0845....:a:+-.e•.:ra.5✓R'.,u.—.�.,.`.-:�.,..,�.r�,.w�,..�r..�.. .-. .—+—�r � ,—a.—a—,.—•+.� �d..�...�„— �... .r • �.� �— .-:.-:,;w�.�„—„—,x..,, � ....x—.�.�.,...� a
NOTE:
•With proper validation
this form constitutes an
encroachment permit CITY' OF LA QUINTA.
7.
APPLICATION 'FOR. PERMIT -
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
.One °Trip . Oversmze-,Load .Permit
OF TElB
For. the construction of public or private curbs, driveway's, pavements, sidewalks, parking -lots, sewers, water mains 'r•
and other, like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
- .. fir^ •' • 1 • ' .. • • •' Y' . : �. •..• , ..
1 / 2 7 / 9 0Subdivision Improvement Permit -'Class Il l.,
DATE':' ` ` Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move eckuipment ,
(Street addressor Description of Location)
'PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)-,
'DESCRIPTION.OF-CONSTRUCTION '623' B, 14!h',,.1`01w, 110,000 lbs-
'HAUL
bs 'HAUL ROUTE: Ave. 48 and
YT DIMENSION OF INSTALL"AT,ION'OR`REMOVAL Washington south' to •Ave. 50, east
to -Jefferson, north to Ave 48
SIZE'OF EXCAVATION; IF NEEDED 'Haul. date: 9'/•28/90
_,
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ '
(Including removal of all obstruction, materials, and debris, backfilling, com-
p
oin
paction and placing permanent resurfacing and/or replacing improvements) -
In consideration of the granting of this.permit,!the applicant hereby agrees to:
` t- •. a
Indemnify, -defend and save the CitY. its authorized agents, officers, representatives and employees, harmless from and against any arid all
penalties,liabilities or'loss resulting from claims or court, action -and arising out'of any accident,; loss or damage to persons oi� 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. `
v'signatureApplicant or Agent ; a
Nuevo Engineeririq 79=81T Country Club Bernuda Dunes' 345-1778
Name of Applicant (please print)� rt Business.Address Telephone No.
Name of Contractor and Job.. Foreman ' Business Address' '" Telephone No. Y
on -file ' ' on file
Contractor's-License,No. City Business License No.
on. file y e
Applicant's,lnsurance Company +' Policy Number
FEES:. Subdivision Improvement Permit — Class I II
ON) S:g11 FI 77 T 0q t7_90 10 `
.I ' t, . TZ i0a00
Public improvements: 3%.of estimated construction costs�AS_ ' .
Private improvements: 3% of estimated construction costs �+
Minor Improvement Permit —Class IV: See attached schedule •� ®� �'
Inspection Fee „•.+ $ a PERMIT VALIDATION
Permit Fee 10.0 0,
PERMIT NO. 0 R'4 S
,Penalty
Cash Deposit Surety Bond'DATE APPROVED 9 / 2.7 / 9 0 s
if required EXPIRATION DATE 9/28/90
'10.00
TOTAL:$ ' ~ .9/2.7/,.90
DATE 'ISSUED
Receipt No.
By
Received by Date Adminisirative Authority
Recorded'by 'TELEPHONE: (619) 564-2246
V,
:� ":.� .. ... � ....� r ... Ali
.w�' .+. ae.e `*+•.� ++^�•ii>.w•r. r 'a. r. AS- — r - — w r r r � — — - —
NOTE:
With properwalidation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
One Trip Oversmze 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
1/27/90 Subdivision Improvement Permit — Class I II
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
move etuipment
(Street addressor Description of Location)
PURPOSE OF CONSTRUCTION
Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 623 B 141h, 10'w, 110,000 lbs
HAUL ROUTE: Ave. 48 and
DIMENSION OF INSTALLATION OR REMOVAL Washington south to Ave. 50, east
to Jefferson, north to Ave. 48 `
SIZE OF EXCAVATION, IF NEEDED Haul date: 9/28/90
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION ,
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction andplacing 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.
"via
Signature of A,`pplicant.or Agent
Nuevo Engineering 79-811 Country Club Bernuda 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.
on file
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class 111"°'` _
Q09� 8� 72 0 ''7' 90 0
Public improvements:.3% of estimated construction costs 1UF(4 37AL i).40.
Private. improvements: 3% of estimated construction costsYt9 n �•5
Minor Improvement Permit — Class IV: See attached schedule V sk
Inspection Fee $
Permit Fee
Penalty .
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
MOO
10.00
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 0845
DATE APPROVED 9/27/90
EXPIRATION DATE 9/28/90
DATE ISSUED 9127/90
By
Administrative Authority
TELEPHONE: (619) 564-2246.
TOTE: .
Vith prober validation
Ms form constitutes an
nctoachment permit
0
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
r� Subdivision Improvement Permit — Class III
DATE: �(� _ « Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Oescription of Locationi
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
"Paid
DI Efil( NSION OF INSTALLATION OR REMaM
-To,
SIZE OF EXCAVATION, IF NEEDED
IV �
APPROXIMATE TIME WHEN WORK WILL BEGIN 1 I
APPROXIMATE TIME OF COMPLETION ,n
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction materials and debris backfilling, com-
(ln g .9paction 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 of Appli t or gent
Nuevo Engineering, Inc. 79-811 Country Club Bermuda Dunes 619-345-1778
ame'of Applicant (please print) Business Address Telephone No.
of Contractor and Job Foreman
License No.
Insurance Company
Business Address
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
spection Fee
ermit Fee
nalty
ash Deposit -Surety Bond
required .
TOTAL:
eceipt No.
by Date
by
A
// Telephone No.
City Business L�cynsg( o
f "P
Policy Number
N°
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619),564.2246