0905r
- r.•.ro�e...`.::Y +-.....mss ..•......� .r_a .+-.•�-.,-,-..w rr.
Fa _
j NOTE:
With proper validation
�'- th's f rm c nstitutes arr � � '
r •
f
! i o oCITY OF LA QUINTA
encroachment permit -
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
(0QF_ ` PZ1P 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.
1
Subdivision Improvement Permit - Class I I I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street: address or Description of Location) ,
PURPOSE OF CONSTRUCTION MDV E. EQ U I F., Sketch `(attach construction plans if appropriate)
TION OF CONSTRUCTIO
DIMENSION OF INSTALLATION OR REMOVAL
HALAL 'Ro 1A T E
AVE 5& � MADI SON k /B TD S'q
VSB TO UrFFERSOA) U/F TO SZ.
Vi/E) TO VtJASH/"6T6/V ►.i/S
'To 4\k)Y I I I '
SIZE OF EXCAVATION, IF NEEDED
•
APPROXIMATE TIME WHEN WORK WILL BEGIN _
APPROXIMATE TIME OF COMPLETION 1AA Ak- I)ATF� s,' 11- 9 q 0
1't 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
i 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 (24Y hours in advance of the time when work will be started.
Comply with al 1, 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 AV�plicant or Agent
KILIEVD FDIC-IAIEER1Mb �ZRAI bIA nAIaF_s1. �01 3`#5'-!77$
Name of Applicant (please print) Business Address Telephone No.
PICOtO 1 ' "TRUCK I IQ
Name of Contractor and Job Foreman Business Address Telephone No.
OA) a F1 L E N) Pil- F_
Contractor's License No. . 4 City Business'License No.; y
10A1 FILE DIV F! L E'
Applicant's Insurance Company Policy umber
O ^
—94 k.
FEES: 'Subdivision Improvement Permit — Class I II
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs'
Minor Improvement Permit — Class IV:'See attached schedule N`
. Inspection Fee
{ • Permit Fee ;
10.00lox
..
Penalty `
Cash Deposit -Surety Bond
if required }
TOTAL:.
Receipt No.
$
$ %0 .00
Received by Date
Recorded by
r-
PERMIT VALIDATION
PERMIT NO. '090s,
t DATE APPROVED
EXPIRATION DATE /L 9 190' '
DATE
IS�,�
ISSUED'
P-9-.90.
By—
Administrative. Authority
TELEPHONE: (619) 564-2246
' _ � �+► w. s eu �F�' �.r .�..� T rr+.�-�.... w: ww, t....n r.-w.or 1!4-.►- .P� +ia- = '.�T.=3b'.9 Mr �O �- �` Nr .u -+.:.f. wr SIF, r++.r �. .� w. 'T .►, w �.. « a
Y
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
(0, IF OVEK�IL E LOAD PE_6� iT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and otheHike public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class III
DATE: ) Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION' -
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOV F- ) Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION %z
DIMENSION OF INSTALLATION OR REMOVAL
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)
YA.-AbI L ,D b T E
AMP"5& 4 PI ADI SfX� &V3 nD 5 Y
W18 its :3 r- FF E; DAJ til/% TO Z
W/b TO VVA'--.,Hi Mf -7 TON NJ/B
TO �kvoY 141
IdkuA, i I 1 : )1 cl-9(11
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 ail 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
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
,NQ ELLE FI L. �1
Contractor's License No. City Business License No.
QAJ FiL E 19A F1I_ C
Applicant's Insurance Company Poli%Num�ber^N i
ry
FEES: Subdivision Improvement Permit — Class I II
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
bv`
PERMIT VALIDATION
PERMIT NO. 7 a
DATE APPROVED � � 9 0
EXPIRATION DATE 1L9_90
DATE ISSUED /V9,90
By—
Administrative Authority
TELEPHONE: (619) 564-2246
.rY.4------------- _ -.- �.-•--------------------- --- ---- -.-- -- -- - -- - -- - - r.
A�
NOTE:
With proper validation �b
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION. FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) 9S
(0UF_ TRIP OVERSIL.E LOAD PERMIT) oFTt�
For the, construction of public or private curbs, driveways, pa0ements, 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: Minor Improvement Permit Class IV
r LOCATION OF CONSTRUCTION
(Street address or Description of Location)
- MOVE. EQUIP ,•
PURPOSE OF CONSTRUCTION � Sketch (attach_ construction if appropriate) "
DESCRRIP�TIONN OF CONSTRUCTION • 23 NAU L ROUTE
E
+' 1+ 10'W 110, 000 LV35 ,D`IV'E 5l0 tMADISoAl AJ/13TO Sy
DIMENSION OF INSTALLATION OR REMOVAL' vW 13TO 7EFFE9G6&I``AJ/1B TO SZ
W/B TO V1JASH/k)bTbN W/S
TO - "-vUY III
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN A
APPROXIMATE TIME OF COMPLETION q(A1. DAT'F 11' CI' q O
ESTIMATED CONSTRUCTION COST $
M (Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
t 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
T - 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 is 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.
t Signature of pli or Agent ,
` •.4 AlUEVO EMG INEERI IUL1 _ge>4AubA nANES ��1�) 3`t5-1778 '
Name of Applicant (please print) Business Address Telephone No.
Picoto I TRUCK 1,kiILI '
-r. Name of Contractor and Job Foreman Business Address Telephone No.
t ON - FILE OAJ FI L F_
Contractor's License No. City Business License No.
Q/J FILL DN FILE"
Applicant's Insurance Company Polic�r�� 8 b 0�-40 ti
sus# < k
••v
FEES: Subdivision Improvement Permit — Class III `
Public improvements: 3%of'estimated construction costs
Private improvements: 3% of estimated construction costs w1
Minor Improvement Permit — Class IV: See attached schedule N2 0905
Inspection Fee $ PERMIT VALIDATION
Permit Fee IO' 0 7 9 O S•
r
' PERMIT NO. `
,Penalty
Cash Deposit -Surety Bond DATE APPROVED/1-9-90
if required EXPIRATION DATE II' 9 - 90
J TOTAL: ` $ 10-00 1/-8'90 L- DATE ISSUED
r
Receipt No. �(I,GIiWf . D►/''L� ,;.
By
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564.2246.
NOTE:..,
With proper validation
this form constitutes an
encroachment 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
Subdivision Improvement Permit —Class III
DATE: - Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location!
PURPOSE OF CONSTRUCTION Q P -1 �l ; Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTIONLOD
�Z '
SonX13
Dyt
DIMENSION F INSTALLATION OR REMOVAL
+0 meta`-{ IJ 1 e)
SIZE OF EXCAVATION, IF NEEDED N J
+Z P�V�
APPROXIMATE TIME WHEN WORK WILL BEGIN - U a Sh' j�%Oy1)
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 1241 hours in advance of the time when work will be started.
I 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 A p can r Agent
_Nuevo Engineering, Inc. 79-811 Country Club, Bermuda Dunes 619-345-1778
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
--gin�IZVI qTle,
Contractor's Licen a No City Business License No.
Applicant's Insurance Company P Icy Number
■ FEES:
Subdivision Improvement Permit — Class 111
Public improvements: 3%'of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Fee $
,rmit Fee
natty
ish Deposit -Surety Bond
required
TOTAL:
eceipt No.
eceived by
by
Date
N°
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564.2246