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NOTE:
With proper validation
this form constitutes an C /
encroachment permit CITY •OF LA QUINTA
' 'APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP OVERSIZE LOAD PERMIT,
r
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
September 18, 1990 Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment
(Street address or Description of Location) ,
PURPOSE OF CONSTRUCTION- D. bDozerl. Sketch (attach construction plans if appropriate)
11-10".w, 10' h, 75,00 lbs
DESCRIPTION OF CONSTRUCTION ; HAUL ROUTE:' HWY 111 and Washing,
to s/b: to Ave.. 48
DIMENSION OF INSTALLATION OR REMOVAL Haul date: 9/18/90'
SIZE OF�EXCAVATION,.IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE -TIME OF -COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal:of all obstruction;Finaterials, and debris,' backfilling, com-
paction and placing permanent resurfacing, and/or replacing 'improvements)
In '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-lois' resulting from claims or court action and arising out of any accident, loss or damageM1to 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, Ordiriances, 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.
" '9ignature of Applin t orl'Agent
Tliie��tn S.'nni nca•c+ri Tmr' 7Q—R1'1 .rn11n1•rxr . 0111h Rarmlltla n11"P.q . 345-1778
Name of Applicant (please print►,Business Address Telephone No.
Name of Contractor and Job•Foreman Business Address Telephone No. ..
on file'_ on file
Contractorrs. License No". City Business License No..,
on' file
Applicant's Insurance Company Policy Number i
FEES: Subdivision Improvement Permit — Class II l (�Q518 70 8-90 _ 10
Public improvements: 3% of estimated construction costs iU 1 �AH i1AL SO.QO
Private improvements: 3% of estimated construction costs
-0833
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond .
if required
TOTA L: $ 10,.0 0
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
• •
PERMIT NO. 0833
DATE APPROVED 9/18/90
EXPIRATION DATE 9/18/90
DATE ISSUED 9/18/90
By
Administrative Authority
TELEPHONE: (619) 564-2246.
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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
September 18, 1990 Subdivision Improvement Permit —Class 111
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION D 15Dozer Sketch (attach construction plans if appropriate)
.11-10"'W, 10'.'h, 75,00 lbs
DESCRIPTION OF CONSTRUCTION HAUL ROUTE: HWY 111 and Washir
to s/b to Ave. 48
DIMENSION OF INSTALLATION OR REMOVAL `Haul date: 9/18/90
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 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 of Appli6t or,Agent'
Ah+e+�tn Vnrrincit=rinrr 7A—R11 (701inf,^e, (']yah Riprmuda: Dunes 345-'1778
Name of Applicarit.(please pri
Business.Address
Telephone No.
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 Q ?(j(� %91- 8-94 p
Public improvements: 3% of estimated construction costs S:V �A N 1 i tf 0.00
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule' V��
Inspection Fee $
-Permit Fee 10.00
Penalty
Cash beposit-Surety Bond
if required
TOTAL: $ 10000
Receipt No:
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 0833
DATEAPPROVED 9/18/90
EXPIRATION DATE 9/18/90
DATE ISSUED % 9/16/90
By
Administrative Authority
TELEPHONE: (619) 564-2246
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NUEVO`ENGINEERING: INC:' y ..
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79-811',COUNTRY'CLUB DR., PH.- 619-345-1778
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1BERMUDA
DUNES. CA '92201
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PAY TOrTHE • -
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0369439!9'80
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THIS'CHECK.IS DELIVERED FOR PAYMENT ON THE ACCOUNTS SHOWN "OVE.
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TOTE:
lith proper validation
tis form constitutes an ;, CITY OF LA QUINTA
ncroachment 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
pp Subdivision Improvement Permit-- Class III
)ATE: l C� Minor Improvernent Permit Class IV
LOCATION OF CONSTRUCTION
'Street address or Description of Location)
)URPOSE OF CONSTRUCTION 00 2L Q J `� M�4 Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION `n (p �D DZ14,a-o 1, 2
DIMENSION OF INSTALLATION OR REMOVAL 1 l ��� N % � � 1JA 5 i, .,yl/� v
s/3 .� �1✓ �` .�
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 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 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 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 Ouinte and to pay for any additional replacement necessary as the result of .this work.
Sign u4 of Applicant or Agent
Nuevo En ineerin ,Inc. 79-811 Country Club Bermuda Dunes '.619-345-1778
ame of Applicant (please print) Business Address Telephone No.
of Contractor and Job Foreman
actor's License No.
_0-�N I
cant's Insurance Company
Business Address Tele hone No.
City Business 'cense No.
0
EES: 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
Policy Number
No
spection Fee $ PERMIT VALIDATION
ermit Fee i
PERMIT NO.
nalty
ash Deposit -Surety Bond DATE APPROVED,
required EXPIRATION DATE
TOTAL: $ `DATE ISSUED
eceipt No.
By
eceived by Date. Administrative Authority
ecorded by TELEPHONE: (619) 564-2246