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NOTE:
With proper validation"
this form constitutes ian
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP OVERSIZE LOAD PERMIT
i
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
June 25 .1990
DATE: {, i f Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment
j
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
824 C Vozer is y •
DESCRIPTION F CONST"� C
wide, (43 n, y i, i�UN HAUL ROUTE: Ave. 52 to
Washington North to Miles north
to Fred Waring
DIMENSION OF INSTALLATION OR REMOVAL
HAUL DATE: June 25, 1990
SIZE'OFEX6, AVATION, IF NEEDED PILOT CAR REQUIRED
'APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
1 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 C yiits 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 CiiyAQrdinances, 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 bf this wo k.
Signature ;f�Applicant or Agent
Nuevo Engineering 79-811 Country Club. Bermuda Dunes.'CA619 345-1778
Name of Applicant (please print) Business Address Telephone No.
Piconi Trucking
Name of Contractor and Job Foreman Business Address Telephone No.
438839 157
Contractor's License No. City Business License No.
Cal Ag Ins. CTS 009151
L
Appjicant's Insurance Company Policy Number
# 10 CASH i TOTAL i -yv i0.00
10
FEES: Subdivision Improvement Permit —Class .11 I
! Public improvements: 3% of estimated construction costs
f
Private improvements: 3% of estimated construction costs`
Minor Improvement Permit — Class IV: See attached schedule N 07
18
Inspection Fee $
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required .
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 0718
DATE APPROVED 6/25/90
EXPIRATION DATE • 6/25/90
DATE ISSUED 6/25/90
By—
Administrative Authority
TELEPHONE: (619) 564-2246
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,�y'
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t
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NOTE:
With proper validation 2
this form constitutes an
} ,CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
8
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)��
ONE TRIP OVERSIZE LOAD PERMIT UFT[��
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 25, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION — move equipment
(Streetaddress or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTIONIOF CONSTRUCTION 824 C Dozer 1.3
wide, 3 h, 97,000; HAUL ROUTE: Ave. 52 to
Washington North to Miles north
DIMENSION OF INSTALLATION OR REMOVAL to Fred Waring
HAUL DATE: June 25, 1990
SIZE OF EXCAVATION, IF NEEDED
PILOT CAR REQUIRED
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�o i Applicant or Agent-
mi,g%rn Rnainpprincx 79 -All country Club, Bermuda Dunes, CA619 345-1778
Name of Applicant (please print) V 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.
Cal Ag Ins. CTS 009151
Applicant's Insurance Company Policy Number '
—�o—�v i0
FEES: Subdivision Improvement Permit —Class 111 10 CASH 1 T01 L i. 10x00 '
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs q`o pp
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
1.0.00
$ 10.00
Date
PERMIT VALIDATION
PERMIT NO.
0718
6/25/90
DATE APPROVED
6/25/90
EXPIRATION DATE
6/25/90�
DATE ISSUE
By
'
Administrative Authority
TELEPHONE: (619) 564-2246