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0706.� mo+�' . . With proper validation this form � ' K�|T� �� ^ K��^ encroachment � ' - � _ �Q�� ^ APPLICATION. FOR PERMIT...' � - ' mains and cthoi|ikepublic-works improvomon1o'inconnection with MINOR |MpROVENENTSevdAPPROVED SUBDIVISIONS . . Subdivision Improvement Permit - Class |U ' DATE' Minor Improvement Permit [xaa |V ' '--_--�--r-- LOCATION OF CONSTRUCTION ' (St�eet address or Description of Location)' .PURPOSE OF CONSTRUCTION Sketch (attach, construction plans if. appropriate) DESCRIPTION OF CONSTRUCTION ON WASHINGTON' TO' -AVE 52 EAST -DIMENSION ~. ..~..^^...~.,~..^..,.^ SIZE O IF NEEDED . . APPROXIMATE TIME WHEN WORK WILL BEGI.N APPROXIMATE TIME OF COMPLETION^ ESTIMATED CONSTRUCTION COST$ ' (|mdud!ngremoval nfall obstruction, materials" and debris, backfilling, com- paction and placing permanent resurfacing and/o, replacing improvements) In oonoidomdon'of-tho gmntingof d`io permit, the applicant hereby agrees tn�� ' ' . . |nuemnxv uomnu and save the City, its authorized agents, vffmom' representatives and against any and i penalties, liabilities or loss resulting from claims or.coUrt action and arising out of any accident, loss or damage to persons or property ' xeonon/no or vourri6oa,v proximate'result of any work undertaken umno, thenonn/t granted nur svant to this unn/icatmn. Nmi%/uoAdministrative Xvmo,in'ut/eumm"nm�vu,(u4)xovminadvance- oxmoomowhen work ~x/uomo�eu. Comply with �i.onnxco '/n, Ordinances, mv*mvno and conditionsapplicable rules and.regulations of the City of La oui,ta and to nay for any additional replacement necessary as the. � ' ^ _ - mofAppioantorAQentr . . 0UEVO ENGINEERING INC 79-'811 COUNTRY qL B8RMDDA'lJU0ES`345�1778' ' Name ofApplicant (please print) ' ' -Businoo Address � � Telephone No. Name of Contractor and Job Foreman- Business Address Telephone,No. City Busi ss Li - rise No. Applicant's Insurance Company Policy. Number FEES: . Subdivision Improvernerft Permit Oub|iuimpnovemema: 3&ofestimated oonm,uitioncosts Private improvements: 3&ofootimat�eclconstruction costs Minor Improvement Permit --Class |V' S.00utt*ohod. schedule Inspection Fee $ Permit Fee 1 n. nn n-"a, _~ CadhDeposit-Surety Bond if requiTOTAred ` $ ^ Receipt No. Received by ' �Date Recorded by 4� `�.T'g.- 0706 70~ PERMIT / DAT|O0'PWBLUC WORKS, CONSTRUCTION. (ENCROACHMENT),_ construction of public o, private curbs, driveways, pavements,sidewalks, :parking lots, sewers, water ote ~ � � � � PERMIT NO. ' � DATE APPHOVE EXPIR—AII.ON DATE '6-18-90 DATE ISSUED^ Administrative Authority � 'TELEPHONE': (619) ._...1°*.._: +..,» 'i _-"I, i`s"jra,,,-`^Vi—.��....d�.S.—...•.I . d";.: A--`r'`Fi'v%rp;(v `i .4�#'. •.a%.'i. �'.�, `. -iGr .'� —.r.= ��/.�C-•:oa�4o�-r++!�^Yi'•i'�;5'9�!>~``47F !n..r+ �i. r. �+ +.-w rw w ,r r �r ir�a.. �i+.. w �. +w -+. �►r. r �. W r .:. w•an rf�.,. s p..'w �.-ve�w w w� r.w .�i..wr.r n:-w.-w� m 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 Subdivision Improvement Permit — Class II I DATE: A— Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION — ONTEuc=IM T^ A (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 6170 9rAAP7R HAUL ROUTEIDNHWY 111 1]RS 8 H 144325 OUTH ON -WASHINGTON TO AVE 52 EAST DIMENSION OF INSTALLATION OR REMOVAL /4 MILE SIZE OF EXCAVATION, IF NEEDED 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 e�.f. enalties, liabilities or loss resulting from claims or court action and arising out of an accident, loss or dama a to ersons or ex P 9 9 Y 9 p, 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. NUEVO ENGINEERING INC 79— 811 COUNTRY Name of Applicant (please print) WJ/ hure of Applicant or,Agent, �B BERMUDA DUNES'345-1778. Business Address Telephone No. KEMMES LOWBEB Name of Contractor and Job Foreman Business Address Telephone. No. 4I R A nn4�n r, 7:tz47AA-40...QA 14 Contractor's License No. City Business LicenselN1o. T 7RI_ 10.00 DAGGET ASSOCIATES BA2462157-57-02 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: $ 10 - on Receipt No. Received by Date Recorded by � � 0706 PERMIT VALIDATION PERMIT NO. n7nti DATE APPROVE6-18'90 EXPIRATION DATE 6-18-90 DATE ISSUED /6-18-90 By Administrative Authority TELEPHONE: (619) 564-2246 NOTE," With proper validation tali form constitutes an encroachment permit • is 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 Subdivision Improvement Permit — Class III DATE: �� ^ —I Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) OF DIMENSION OF INSTALLATION OR REMOVAL _ SIZE OF EXCAVATION, IF NEEDED 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: ROO /qryfi le - 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 es the result of this work. Signature of Applicant or Agent Nuevo Engineering, Inc. 79-811 Country Club, Bermuda Dunes .619-345-1778 Name of Applicant (please print) Business Address Telephone No. em Ynl s. Name of Contractor and Job Foreman Business Address Telephone No. L4 jsr7 Contractor's License No. City Business License'No. Da- C,),o0iSaaLI (ea) —7 - 5-7-0a 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 NO Minor Improvement Permit — Class IV: See attached schedule lrO Inspection Fee $ I PERMIT VALIDATION Permit Fee PERMIT NO. Penalty DATE APPROVED Cash Deposit -Surety Bond � If required EXPIRATION DATE TOTAL: $ DATE ISSUED Receipt No. By Received by Date - Administrative Authority Recorded by TELEPHONE: (619) 564-2246