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With proper validation j this form constitutes anmss, encroachment permit CITY OF "LA QUINTA` APPLICATION FOR ,PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) 0 i For the construction . of public or private curbs,. drivevvays .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 II I - 3-15-91 DATE:' Minor Improvement Permit Class�IV LOCATION OF CONSTRUCTION t`• (Street address or Description of Location) MOVEEQUIPMENT ` ; ' appropriate) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if DESCRIPTION OF CONSTRUCTION D6' HAUL ROUTE HWY 111 AND ' (pjASHINGTON T0:'- 48th AND WASHINGTON DIMENSION OF INSTALLATION OR.REMOVAL- 10 jH, 11 ! lOW ,' .. • s°: 70,000 ,LBS r. HAUL'DATE 3-15 w SIZE OF EXCAVATION_, IF NEEDED' ' APPROXIMATE TIME WHEN WORK WILL BEGIN z —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'ary 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 A0 .La Quinta and to pay .for any additional replacement necessary as tfie'result of this work. Signature of Applicant or Agent U 1. NUEBO ENGINEERING INC 79 -811 -COUNTRY- CLUB �JBERMUDAS DUNES 345'=1178. , A ' Name of Applicant (please print) ` Business Address Telephone No.: Name of Contractor and Job, Foreman. Business'Addre'ss Telephone No. M-1 FaT.F ON FZI;E= ..:Contractor's License No. -. � . City Business License No. r _ ( ��,` t• , ^�* r TT_T.E c ` 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 : ,�.opppSiB'' •%iij� gg �7 ppi5-9i i0 i0 CAS ' f• TOPi33 f i0:00 Minor Improvement Permit — Class IV; See. attached schedule. t, Inspection Fee $ PERMIT.:VALIDATION r ' Permit Fee 10.0 0 1'0 31' .PERMIT NO. 4 Penalty r Cash Deposit -Surety Bond ' r DATE.APFROVED if, required EXPIRATION DATE 3 1'6=91 J 10.00 y, TOTAL:. $ y 3-15,=91- DATE I, SUED Receipt No. ,By. \ Received by DateAdministrative Authority• 1+ Recorded by TELEPHONE: (619) 564-2246 f ` r. U a s, NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment 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: 3-15-91 LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION MOVE EQUIPMENT DESCRIPTION OF CONSTRUCTION D6 DIMENSION OF INSTALLATION OR REMOVAL 10 H a 11' IOW 70,000 LBS SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Subdivision Improvement Permit— Class III Minor Improvement Permit Class IV 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: Sketch (attach construction plans if appropriate) HAUL ROUTE HWY 111 AND WASHINGTON TO 48th AND WASHINGTON HAUL DATE 3-15-92 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 properrty 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 alb 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 NUEBO ENGINEERING INC 79-811 COUNTRY CLUB IBERMUDAS DUNES 345-1176 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. ON FTT.F. Contractor's License No. ON FILE City Business License No. ON FTT.F. � Applicant's Insurance Company Policy 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 Inspection Fee $ Permit Fee 10.00 Penalty Cash Deposit -Surety Bond if. required 10.00 TOTAL: $ Receipt No. Received by Date Recorded by IB "'iA�QTOTAL 15 -91 10.00 PERMIT VALIDATION 1031 PERMIT NO. DATE APPROVED 3-15-91 EXPIRAT.IO.N DATE 3-16-91 DATE�ISSUED Al -3-15-91 By Administrative Authority TELEPHONE: (619) 564-2246 � may. K �. '• x � t ' • � � t ..' I.+ I• NOTE: �S • With proper validation s • s "'h • ��} I �. this',form constitutes an ' l -encroachment permit CITY OF LA QUINTA v ; ,t, r 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 3-15-91 ti Subdivision Improvement Permit - Class III r DATE: `r Minor Improvement Permit Class IV' LOCATION OF'CONSTRUCTION' - i •r . (Street address or Description of Location) 1MOUE EQUIPMENT • ... • y PURPOSE OF CONSTRUCTION. ;', Sketch (attach construction plans if `appropriate) i • i • DESCRIPTION OF CONSTRUCTION D6 HAUL ROUTE + HWY 11.1 . AND WASHINGTON TO 48th AND WASHINGTON i DIMENSIpp' N OF•INSTALLATION OR REMOVAL 10.,'.H.;,11 IOW 70,000 LBS HAUL DATE 3-15-91 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN'.WORK WILL BEGIN IT APPROXIMATE TIME OF COMPLETION ` ^ ESTIMATED CONSTRUCTION COST $ r• (Including removal of all obstruction, materials, and debris backfilling, com• paction and placing { p g permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, ihe.applicant hereby agrees to: Indemnify, defend and save the City, its authorized-age officers, representatives and employees, harmless from and against any and all. penalties, liabilities or loss resulting from claims.or court action and arising outof 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: r ` �.6. 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 ti p La Quint; and to pay for any additional replacement necessary as the It of this work. y . '. Signa re of Applicant or Agent' NUEBO ENGINEERING .INC.•7,9-8.11 CQUNTRY,CLUB ERMUDAS DUNES •345=1778 Name. of Applicant (please print) to-. '' ; . Business Address t Telephone No. Name of Contractor and Job Foreman' Business Address , Telephone No. i (1N• FTT.R' ON. FILE .F�. "Contractor's License No. ti City Business License No. _ k r)N FILE" Applicant's Insurance Company ,ti V^ " Policy Number FEES. Subdivision Improvement Permit - Class 111 7 a Public improvements: 3% of estimated construction costs Private improvements' 3% of estimated construction costs p 518? i k 0 ICAS TAL f . 10.00 +r Minor Improvement Permit - Class IV: See attached. schedule f Inspection Fee. $ }, PERMIT. VALIDATION .% 1 s •" "Permit Fee 10.:00 v 1"0.31.' ` -s PERMIT NO. s , Penaltys ` Cash Deposit-Surety Bond5 - t DATE APPROVED- `3-15-91 l f if requireda EXPIRATI DATE 3-15- 10 00 '91 TOTAL: $ r 3-15 Y91 DATE UED Receipt No. .. By " Received by Date jAdministrative Authority h Recorded by TELEPHONE:,(619) 564-2246 «t +` DOTE: Vith,proper(validation :his form constitutes an e CITY OF LA QU.INTA mcroachrnent 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 1�Subdivision Improvement Permit — Class III DATE: / - Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) c PURPOSE OF CONSTRUCTION_ Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION ka i DIMENSION OF INSTALLATION OR REMOVAL rf I ► i �"�1 I ' ' III c SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN // l APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST S /5/Q r (including removal of all obstruction, materials, and deb:•is, backfilling, com- paction and..placing permanent resurfacing 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 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 124) 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 iules and "regulations of the City of La Quints and to pay for any additional replacement necessary as the result of this work. Signature of App(nt o gent Nuevo Engineering', Inc. 79-811.Country Club, Bermuda Dunes 619-345-1778 Name of Applicant (please print). Business Address Telephone No. of Contractor and Job Foreman I�ctlorr''sY License No. :ant's Insurance Company Business Address Telephone No.- - Alle, City Business Licence No. 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 pection Fee $ Fee Ish Deposit -Surety Bond required TOTAL: $ No. ived by Date by Policy Number N° PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By TELEPHONE: (619) 564.2246 4 Administrative Authority