0720"S�y-� t-� T+:�'"�` "'ozf'�+ ' {°>��� �'�`�'�.,T� �"'�,r+�'i yrj'��'��'� � • �v'i"'7°ti�`�'�(� �� �"`�`;t ��,
NOTE
With proper validation 2
this form constitutes an
CITY OF LA QUINTA
encroachment permit
'
APPLICATION FOR :PERMIT - -
PUBLIC WORKS CONSTRUCTION JENCROACHMENT)
i
OF
ONE TRIP,", 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 ana APPROVED SUBDIVISIONS
Subdivision Improvement Permitf— Class l'l l
DATE: June 25, 1990 Minor Improvement Permit Class.IV
LOCATION OF CONSTRUCTION mOVO e2q1*213tt
(Street_ address or Description of Location)
PURPOSE OF CONSTRUCTION y` Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 623 B Scraper
1 1A 1 -hs _ HAUL ROUTE: AVE; 5 2 ' to
Washington north to out of city
DIMENSION OF INSTALLATION OR REMOVAL limits
SIZE OF EXCAVATION, IF. NEEDEDHaul date:' June 25, 1990
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE -TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST$
(Including removal of all obstruction; materials, and debris, backfilling, corm `.
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,'xepresentafiGes 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 grarited 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 resul of this 'Tor .
Signature ofl Applicant or'Agent '
»t,Pro 'Fnaineerina 79=811 Country Club, Bermuda Dunes. '.345-1778
Name of Applicant (please print), Business Address! Telephone No.
Pinoni T uckina
Name of Contractor and Job Foreman Business Address, 'Telephone No;
438834 157.'
Contractor's License No. City Busiriessticense No. ".
Cal Aa Tns. CTS 009151
Applicant's, Insurance Company Policy Number
FEES:' Subdivision Improvement Permit— Class III 005182 0 5327 06-25-90 i 10
10 CAS 1 TOTAL,i 10:,00
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule Yc.To 0720
Inspection Fee $ PERMIT VALIDATION
10.00
wPermit, Fee PERMIT NO. 0720
Penalty- • //
Cash Deposit -Surety Bond PATE APPROVp25/:90
if required Sf ` EXPIRATION'DATE 6/25/90
TOTAL: $ 10.00
DAITE`ISSUED• i 6/25/90
aa�
Receipt No.
By .
Received by Date Administrative Authority
Recorded by'- TELEPHONE: (619) 564-2246
r�,:r�f3..r,,r�'^�-M'�'`"".4. �w-._••r�..>~'►-��ty,"63`:.�.s$'r��`,�.r:f.�t�.v.�•,,:�..int"'�=""=--=if*ti�.v?°Yj:r�..,.�-r.':r'-�,,'".,;"''..�y r. `,w �:�.rk, ..ri`�1s. �..i` ��r.,:�,
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�t
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP OVERSIZE 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: June 25, 1990
LOCATION OF CONSTRUCTION move eggpu>p metit
Subdivision Improvement Permit —Class I II
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 623 B Scraper
1AIu 11110" 1190138 lbs HAUL ROUTE: AVE. 52 to
Washington north to out Of city
DIMENSION OF INSTALLATION OR REMOVAL limits
SIZE OF EXCAVATION, IF NEEDED Haul date: June 25, 1990
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 ofI Applicant or Agent
Nuevo Enaineering 79-•811 Country Club, Bermuda Dunes 345-1778
Name of Applicant (please print) Business Address Telephone No.
Pi -coni Trucking
Name of Contractor and Job Foreman Business Address Telephone No.
438834 157
Contractor's License No. City Business License No.
Cal Act Ins. CTS 009151
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class 111 00516? ,0 5307 06--25-90 i0
10 I .AS i 1r(37AL i 14.00
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
10.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
$ 10.00
Date
N! 0720
PERMIT VALIDATION
PERMIT NO. // 0720
DATE APPROJ� 25/90
EXPIRATION DATE 6/25/90
DATE ISSUED' ' 6/25/90
By
Administrative Authority
TELEPHONE: (619) 564-2246