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08367 41C NOTE: � r .-_�� 71�' Ya. 1. � r - ' • r� N. r I . �.'^ +.. � �T ' r `•.' / • With proper validation ,_ _ •,• • ^' . . + , •�,,'� _ forrri.constitu e's'any .CITY 'OF LAxQUINTA O r ,encroachment permit ', r h ,'APPLICATION, •FOR='PERMIT.93 ° $ . �.: 4 .• ` . PUBLIC WORKS' CONSTRUCTION ;(ENCROACHMENT)��Sw�� ONE TRIP.,OVERSIZE LOMPERMIT For',c theonstruction' of • public' or 'private 'curbs, driveways; •pavements,.;sidewalk's,r parking lots, sewers, water mains - .._}'randlother like'•public works improvements in connection with MINOR-IMPROVEMENTS and APPROVED SUBDIVISIONS + + W. r - F '`' •. �' r" <' , �'�a, Subdivision. Improvement Permit — Class Ill DATE: w�'-Ot@mbC'r .`'19 1990` •� t , Minor Improvement Permit Class 'IV • +• LOCATION .OF CONSTRUCTION' MOve x'eou pine`n f (Street x�address or Description of Location) . ,PURPOSE°OF'CONSTRUCTION A -4 'F4'•"4r+rranA,r r ' �Sketch=(attach construction plans if.appro_phate) A $ t; 7 n i �:�' 19 cap 1 'i €2,•L h�` DESCRIPTION OF CONSTRUCTION y � � ' . ` ;Y, r .• Haul Route. : Madison and Airport x• _ , . =rrr '•. 'N ;to' .Ave. 54, W"to Jefferson,N to' t DIMENSION •OF INSTALLATION OR REMOVAL'. .s hv.e:. , 52, ,19 to, Nas1Angt6n 'N,rto Ave. 487 Hauldate• T9/19/90 SIZE OF:EXCAVATIONJF NEEDED,""• '~ '' " ,APPROXIMATE TIME WHEN WORK WILL BEGIN •' ETI ME1OF COMPLETION` $ ESTIMATED CONSTRUCTION COST \ (Including removal-of all obstruction;-mat6rials, and debris, backfilling, com ;• , . - , ' paction,,�and placing permanent resurfacing and/or'replacing improvements) Inconsideration of the ,granting of �this'permit, the. applicant,hereby agrees.to: ,Indemnify,.defend,and;save the City; it`s 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 on 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;alhapplicable„City Ordinances, the terms and conditions of the permit and.all,applicable'rules'and `regulations of the City of Li Quiri `and to pay for, any additional replacement necessary, as'the result"of this work: ` ti -'T �. ' y 's,. Signature of 'Applicant ortAgerit • ` �+ _ ! 5 r `,'' i�up-vo 'Enairieerinca - 79-81'1`•+Country Club : Bermuda, Dunes 345-1778 Name of Applicant -(please print) " ,”. Business Address ;Telephone No. Name of Contractor and Job Foreman +: f�'k 'Business Address-'.• Telephone No. , _ Vn • file `' •• f _ •,,.. Y 1 - M,I�J.`' r '"R:' p �. _ . on ••Elle •' Contractor's License No.. ' " ' r (' ` . �" , , ` City Business LicensJet No. , °. ; Applicant's:lnsurince Company .'R ;.' A � Policy Number . . •� _, - c.. �t, • - 'fit. - �: FEES-, Subdivision Improvement'Permit• _Class•III "' _'.'• ` - '00 i8 ��pp�� li©�'pq-19-90 10 s Publ c improvements: 3% of estimated construction costs - r► i� A H' 4, 701"AL i 10.00 Private improvements: 3% of estimated•construction costs; f �. Minor ImproJement,Permit _ Class IV: See attached schedule r R�ATQY ! 0 0 3°6 Inspection.Fee : $ - PERMIT VALIDATION v { 10 a 00 + •0836 Permit Fee PERMIT NO. _ Penalty Cash Deposit Surety Bond ' ~ ', ��: DATE APPROVED 9 19 19 if required'EXPIRATION DATE' 9/19/90' TOTAL: $ 1'� f)fl .. a .. 9/19%90 DATE ISSUED �� Receipt No. • By - •,. ► , �' Administrative Authority Received by Date `Recorded by • TE•LEPHONE: (619) 564-2246 d.S:..• �•.s,ca '�� �,- � ..:/..+�%'-•-'i�')`y 1:;j•$ <-�t.,,�.::.«.� ..:aye,.. i�:aJ;::.,, .., ", ,.-I '.y;:::?�x..ti:-�,;�.., ;.:,u •jt1R.,y',�.:�:`ir,a'+ 3 r _ 'H!'Y�s:+ gip.. (.,�.�.Y.•.4. 4r Y•-', .. r.W Gi �i"cia .fY•ryi .Y: 4n.ww'J`Y� V w w w �Q, O. r �. d M��..w r wiu v NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ONE TRIP OVERSIZE LOM PER141T For the co,n,struction 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 (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) lAIh 101tr 1111 1 �.R•.11;G DESCRIPTION OF CONSTRUCTION Haul Route: Madison and Airport N to Ave. 54, w to Jefferson N•to DIMENSION OF INSTALLATION OR REMOVAL Ave. 52 8 to Washington N to Ave. 48 Haul dates 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 lossresulting 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 t, Nuevo Enaineering 79-811 Country Club Bermuda Dunes 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 Contractor's License No. City Business License No. nn fila Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I I I Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ 10.00 Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date Recorded by O0U�iI34SIi �1�.��a�:-��--�o t•c�.oci ° PERMIT VALIDATION 0836 PERMIT NO. DATE APPROVED 9/19/90 EXPIRATION DATE 9/19/90 DATE ISSUED X9/19/90 , Administrative Authority TELEPHONE: (619) 564-2246 TOTE: ilith proper validation his form constitutes an ncroacFiment permit ti 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 p Subdivision Improvement Permit — Class 111 SATE: L� - Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 'Street address or Description of Location), )URPOSE OF CONSTRUCTION MOLE L���� Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION P DIMENSION OF IALSTALLATION OR REMOVkc � 46 K\Ing� SIZE OF EXCAVATION, IF NEEDED �Ye LR APPROXIMATE TIME WHEN WORK WILL BEGIN paid APPROXIMATE TIME OF COMPLETION paid 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 Quints and to pay for any additional replacement necessary as the result of this work. Signature ofp li nt or Agent Nuevo,Engineering, Inc. 79-811 Country Club, Bermuda Dunes 619-345-1778 Name of Applicant (please•printl Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No., ontractor's License No. City Business License No. 4)0 pplicant's Insurance Company Policy Number 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 Fee $ it Fee natty ash Deposit -Surety Bond required TOTAL: $ eceipt No. eceived by Date by PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By TELEPHONE: 1619) 564.2246 Administrative Authority