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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
• Subdivision Improvement Permit -Class II I
DATE: June -13,,-1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment
(Street address or Description of Location) r
_,PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
,
DESCRIPTION OF CONSTRUCTION' �_MnZer, 1'n `h 1 1 11 nif
75;000 lbs HAUL ROUTE:AVE.'. 52 to
WASHINGTON NORTH TO AVE.. 50
DIMENSION OF -INSTALLATION OR REMOVAL Eatt 1/4 mile
SIZE OF, EXCAVATION, 1 F NEEDED 4 Haul Dates 6/14/90
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, 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.
•
Signal
ture.of Applicant or Agerit UU J
Nuevo -Engineering Inc 79=811 Country Club Bermuda Dunes 345-1778
Name of Applicant (please print) Business"Address Telephone No.
`Piconi Trucking
Name of Contractor and Job Foreman . Business Address' Telephone No.'
438834 157
Contractor's License'No. _ , • City Business License No.
Scottsdale, Ins. •CT500915i
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III
Public improvements: 3% of estimated construction costs pp i T 51822 ii0 0g) 0— 3-90 i0
i��-;CA H OTAL 10.00
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached scheduleTo 0 6 99
Inspection. Fee $ PERMIT VALIDATION `
Permit Fee PERMIT NO. 0699
10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
DATE APPROVED , '6/13/90
EXPIRATION DATE 6/14/90
DATE ISSUED�- (� A 6/13/90
Administrative Authority
TELEPHONE: (619) 564-2246 .
u;
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NOTE:. ,
With proper4vilidation
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
Subdivision Improvement Permit — Class III
DATE: June 13, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment
(Street address or Description of Location) `
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION nti near 1 n h.- 1 1 11 AN
75,000 lbs HAUL ROUTE: AVE. 52 to
WASHINGTON NORTH TO AVE. 50
DIMENSION OF INSTALLATION OR REMOVAL Eatt 1/4 mile
SIZE OF EXCAVATION, IF NEEDED Haul Date: 6114/90
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, 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 Inc 79-811 Country Club Bermuda Dunes 345-1778
Name of Applicant (please print) Business Address Telephone No.
Piconi'Trucking
Name of Contractor and Job Foreman Business Address Telephone No.
438834 157
Contractor's License No. City Business License No.
Scottsdale, Ins. CT5009151
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costsSig A °� � �`� -13-90 a,Goio
Private improvements: 3% of estimated construction costs0699
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00
PERMIT NO. 0699
Penalty DATE APPROVED• 6/13/90
Cash Deposit -Surety Bond
if required EXPIRATION DATE 6/14/90
TOTAL: $ 10.00 6/13/90
DATE
EIISSSUE`D� /
Receipt No. By
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
DATE:
LOCATION OF CONSTRUCTION'rs
{Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
0MENSION Of INSTALLATION -QR REMV,AL _
�01 ' I I () (,) 5('�'lr) I h
SIZE OF EXCAVATION, IF NEEDED
Sketch (attach construction plans if appropriate)
Ra,wL
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, 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 rules 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
Nuevo Engineering, Inc. 79-_8_1.1 Country Club, Bermuda Dunes 619-345-1778
No a of Applicant (please print) Business Address Telephone No.
T
Name of Contractor and Job Foreman Business Address Telephone No.
�79?4 1si7
Contractor's License No. City Business License No.
Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111
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.
Received by Date
Recorded by
No (e99
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (6191564.2246