08500
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NOTE:
{
With proper validation' • �
O
this form constitutes an � ��.-'•
CITY OF� LA QUINTA
encroachment permit , - 1 ' 4 ,,, •
APPLICATION,fOR PERMIT ..
•PUBLIC{ WORKS',CONSTRUCTION, (ENCROACHMENT)
`'- -ONE TRIP' OVERSTZE.;LOAD' PERMIT - * ` 0F
For the' construction of public or private curbs; driveways, pavements, sidewalks,' parking .lots, sewer.
water_ -'mains t
and other"like public works. .improvements.in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS • `
�. Subdivision`Improvement Permit'— Class III
DATE: OCtober 2,' 1990 y • r Minor Improvement Permit Class IV ,
LOCATION OF CONSTRUCTION malie eauinment-.
(Street address or Descrfption'of Location) -r - �� �! f: ` •a `
'' .•' • - •. •' 225 _Cat `excavator. � y' •••
PURPOSE OF, CONSTRUCTION,— ''Sketch',(attach construction plans if appropriate)
h-13 1-30' w' 60, 000. width {10' 5" 4<: ;� s{ ' ' •v
{DESCRIPTION OF -CONSTRUCTION
" ;: ' .'. South, on'Washington oto' Eisenhower
right on'" Fernando ' '► -�
DIMENS'ION'OF INSTALLATION OR REMOVAL' .r ' �' ` %•;' �`' '
Hauldate: 10/24901 a
SIZE OF., EXCAVATION, IF NEE'DED'.-
APPROXIMATE
EEDED APPROXIMATE TIME WH-EN'WORK WILL BEGIN ,
~APPROXIMATE TIME OF COMPLETION" f �
,ESTIMATED CONSTRUCTION COST
(Including removal of tall obstruction, materials, and debris, backfilling, com ,
paction and placing permanent ,resuefaci'ng: and/or' replacing improvements)r
' 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 ail
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 urider.the�permit'granted pursuant to this application. c
r 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. Crclinances,•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.. "r ' ,. • .r
, {,
••
�• Signature of:Applicanf or Agent' r {
Walton`s" Backhoe -Service 77550 Robin: ,Rd. ,.'Palui Desert 345=-5215• .r
Name of Applicant,(please print) i - • Business Address +` 'Jiiilephone No..
icon,i Trucking
Name of Contractor and.Job Foreman.' -° Business Address �f. , ^'' `'Telephone No.
nn• •f � l�a _ .�, � ', "-, T-,- nn ,�� a. � tet. `..• ,
Contractor's License No: '{' { . ' ; x `. City Business"Licen'se�No.
on .file
l {_
Applicant's,Insurance Company . ' ' * `wy Policy Number, • "
t..
--FEES: -Subdivision Improvement•Perm'it==Class'I I I r , ' - p 5i8 i ; 73 iipp-p2 90 -� io
' Public improvementsr 3% of estimated construction costs:,?
Private`impr.ovements: 3% of estimated construction costs ►.{ •{: t' ppY CC,nn � ` {
' Minor'[mprovement Permit`- .Class IV: See`attached schedule N2. '
Inspection Fee $
PERMIT VALIDATION '
Permit Fee 10.00 '085Q,, . .
.� PERMIT -NQ., --`T
• Penalty r .,...a, - ,
Cash Deposit -Surety Bond F {DATE APPROVE6.D/219(1
if required' 10290 -
•:EXPLRATION DATE / / •
-TOTAL-"• 4$ 10.00..
DATE ISSUED -
Receipt No.
By
Received by t Date - + ` . ' Administrative Authority
Recorded by TELEPHONE: (619) 564-2246. `
vnw�:e.:+.�er�:e�.r.ca.a'�+Ncii•ba`1K�1+.1F�w r aria a.. �. y...� s•s� r. y — — — — M — — — — — r — .r — — — — — — — -- — — — — — y. - R+ r
I
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit ,
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP OV- RSIZE LOAD PEW2IT
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 II
DATE: October 2, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment
(Street address or Description of Location)
PURPOSEOF CONSTRUCTION 225 cat excavator Sketch (attach construction plans if appropriate)
h-131 1-301 w 60,000 wilt. 1015"
DESCRIPTION OF CONSTRUCTION
South on Tlashington to Eisenhower
right on Fernando
DIMENSION OF INSTALLATION OR REMOVAL
Haul date: 10/2/90
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.
Nff� OI
Signature of Applicant or Agent
Waltons Backhoe Service 77530 Robin Rd. Palm Desert 345-5215
Name of Applicant (please print) Business Address Telephone No.
John Piconi Trucking
Name of Contractor and Job Foreman Business Address Telephone No.
nn f i l o on f i I -p -
Contractor's License No. City Business License No.
on file
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 10. 010
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by ' Date
740
PERMIT VALIDATION
PERMIT NO. 0850
DATE APPROVED:0./2/90
EXPIRATION DATE 10/2/90
DATE ISSUED_ 10/$/90
By�y
Administrative Authority
Recorded by , II TELEPHONE: (619) 564-2246
NOTE
With- proper=vafidationt
this form'constitutes an=•
encroachment permit
CITY OF' LA QUINTA''
APPLICATION. FOR.,PERMIT'
PUBLIC, WORKSs CONSTRUCTION�:(ENCROACHMENT)'
For the construction• of public:- or 1private curbs, driveways, pavements; sidewalks;. parking lots, sewers,, watertPmaFrts _
and other- like public works improvements in connection with MINOR IMPROVEMENTS"and APPROVED SUBDIVISIONS".'
October 2 1990 Subdivision Improvement Permit — Class III -
DATE: , MinorlmprovemenrPermit Class -IV
LOCATION OF CONSTRUCTION, more auiument -
(Street address or Description of Loationl ,
PURPOSE OF CONSTAUCTiQN225 Cat- Excavator ' Sketch (attach, construction plans if approprists►
,uei&,ht 131. Length Or eig ,., W.LUULL TO
DESCRIPTION OF CONSTRUCTION' '
South on Wast ngton_ to
Eisenhower right on
DIMENSION OF INSTALLATION..OR REMOVAL.
Fernando. Destination
Fernando
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, bar—*filling,' com
paction and placing permanent resurfacing and/or replacing improvements)
in consideration of the granting of this permit, the applicant hereby agrees to:
Indemmfv,,defend- and save,the City, its authorized agents, officers, representatives and employees, harmless from and against arry end NI
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damege•to persons or prape. ty
happening or occurring as a proximate• result of any work undertaken under the permit grained pursuant to this application.
Notify the Administrative Authority at least twenty-four (241 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-ruies•arid regulations of the City of
La Quints' and to pay for, any,sdditionai-roplacemerwynecesssry�ss the nwit,of this work.
Signature of Applicant or Agent
10�;;3tQ, IQ Rn
aklgoP Service . 77580 Robin Rd., Palm Desert 92260 345-5212
ti 'Name of Applicant (please printf Business Address Telephone No.
;,ghry Pi nnni Trnpki na
Name of. Contractor and Job Foreman Business Address Telephone No.
r
on file on file
Contractor's License No. City Business License No.
on file
on file
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 Imorovement Permit Class IV: See attached schedule
Insoectlon Fee S
Permit Fee -
Penalty
Cash Deposit -Surety Bond
if required
TOTA L: $
Receipt No.
Received by Date
Recorded by ..
PERMIT VALIDATION
PERMIT NO.
DATE°APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE. (6191664.2246