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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
July 25, 1990 Subdivision Improvement Permit— Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 4iove equipment
5
(Sheet address or Description oflocation)
PURPOSE OF CONSTRUCTION Cat 623 B scraper
14 ki 12 w, 138 lbs gw
DESCRIPTION OF CONSTRUCTION
r -
DIMENSION OF INSTALLATION OR REMOVAL
Sketch (attach construction plans if appropriate)
HAUL ROUTE-: WASZ3GGTON AT FRED
WARING SOUTH TO Avenue 48
�.Q Si CASH i TOTAL? i 590 0.00�4
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 7/25/90 HAUL DATE:' 7/25/90
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)
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 thR_result of this work.
I
Signature of Applicant or Agent
Nuevo Engineering 79-811 Country Club Bermuda Dunes 345-1778
Name of Applicant (please print) Business Address Telephone No.
Johnson Trucking
Name of Contractor and Job Foreman Business Address Telephone No.
on. f ile
Contractor's License No.
on file
on f ile
City Business License No.
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:
Receipt No.
Received by
Recorded by
10.00
$ 10.00
Date
N2 0754
PERMIT VALIDATION
PERMIT NO. 0754
DATE APPROVED
7/25/90
EXPIRATION DATE 7/25/90
DATE ISSUED- i 7/25/90
By
Administrative Authority
TELEPHONE: (619) 564-2246
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.,
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
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
July 25, 1990 Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION wove equipment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Cat 623 B scraper
14 fit, 12 W j 138 lbs gW
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 7/25/90
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)
Sketch (attach construction plans if appropriate)
HAUL ROUTE: WASEZSGTON AT FRED
WARING SOUTH TO Avenue 48
In consideration of the granting of this permit, the applicant hereby agrees to:
1.%05JEF
0 s60i ITATT-25-90
719 9(I 0.00i4
HAUL DATE; 7/25/90
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 asth_result( offtthis
/work. - n
Signature of Applicant or Agent
Nuevo Engineering 79-811 Country Club Bermuda Dunes 345-1778
Name of Applicant (please print) Business Address Telephone No.
. Johnson Trucking
Name of Contractor and Job Foreman Business Address' Telephone No.
on file on file
Contractor's License No. City Business License No.
on file
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:
10.00
$ 10.00
Receipt No.
Received by Date
A 0754
PERMIT VALIDATION
PERMIT NO. 0754
DATE APPROVED 7/25/90
EXPIRATION DATE
7/25/90
DATE ISSUED- f 7/25/90
By
Administrative Authority
Recorded by II . TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form constitutes an
encroachment permit
i �•
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
U
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)
RIPTION OF
DIMENSION OF INSTALLATION OR REMOVAL ._
dLki'h
SIZE OF EXCAVATION, IF NEEDED � , G�- ,
APPROXIMATE TIME WHEN WORK WILL BEGIN _Z.L&
APPROXIMATE TIME OF COMPLETION—
ESTIMATED
OMPLETION ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and deb. is, 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 ell
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 env work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four 1241 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 pav 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.
ah nn
7-ru.C',
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
0S- _ col -
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:
Receipt No.
S
Received by Date
Recorded by
N°
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246