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NOTE:-
With
OTE:With proper validation: 2.n
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
F �
Subdivision Improvement Permit — Class I II
DATE: June l3 ; 1.990 Minor Improvement Permit Class IV
LOCATIbN'OF CONSTRUCTION mn��e� crni r�m�r��•
(Street address or DescF$tion of Location) '
,PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 623 B scraper
•14' h, 11'10'w', 119,138 lbs HAUL ROUTE: Hwy 111 and WashingtQr
South t6 Ave. 50 east -'1/4 mi1dl
DIMENSION OF INSTALLATION OWREMOVAL {�
' SIZE OF EXCAVATIQN; IF NEEDED
r,
APPROXIMATE TIME WHEN WORK WILL'BEGIN HAUL DATE: June 14, 1990
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)
i
In consideration' of the -granting of this permit, the applicant hereby agrees to:
t ,
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 Quinfa and to pay for. any additional replacement necessary as the result .of this work.
bw
} Signat re of Applicant or Agent Ls
Nueovo Engineering 79-811 Country Club Bermuda '345-1778
Name of Applicant (please print) Business Address Telephone No..
Piconi Trucking
.Name of Contractor and Job Foreman Business Address Telephone No..
I 438834 157 .
Contractor's License No. City Business License No.
Scottsdale Ins CT5009151 '
Applicant's Insurance Company Policy Number
FEES:, Subdivision Improvement Permit — Class I II
Public,improvements: 3% of estimated construction costs Si'f3� 0 3 fa=i3-90 ?o
Private improvements:l3%'of estimated construction costs ' ��OT")' i i4'f?r�
Minor Improvement Permit— Class IV: See attached schedule N2
0700
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 ���
PERMIT NO.
) 6/13/90
shPenalty
yDe
Caposit-Surety Bond DATE APPROVED '
if required EXPIRATION DATE 6/141/90
TOTAL: $ 10.00
DATE ISSUE/D
Receipt No. By
Received by Date - Y Administrative Authority
Recorded by TELEPHONE: (619) 564-2246 .
I!
Fes, i rr �
.�rGw�N+AHC'�V!�fS'111."fT!�C.M•.�J�C'M.+"`!..+tiw.fir. .Y. N .r y W. v w rw — v r r r Y 4 M w Y iii. q.a iYw Y W -fes W 0 _L M— Y--- M'Y�.�
NOTE:
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
DATE: Jung- . 13 . 1990
LOCATION OF CONSTRUCTION mnvn <arny i ntneani-
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
(Street address or Description of Location)
,4t
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 623 B scraper
14' h, 11110"w, 119,138 lbs
DIMENSION OF INSTALLATION OR REMOVAL
t ,
SIZE OF EXCAVATION, IF NEEDED
I
HAUL ROUTE: Hwy 111a Washington
south to Ave. 50 east, /4 milO
' a
APPROXIMATE TIME WHEN WORK WILL-BNEGIN HAUL DATE: June 14, 1990
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, ~materials, and debris, backfilling, com-
paction and placirig,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.
j'
,Notify the Administrative Authority -at least twenty-four (240hours 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
Nueovo Engineering 79-811 Country Club Bermud nes N-345--1778
Name of Applicant (please print) Business Address Telephone No.
Piconi.Trucking t
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 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
Recorded by
10.00
$ 10.00 t,
Date
0{51,31) �O�OTA�Ti 90 iaAOto
N' 070€
PERMIT VALIDATION
PERMIT NO. 0700
DATE APPROVED 6/13'/90
EXPIRATION DATE 6/141/90
DATE ISSUEDW,1
B
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE:
VCtA proper validation
this form coiastitutes an
encrdchment permit
4
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For 4the 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: �L' I - Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DEgCjjIfTIONpF�1 ONSTRUCTION ir0 214161. -�
DIMENSION OF INSTALLATION OR REMOVAL _
SIZE OF EXCAVATION, IF NEEDED
Sketch (attach construction plans if appropriate)
aoJ
00 n
�D"cam-it-1
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 authoii:ed agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities or loss resulting from claims or court action andarising 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 O.uinta 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 619-345-1778
Na a of Applicant Ip ease print) Business Address Telephone No.
Name of Contractor and Job Foreman
Contractor's License No.
Business Address Telephone No.
City Business License No.
Applicant's 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
N? 7.0 0
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 664-2246