0645NOTE:
With proper validation
this form constitutes an
'encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS. 'CONSTRUCTION (ENCROACHMENT)
ONE TRIP OVERSIZE LOAD PERMIT
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
May 17, 1990
DATE:
LOCATION OF CONSTRUCTION move eauioment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION 7,80 Disc 161w, 5:"
40, 00tk lbs
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME WHEN WORK WILL BEGIN
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:
HAUL ROUTE:' Hwy -111 to
Washington'to Avenue 50 to Park
PILOT CARS WILL BE REQUIRED
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 andlall applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result ofthis wolrlkN,
ureojf Applicant or Agent
Name of Applicant (please print) Business Address Telephone No.
Pidoni Trucking 39723 Old Carriage Rd., Murrieta, CA
Name of Contractor and Job. Foreman Business Address Telephone No.
A'IRA'AA
Contractor's License No.
City Business License No.
Farmprc 'Tris - Crninn Cnn( 71 -,1'7
Applicant's Insurance Company' o Policy Number
FEES: Subdivision Improvement Permit — Class III 005182 J.01 44885—OTAL i _90 . ia.+�p 0
Public improvements: 3% of estimated construction costs
Private improvements: 3%.of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Free $
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond .
if required
TOTAL: $ 10.00.
Receipt No.
Received by Date
Recorded by
N° 064.5
PERMIT VALIDATION
PERMIT NO. 0645
DATE APPROVED S/17/qn
EXPIRATION DATE 5/18/90
DATE ISSUED -`_-5//l8/90
By
Administrative Authority
TELEPHONE: (619) 564-2246
r y
t
�..r?./iktiCr'--. _ � �ri-w.•+.. w w..r �.•a .r r. .,-.,. r .. w �..i. � t... err �i. -u..�w w ar..� r .w «c �r � .1 wr..:�... r �r ... .ri: N.'.r •.w +.� .. r w .i. w-�i+7
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit.,
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP .OVERSIZE LOAD PERMIT
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
4May 17, 1990
DATE:
LOCATION OF CONSTRUCTION move earui>,ment
Subdivision Improvement Permit —Class II I
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION X80 Disc 161w, "
40,001 lhs HAUL ROUTE: Hwy 111 to
Washington to Avenue 50 to Park
DIMENSION OF INSTALLATION OR REMOVAL
PILOT CARS WILL BE REQUIRED
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN R/1 0100
APPROXIMATETIME 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 andgall applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result o!`this work?
Signature of Applicant or Agent
Nuetro Fnai_nep.ri ncr -- - - - - 7A—R] 'I. �roiintry r1iih nr. Rprmvida ntanPs
Name of Applicant (please print) Business Address Telephone No.
Pidoni Trucking. 39723 Old Carriage Rd., Murrieta, CA
Name of Contractor and Job Foreman Business Address Telephone No.
438834 t57
Contractor's License No. City Business License No.
FarmarR Ins. Grouta 600221517
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111 0854241 H 48 L11 AI. f7 •9O a iQ. O0 O
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costsq
Minor Improvement Permit — Class 1V: See attached schedule 0645
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 0645
PERMIT NO.
Penalty
Cash Deposit -Surety Bond 'DATE APPROVED 5/17/90
if required EXPIRATION DATE 5/1$/90
TOTAL: $ 10.00 DATE ISSUED, 5/18/90
Receipt No. B�,(
Y
Received by Date - Administrative Authority
Recorded by _ 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
4 Subdivision Improvement Permit'— Class III
DATE: l Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION l'J�������2—� 0A
a
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DlIYENSION OF INSTALLATION OR REMOVAL
to WcL�KARq- � tc)
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION 'r _
ESTIMATED CONSTRUCTION COST $
(Including removal"of all obstruction, materials, and deb,is, 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 124) 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 niles and regulations of the City of
La Quints and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
mw o (ae:cr
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 III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs TO
Minor Improvement Permit — Class IV: See attached schedule NO*..
Inspection Fee,
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
$
Date
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246