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NOTE: ..
With proper, validation
this form constitutes an
encroachment permit
. t ,
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
DATE
May 17, '1990
LOCATION OF CONSTRUCTION move elipipment
.(Street address or Description of Location)
PURPOSE OF�CONSTRUCTION
DESCRIPTION OF CONSTRUCTION Cat 623B • scraper
14' h, 11110" w, 119138
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED • '
Subdivision, Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
HAUL ROUTE: -Hwy 111 to
Washington to Avenue 50 to Parr
APPROXIMATE TIME WHEN WORK WILL BEGIN 5/18/90 r
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
o-Indemnify,-defend and save the City, its authorized agents, officers, repr6sentatives 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
Nuevo Engineering 79-811 Country Club `D : Bermuda Dunes, CA
Name of Applicant (please print) Business Address Telephone No.
Piconi Trucking 39723.01d CArriage, Rd, Murrieta, CA
Name of Contractor and Job Foreman Business Address Telephone No.
438834 157
Contractor's License No. City Business License No.,
Farmers Ins. -Group 600221517
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III ,
Public improvements: 3% of estimated construction costs
0051'82 i4 4486 05�-17-90 10
Private improvements: 3% of estimated construction costso CA?6,14TA 1 10.00
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 PERMIT NO 0646
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
DATE APPROVED 5/17/90
EXPIRATION DATE /1 R lAn
DATE ISSUED/ 5/18/90
By
Administrative Authority
TELEPHONE: (619) 564-2246
K-1 - .-?-
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
May 17, 1990 Subdivision Improvement Permit — Class II l
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION -move edMipment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Cat 623E scraper
14' h, 11110" w, 119138
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL.BEGIN 5/18/90
HAUL ROUTE: Hwy 111 to
Washington to Avenue 50 to Park
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.
Signatureof Applicant or Agent
Nuevo Engineering 79-_811 Country ( - .1 . Bermuda Dunes, CA
Name of Applicant (please print) Business Address Telephone No.
Piconi Trucking 39723 Old CArriage, Rd, Murrieta, CA
Name of Contractor and Job Foreman Business Address Telephone No.
438834 157
Contractor's License No. City Business License No.
Farmers Ins. 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 $
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by
Recorded by
Date
0 51,8') i0QTR
r-i7-90 i0
i iMO
PERMIT VALIDATION
PERMIT NO. 0646
DATE APPROVED 5/17/90
EXPIRATION DATE 5/18/9(1
DATE ISSUED 5/18/90
Byf
Administrative Authority
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
9
DATE: I- l �-i
LOCATION OF,CONSTRUCTION
,r
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
-to
DIMENSION OF INSTALLATION OR REMOVAL SrkDfr
SIZE OF EXCAVATION, IF NEEDED
i
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:
Indemnify, -defend and save the City, its .authorized agents, officers,. representatives and employees,. harm less from and against any and all
penalties, liabilities or loss. resulting, from claims cr '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.
(
Subdivision Improvement Permit - Class 111
nn'' Minor Improvement Permit Class IV
_UCL -
Signature of Applicant or Agent
Name of Applicant (please printl .. Business. Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
t
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 : lr
Minor Improvement Permit - Classj�IV: See attached schedule '.
Inspection Fee $ I PERMIT VALIDATION
Permit Fee
Penalty
Cash Deposit -Surety Bond '
if required
TOTAL: $
.Receipt No.�
Received by Date
)
Recorded by L
PERMIT NO.
DATE APPROVED.
EXPIRATION DATE.
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246