10941111i�11 111, 111 11111 111 "Kr '• .. ' y hiXVo -
•Z,
NOTE:
F
With proper validation "
this form constitutes an CITY OF LAL QUINTA
encroachment permit 4
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION' (ENCROACHMENT)''
(ONE _'TRIP OVERSIZE LOAD PERM IT)
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: ' 471 Subdivision
Improvement Permit Class IV
LOCATION OF -CONSTRUCTION f '•"'� '
(Street address or Description of Location) + ,
-, MOVE EOUI PMENT
PURPOSE -OF CONSTRUCTION y ' = Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION [PZ3 SCRA P E K H AYL VA:T E
r UUA MII�faTaN '6/0 TO WE,50
DIMENSION OF INSTALLATION OR REMOVAL 14 lAl EAST II4 M II_+E
- 110, 000 L65
. 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) t
In consideration of`the granting of this permit, the applicant, hereby agrees to: W �t:,_� r ° 4
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
o La Quinta and to pay for any additional replacement necessary as the result of this work.
' ,CKACY ZrDH SON
r Signature of Applicant or Agent w r'
WEVD • EN61 NERI'NG "lq-'SI I •'tQQkiTRY CLUB BERMUDA' DVME5' CA 1.1
Name of Applicant (please print) Business Address Telephone No. ,
f - (6.19) 345-1778 ;
r
Name of Contractor and Job Foreman Business Address Telephone No:
QN FILE
Contractor's License No. ° City Business License No. '
Dl1/ FII. OAJ lLe -
Applicant's Insurance Company 3 Policy Number
FEES: Subdivision Improvement Permit — Class I II ;
Public improvements: 3% of estimated construction costs i805ig 0AS oi�-91i�.00 i0
�.�..Y�.
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: $ 10.60
Receipt No.
Received by Date
PERMIT VALIDATION
PERMIT NO. I U9 y
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
S' 9
By �i U�"'I '�a�✓�
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
•�,
.�,•
1 1 � ` �.
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�t _ i_y
+ 4
NOTE#"
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
(DIME TRIP DUERSIZE 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
DATE: 5-/-11
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit —Class I I I
Minor Improvement Permit Class IV
(Street address or Description of Location)
PI IRPr1CF nr- r(1NCTRI IrTInKI MOVE 1OW NEKIT Sketch (attach construction lane if a — riate)
DESCRIPTION OF CONSTRUCTION 1PZ3 Sir A EK
DIMENSION OF INSTALLATION OR REMOVAL WH 161M
1 I a DOD L135
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
V pp p
HAUL. DATE 5-2-9)
WA5HING7DN
EA51 1/4 M I L E
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:
S/13 TO AVE SD
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.
-'T'RACY SOH N SDN
Signature of Applicant or Agent
NUEVO EN81NEERINC3 -N-SII CDUMIRY CLUB URMUDA DUNES , CA
Name of Applicant (please print) Business Address Telephone No.
(Lola) 345- 1778
Name of Contractor and Job Foreman Business Address Telephone No.
QN FILE
Contractor's License No. City Business License No.
,OA/ FILE. OAJ F I LE -
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
J
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
$
l4. DD
Date
PERMIT NO.
,8051H
Ito W
ALSi0i--91io.OQ to
PERMIT VALIDATION
lU9q
DATE APPROVED
•,. EXPIRATION DATE
DATE ISSUED 9 1
Administrative Authority
TELEPHONE: (619) 564-2246
OTE: •
lith proper validation
its 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
Subdivision Improvement Permit — Class 111
)ATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
/Street address or Description of Location) p
PURPOSE OF CONSTRUCTION rl��le-. �e+i=� 1 rn(' :n� Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 40--11—\
OIMENSIO F liVST LLATION OR REMOVAL
SIZE OF'EXCAVATION, IF NEEDED ns ,lam` tel'
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 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 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 Applicant or Agent
Nuevo Engineering, Inc.. 79-811 Country Club, Bermuda Dunes 619-345-1778
Jame of ,Applicant (please print) Business Address Telephone No.
.�-2oL
Jame of Contractor and Job Foreman Business Address Te ephone No.
:ontractor's License No. City Business License No.
4pplicant's Insurance Coinpany ' Policy Number
EES: Subdivision Improvement Permit — Class III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costsQ
.Minor Improvement Permit.— Class IV: See attached schedule
spection Fee $ I PERMIT VALIDATION
rmit Fee
PERMIT NO.
malty
sh Deposit -Surety Bond DATE APPROVED
required EXPIRATION DATE
,TOTAL: $ DATE ISSUED
ceipt No.
By
eceived by Date Administrative Authority
ecorded by TELEPHONE: (619) 564-2246