0742I
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 III
DATE: 718-90 Minor Improvement Permit Class IV
LOCATION'OF CONSTRUCTION:�*g�_
-
(Street address or Description of Location)
PURPOSE.,OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION HAM ROMAVE 52 To
WASHINMN NORTH TO N
.�' I12II,ES
DIMENSION OF INSTALLATION OR REMOVAL 140ct BLADE
10'3' h181w 59850 lbs
SIZE OF;EXCAVATION; IF NEEDED
r ; APPROXIMATE TIME WHEN WORK WILL BEGIN. 7-18-90 !
i 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, liabilitier'or,,lbss 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 undertakenunderthe permit granted pursuant to this application.'
Notify the 'Administrative .Authority at least twenty-four (24Y hours in advance of the time when work will be started.
Comply with all applicable City Ordinances,'the terms and conditions of tAw permit a'd all applicable rules and regulations of .the City of
La Quinta and to pay for any additional replacement necessary as the result of his work.
Signatfrefof Applicant or'Agent
345-1778
Name of Applicant (please pint) Business Address' Telephone No.
`PICONI TRUCKING
Name of Contractor and Job Foreman - Business Address Telephone No.
.%
Contractor's License No. City Business License No.
CAL AG INSURANCETS009151
Applicant's Insurance Company Policy Number.
FEES: Subdivision Improvement Permit. -Class III ,
0051=8 ip 5861— 07—i9-90 i0
Public improvements: 3% of estimated construction costs 10 LASH i TOTAL .1. 1.0.00
Private improvements: 3% of estimated construction costs -R
Minor Improvement Permit.— Class IV: See attached schedule 0742
Inspection Fee $ PERMIT VALIDATION '
10.00
Permit Fee PFRnnIT Kiln .0742
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: :$ ] _ 00
Receipt No.
Received by Date'
Recorded by
DATE APPROVED 7-18-90
7-18-90
E.I•RATIO•N�DATE
Dc))
E ISSUE// 7-18-90
By-
( -N t„/ U-Pt-C—A v ( 1
TELEPHONE: (619) 564-2246.
lie,
1:r.6Ry:y�L:,iy�'�r?y-�a•Fcyrw.11fd�i'Ijr'py'!„1'..Vi.:.w �a r +i i.. -�i. r. r..i�,w —..r'w `w�.•.w �.. ,:w r -r of r m «. w• W -..w. -W. r-r.'rr.ii:: `ce .r ^•wvs--:www: a►.w .r.:.-r.-a�r`M.•w •w
M
yy. •
I yrs r
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
'encroachment permit
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: 718-90 Minor Improvement_ Permit Class IV
LOCATION OF CONSTRUCTION Clams —9 r��=
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTIONFjAj)j, ROUTE AVE 52 TD �G1C�1 NORTH TO N
NILES +
DIMENSION OF INSTALLATION OR'REMOVAL 140cr BLADE
1013' h181w 59850 lbs
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 7-18-90
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) 1
•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 talk 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 thisAv,ork.
Signatu/re%of Applicant or Agent
345-1778
Name of Applicant (please print) Business Adart ss Telephone No.
PICOW TRLXXM
Name of Contractor and Job Foreman .,Business Address Telephone No.
^322^_ .157.
Contractor's License No.
City Business License No.
M AG INSURANCE CTS009151"
'Applicant's Insurance Company Policy Number -r.
FEES: Subdivision Improvement Permit — Class I I
0�5i8 s 6AV � e•-90 io:o�i i0
Public improvements: 3% of estimated construction costs iU
Private improvements: 3% of estimated construction costs �y
Minor Improvement Permit — Class IV: See attached schedule N2 0742
Inspection Fee $ I PERMIT VALIDATION
10.00.
Permit ,Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
0742
PERMIT NO.
DATE APPROVED 7-18-90
7-18-90
EXPIRATION DATE
7-18-90
DATE ISSUED,,%=
By w i ,!� f
Adfninistrafi'G Authority
izij
TELEPHONE: (619) 564-2246
NOTE: ;� •
With;rope� validation
this o�m constitutes an CITY OF LA QUINTA
encroachment permit
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
DATE: -714q0 _
LOCATION OF CONSTRUCTION 02'.r S1 Z�
tStriet address or Oescription of Location)
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
D,MENSION OF IQS�TAI�I.ATION OR REMOV
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
.y
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:
*-0 WC,__ShA
()Ok tv� t -o K -1(e -S
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any end 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 f24) 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 as 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.
Name of Contractor and .fob Foreman Business Address Telephone No.
Contractor's lice a No. City Business License No.
a 1- esu ra,�e� i I
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 1�
Inspection Fee $ II PERMIT VALIDATION
Permit Fee
Penalty
Cash Deposit -Surety Bond
If required
TOTAL:
Receipt No.
Received by Date
Recorded by
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (6191564.2246