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e
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
(6ME'7RIF OVER51ZE LOAD PERM i T)
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
DATE: ]L I LI - 90
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE. ED U 1 F .
DESCRIPTION OF CONSTRUCTION �-:) t g i/ ATEK
DIMENSION OF INSTALLATION OR REMOVAL _10W I51H
119.-7L5 L13
SIZE OF EXCAVATION, I.F NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit.— Class I I I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
HALAL KOUTE
5L W13 TD 1JAI5: -11 N (_7 _01kJ
KJ 6 70 CITY LJM )•-T•t:)
PRUL DATE-. i I- 1LI q D
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.
—ya-a
Signature of Applicant or Agent
MLAcVO ENGIAIEERM&I F�ERMUDA* DLAkJF5
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
OiV F 1 L E Oita Fl L E
Contractor's License No. City Business License No.
ZAI FI L F_ ON FILE
Applicant's Insurance Company Policy Number .
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 A9.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ /Q• -OD
Receipt No.
Received by Date
Recorded by
0051&? iQ.8ii—j4---y()
JO USH a OAS i. V,
Ivo 0?- �
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED //-./L/ _ 90
EXPIRATION DATE " 90
DATES ISSUED �f7lIY �90
By �LE�(t&i cXlfi(�/h�
Administrative Authority
TELEPHONE: (619) 564-2246
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ey. c. _Nn: � w�.w,�.�..• � 9. w T -w! Fll -F �•v. w uv. 1.+Tj�
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
V OVE951ZE
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
DATE: i i ` J.Lj — 9 d
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
(Street address or Description of Location)
DI 1RpncG nG rrinlcTPI IrTInnl )\AbU F •01I t � Sketch (attach construction lans if an ropriate)
DESCRIPTION OF CONSTRUCTION TGA
DIMENSION OF INSTALLATION OR REMOVAL MW i a'M
L3a5
SIZE OF EXCAVATION, IF NEEDED
OR
APPROXIMATE TIME WHEN'WK WILL BEGIN
� . _ `�;
P P
OAOL
UE, JD C.) T I
'WF;VIL OF E,. U1 )1-a -110
APPROXIMATE TIME OF COMPLETION
1,
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:
l -
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.
Yr ,
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
fir . >; IbA �' ) Y 1
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
tai F f L F &4 .l ,'/ /_. r1F
Contractor's License No. City Business License No.
r,Al FILE r�N F1 L
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.
Received by Date
005132 CIO
10
PERMIT VALIDATION '
PERMIT NO. 011 / 0
DATE APPROVED //- jq U 90
EXPIRATION DATE /f ' / 4-L Y6
DATE ISSUED
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
VOTE:
Nith proper validation
this form constitutes an,, CITY OF LA QUINTA
:ncroachment permit
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
DATE: �O -
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Class 111
Minor Improvement Permit Class IV
4
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Q�.� �� P Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OFF INSTALLATION(i OR REMOVAL -1 ' 1AJ IF -2µ0
b
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
(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:
Ave. 53 -to Washi n9ion
N Ira _�D 0Cb� m Its :
bock r
0) H lqo
r
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 (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 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 A64licahk or Agent
Nuevo Engineering, Inc. 79-811 Country Club, Bermuda Dunes 619-315-1778
Name of Applicant (please print) Business Address Telephone No.
lName of Contracto and Job Foreman Business Address elephone No.
Contractor's Licepse No. City Business License Bo.
Applicant's Insurance Company Policy Number
'ES: 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
nsPection Fee
ern it Fee
enalty
ash Deposit -Surety Bond
required
TOTAL:
eceipt No.
S
S
by Date
ecorded by
N6
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: .46119) 564-2246