0835NOTE:
With proper validation
this form constitutes ari 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 .
t
September 19, 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 fi23 B scraper Sketch (attach construction plans if appropriate)
141h. 101w. 119.138 lbs
DESCRIPTION.OF"CONSTRUCTION ` Haul Route: 1/4 mile east of
Washington. to Washington N to
. Ave. 48 C
DIMENSION OF INSTALLATION OR REMOVAL
Haul date:.9/19/90
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 Applicant or}Agenf•U J
Nuevo Engineering 79-811 Country Club, Bermuda Dunes, CA 345-1778
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
on file . rn . file .
Contractor's License No. City Business License No.
on file
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class 111 00,5181) & i1.T1 19 -90 10.00 0
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
NT 0835
PERMIT VALIDATION
PERMIT NO. 0835
DATE APPROVED 9/19/90.
y},
EXPIRATION DATE 9 /19 /90
DATE ISSUED—��, 9/19/90
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)
ONt 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 19, 1990 Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment
R (Street address or Description of Location)
PURPOSE OF CONSTRUCTION 623'B scraper
141h. 101w. 119.138 lbs
DESCR•IPTION;OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF. EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
Haul Route: 1/4 mile east of
Washington to Washington N to
Ave. 48
Haul date: 9/19/90
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 the result of this work.
Signature of Applicant or Agent!
Nuevo Engineering 79-811 Country Club, Bermuda Dunes, CA 345-1778
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foremari Business Address Telephone No.
on file m file
Contractor's License No. City Business License No.
on f ile
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
10.00
$ 10.00
Received by Date
Recorded by
17ii0T0 AL iig�$0 0.10P
0835 .
PERMIT VALIDATION
0835
PERMIT NO.
DATE APPROVED 9/19/90
EXPIRATION DATE 9/19/90
DATE ISSUED- / 9/19/90
By
Administrative Authority
TELEPHONE: (619) 564-2246
IOTE:
lith proper validation,
his form constitutes an
ncroachment 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 trains
and other like public works improvements in connection with MINOR IMPROVEMENTS and AP
PROVED SUBDIVISIONS
'Subdivision Improvement Permit — Class 111
SATE: �' � R ' D Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Oescriptionof Location) II
PURPOSE OF CONSTRUCTION—Q'lnl/ P.C(a 1(71mP0�T Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIIEKn�IQIO OF INSTALLATION, OR REMOVAL
I h� _ _ 40
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN f
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 imp`rovementsl
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, hirmlesi from and against any and all
penalties, liabilities or loss resulting from claims or. court action and arising out of any accident, lost 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 Quinta and to pay for any additional replacement necessary , es the result of this work. '
evo Engineering
of Applicant (please print)
Inc. .79-811
Signature of "Plidlant or Agent
Country Club, Bermuda Dunes 619-345-177E
Business Address Telephone No.
ame of Contractor and Job Foreman Business Address Telephone No.
6N FILE
ontractor's License No. City Business License No.
pplicant's Insurance Company .. Policy Number
EES: Subdivision Improvement Permit —Class 111
a
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Fee $
it Fee
nalty
sh Deposit -Surety Bond
required
TOTAL: $
pt No.
ived by
ecorded by
Date
N°
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By _
Administrative Authority
TELEPHONE:'(619) 564.2246
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