0722i
NOTE:
Withro er validation
P p ,
this form constitutes an
encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT .
PUBLIC WORKS "CONSTRUCTION (ENCROACHMENT)
ONE'M�RIP 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
Y
June -25, 1990 Subdivision Improvement Permit —Class III
DATE: 4 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment Y .. '
(Street address or Description of.Location) t
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 16 h R1 aAa
1116" hr 101F"wr 81a5nn HAUL ROUTE: Avenue 52 north
to Washington to out of city
DIMENSION OF INSTALLATION OR REMOVAL limits
SIZE OF EXCAVATION, IF,NEEDED Haul. date: June 25, 1190
APPROXIMATE TIME.WHEN WORK WILL BEGIN
APPROXIMATE TIME OF -COMPLETION
ESTIMATED CONSTRUCTION COST $ 9
(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 resul of this woPk.
Signale of Applicant or Agent r'
Nuevo Engineering 79-811 Country Club nilg 3dc,-177A
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.
Cal Ag Ins. CTS 009151
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit— Class I I I QQ518 A ip 3 b—''5-90 t0
W SH NMI, � 10.00
Public improvements: 3% of estimated construction costs .
Private improvements: 3% of estimated construction costs y� t
Minor Improvement Permit — Class IV: See attached schedule 072.2
2
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ 10.000 ,
Received by Date
PERMIT VALIDATION
PERMIT NO. 0722
DATE APPROVED 6/25/90
EXPIRATION DATE 6/25/90
DATE ISSUE �. 6/25/90
By
"rAdministrative Authority
Recorded by II TELEPHONE: (619) 564-2246
��_ ,f..:.K�i r^'`•'wt r .-.4,M... .,_.... r.. t Y•.,t-'.-i "r . -"~1 ,v'~�3"-r�- „,{,,,W y.,�-+-••,•-�ti.,,a.y,:�.:T�^� ,�r.r...w: :.•.,.1„y--�..�q...ry 7. ..4 .. ::5 .�•^{.ta,
^.:�+a..rrir�. .� .. _- � 'r*'c!r'�.'''!Yr .i+ ww. r v w ww ow r+rw yn � .i.....a'.r w'w ti ... a. a.. r �. w ,w. a.w rt r wd'.�: �e ....:.:. a. w...-pi..w. r •..... r -w s•�....w..w--.► a
.1a
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: June 25, 1990
LOCATION OF CONSTRUCTION move equipment
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION ` 6 G. Wad -
1116"
ad -
1116° h, 1016"w. 83,5no
DIMENSION OF INSTALLATION OR REMOVAL
r°
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
HAUL ROUTE: Avenue 52 north
to Washington to out of city
limits
Haul -.date: June 25, 1&90
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of a ll. 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 worrrk.
Signa#'We of Applicant or Agent
Nuevo Ungineerincg 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.
Cal Ag Ins. CTS 009151
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III fc�Sii3L�ASH 33 Q� Q�— 5-90 OA pib
Public improvements: 3% of estimated construction costs 1 Jsti 1 U H
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
$ 10.000
a
Date
N2 0722
I
PERMIT VALIDATION .
PERMIT NO. 0722
DATE APPROVED 6/25/90
EXPIRATION DATE 6/25/90
DATE ISSUED-:.--,,/ 6/25/90
By—
'r Administrative Authority
TELEPHONE: (619) 564-2246