,... NOTE: 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 DATE ONE TRIP OVERSIZELOLOAD PERMIT MAY 10 1110 Subdivision Improvement Permit — Class II I Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION HAUL ROUTE MILES AVE TO WASHINGTON TO AVE 48 DIMENSION OF INSTALLATION OR REMOVAL CAT 623 B srAPER 14,h, 11,10-W 119, 138, LBS SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN MAX 16; 1990 APPROXIMATE TIME OF COMPLETION M.AY 16-. 1 990 ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) In coAsideration)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 oriproperty 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. • Sign ture of Applicant or Agerit NUEVO ENG N —( I EERING 79 811 'COUNTRY CLUB DR 345-1773 , Name of Applicant (please print) Business Address Telephone No. TRT1rWTNTr_ IS791 QT.n CARV1_A,r_•_Ta D u T?DDTVmmr Name of Contractor and Job. Foremen _ — Business Address V - Telephone No. 438834 y, 'Contractor's License No. City Business License No. FARMERS INSURANCE 600221517 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I I I 005if3" i0 4433 05-16-90 i0 Public improvements: 3% of estimated construction costs 10 FlSN i TOTAL i 10-00 Private, improvements: 3% of estimated construction costs �j OSA Minor Improvement Permit —,Class IV: See attached schedule *`� N2 `� Inspection Fee $ Permit Fee 10..00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 1.0-00 i. Receipt No: Received by Date Recorded by PERMIT VALIDATION PERMIT NO. -0640 DATE APPROVED 9/19/ 90 5/15/90 EXPIRATION DATE DATE-I'SiU E -E y Administrative. Authority TELEPHONE: (619) 564-2246 r1••�lgMVc•��'}'^1M.�aKwi•M�-."t�rr+^w'.si M ter• w � rrw� Mk �.. r.au. �'M cr rr .r '+�..y w ..1�. W r..wti � y r�'wwL. 'Ft .� w.J Y.-�► �.+..w r i. 7"a. V� M 14. "w Iw t rte. NOTE: 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 ONE TRIP OVERSIZELOLOAD PERMIT Subdivision Improvement Permit— Class III DATE: MAY 18 1�>p Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION HAUL ROUTE MILES AVE TO WASHINGTON TO AVE 48 DIMENSION OF INSTALLATION OR REMOVAL CAT 623 B SCAPER 14,h, 11,10 W 119, 138. LBS %. SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN MAY 16. 1.990 APPROXIMATE TIME OF COMPLETION MAY 16 ,. 19911 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 Quinta and to pay for any additional replacement necessary as the result of this work. G, f re of Applicant or Agent NUEVO ENGINEERING 79-811 COUNTRY CLUB DR' 345— Name of Applicant (please print) Business Address Telephone No. n-rf-,Nm-r TRTJCXZNra 39721 OT,T) rARRTAr-F Till MT1RRIE.TTA Name of Contractor and Job Foreman Business Address Telephone No. 438834 Contractor's License No. City Business License No. FARMERS INSURANCE 600221517 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 4 TOTAL: $ 10.00 Receipt No. Received by Date Recorded by c 5i8, HO i TOTAL �i &-90 io a 0010 N° 0640 PERMIT VALIDATION PERMIT NO. 0640 DATE APPROVED 5/16/ 90 5/16/90 EXPIRATION DATE 5464P, DATEfISS EU D-- yAdministrative Authority TELEPHONE: (619) 564-2246