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0830NOTE: With proper validation 2 this form constitutes an CITY OF LA QUINTA encroachment' permit APPLICATION FOR PERMIT - PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)�� 'wSw�ti ONE TRIP OVtRSZZ'E LOAD 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 I I I DATE: 9/17/90 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION move . equipment (Street address or Description of Location) PURPOSE OF CONSTRUCTION 99ci rat- 1 n r ci" trr: Sketch (attach 'construction plans if appropriate) 1 r-,ncrt-h and hcni eThi- 1 omrxa1 _ rami rxhi- 109; _ Q00 DESCRIPTION OF CONSTRUCTION HAUL ROUTE: HWY 111 South on Washington to Ave. 50 cast DIMENSION OF INSTALLATION OR REMOVAL Haul date: 9/17/90 SIZE OF, -EXCAVATION, IF NEEDED APPRO;�I.MATE 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) fn 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 l.a Quinta and to pay for any additional replacement necessary as the result -of this work. i� -"Signature of Applicant or Agent Nuero Enaineerina 79-811 Country 01ub Bermuda Dunes Name of Applicant (please print) Business Address Telephone No. Pi ron& Tr*ckina Name of Contractor and Job Foreman Business Address Telephone No. nn file on file Contractor's License No. City Business, License No. on f ile Applicant's Insurance Company Policy Number 0051.82 10 7054 09-17-9" FEES: Subdivision Improvement Permit — Class I I I 1.0 CASH i T[ IAL ,1 .^.�; .. 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 1 n () 01 $ 10.00 Date 0930 PERMIT VALIDATION PERMIT NO: 0830 DATE APPROVED 9•/17/90 EXPIRATION DATE n/1 -710A DATE ISSUED , 9/17/90 By Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 ^�w+•Fr.•�+a1iw•R+ - - _ AK'k*"+.+++ r r r w • w: r — — — s — W r — r r w w — — — w: r. 7s... _ rww• ar ew w.... r w r ...T r ww ....r — w. M p. r w w .r 0-j f NOTE: With proper validation this form constitutes an encroachment permit CITY OF LA O,UINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ONL TRIP OVE'�,,ISZZE LOAD 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 9/17/90 Subdivision Improvement Permit — Class I II Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION move . ccjuipment (Street address or Description of Location) PURPOSE OF CONSTRUCTION 21�; r- t 1011"1n erg, lonrrt-h Jnr? hpiaht trrP.iahi- 105.000 DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN'WORK WILL BEGIN Sketch (attach construction plans if appropriate) APPROXIMATE TIME OF COMPLETION' ESTIMATED CONSTRUCTION COST $ ((Including removal 6f -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: HAUL ROUTE: HL^JY 111 south on Washington to Ave. 50 east Haul date: 9/17/90 I 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 -o. this work. ``Signature of Applicant or Agent Nuevo Enctineerinq '� 79-311 Country 01ub Bermuda Dunes Name of Applicant (please print) Business Address Telephone No. Piconm Tricking ` Name of Contractor and Job Foreman Business Address Telephone No. on file: �bn file Contractor's License No. City Business. License No. on file Applicant's Insurance Company Policy Number - FEES: Subdivision Improvement Permit— Class III 005181-1 I•© 7054 oy_1 lsr0 i0 LASq x TGfAL t 1.0100 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 10.00 Penalty Cash Deposit-Surety.Bond if required TOTAL: $ 1.0.00 Receipt No. Received by Date 093C PERMIT VALIDATION 0830 PERMIT NO. DATE APPROVED 9/17/90 EXPIRATION DATE 2/17/211) DATE ISSUED/,I 4/17/90 By Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 NOTE: With•properwaiidation-i- this form constitutes an encroachmenrpermit CITY OF LA QUINTA APPLICATION FOR PERMIT !B PUBLIC. WORKS CONSTRUCTION,: (ENCROACHMENT) For the construction, of public or `private curbs, driveways; pavements, sidewalks, parking lots, sewers,- and ewers,and other like public works, improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS-,, l 'Subdivision Improvement -Permit — Class ill DATE: l I / Minor Improvement Permit Clan.IV LOCATION OF CONSTRUCTION' S 0 (Street address or Description of Locitionit. .PURPOSE OF CONSTRUCTION T, /�x m e I/4 Sketch-lattach construction pians if approprwy pv> DESCRIPTION OF CONSTRUCTION fON OF INST DIMENSION CATION OR REMOVAL ��-7 SIZE OF EXCAVATION, IF NEEDED 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 end'employees, harmless from and against'sme end"all- penalties, liabilities or. loss resulting from claims or court action and arising out of any accident, loss or damage to persons or propst*y Is 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 Clty. of, La Quints and to pay for any additional replacement- necessary as the result of this work. Signature of Applicant or Agent d wCt,yaJ f NlJCGCJ LV Name of Applicant (please /pint) usiness Address Telephone.No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class Ill Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs NO Minor Improvement Permit - Class IV: See attached schedule . lr Insoectlon Fee S , PERMIT VALIDATION Permit Fee PERMIT NO. 5 Penalty DATE APPROVED .Cash Deposit -Surety Bond if required EXPIRATION DATE TOTAL: $ DATE ISSUED 'Receipt No. By Received by Date Administrative Authority Recorded by TELEPHONE:16191564-2246 .