1099R
this -form constitutes an
encroachment permit 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 I I
DATE: 5/6/91 Minor Improvement Permit Class IV
.LOCATION OFCONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIPMENT Sketch (attach construction plans if appropriate) .:.
DESCRIPTION OF CONSTRUCTION D6 DOZER HAUL. ROUTE::
AVE 50 W/B TO WASHINGTON N/B TO•.
CITY LIMITITY LIMITS
DIMENSION:OF INSTALLATION OR REMOVAL 10' H. 11'10" W
M000 ' lbs HAUL ,DATE 5/7/91
SIZE OF EXCAVATION, IF NEEDED
APPROXIMAT;ETIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION.
. ,ESTIMATED CONSTRUCTION COST,$
(Inclu'ding.removal of,all obstruction, materials, and debris, backfilling, com ..
paction'and : R(acing 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
. ~:}ar
.,penalties,l 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.
+ Compiy with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations -of the City, of,
r 1a,'Quinta and to pay for any additional replacement necessary as the result of this .work.
Signature o ppplgant or Agent F
11PICONI TRUCKING. 39723 OLD CARRIAGE RD. MURRIETA, CA'923'62 (714)677:8196.-
Name of Applicant (please,print) Business Address Telephone No'. '
:Nuevo Engineering, Inc.- 79=811 Country Club Dr. Bermuda Dunes, 345-1:778
Name.of Contractor and Job Foreman Business Address Telephone No. .
on file on file {
Contra'ctor's License No. City Business License No.
on f ile on file .
k Applicant's Insurance Company Policy Number'
FEES: •Subdivision Improvement Permit - Class III o05ig i0 Sg 4 5-06-9.1
° SCS C sH 1 T�TAL° 1 -io '00
Public improvements., 3/0 of estimated construction costs p
Private improvements: 3% of estimated construction costs _ u'. 1 0 7 �•
Minor Improvement Permit — Class IV: See attached -schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee ; 'Zo' 1099
PERMIT N0.
Penalty - '
Cash Deposit Surety Bond DATEAPPROVED.
s
if.required EXPIRATION.DATE
TOTAL: $ �D O U _A Cf /
Receipt No.
Received by Date
Recorded by
v.
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246
rte.
NOTE:
`w.�With proper vdtio,n:___,_�
this f rm c nstitutes en
0 o CITY OF LA QUINTA `
encroachment permit f
APPLICATION FOR PERMIT Jj
t
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
FB7_,111111110
5/6/91
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location) 4 r
PURPOSE OF CONSTRUCTION MOVE EQUIPMENT �`'' Sketch (attach construction plans 'if appropriate)
DESCRIPTION OF CONSTRUCTION D6 DOZER HAUL ROUTE:
AVE 50 W/B TO WASHINGTON N/B TO
___g1T7 LIMITITY' LVITS
DIMENSION OF INSTALLATION OR REMOVAL 10f H., -1"h»lO11 W
70,000 lbs HAUL DATE 5/7/91
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST,,$
(Including removal of all obstruction,Imaterials, 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�toA�
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 W-hen'work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable fules and regulations of the City of
La Quinta and to pay `for any additional replaceme tynry ecessaas the result of this work.
�
Signature of(Applip�nt or Agent
-PICONI TRUCKING 39723 OLD CARRIAGE RD. MURRIETA, CA 92362 (714)677-8196
Name of Applicant (please print) Business Address"-- Telephone No.
Nuevo Engineering, Inc. 79-811 Country Club Dr. Bermuda Dunes, 345-1778 w
Name of Contractor and Job Foreman Business Address Telephone No.
On f ile on file
Contractor's License No. City Business License No.
on file on file
Applicant's Insurance Company Policy Number f� , „`'•° t
FEES: Subdivision Improvement Per — Class III 40SUSPiTIAPi06-91i0.00i0
Public improvements: 3% of estimated construction costs 1099
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee O '
Penalty
Cash Deposit -Surety Bond
if,required l '
TOTAL: $
Receipt No.
Received by Date '
Recorded by
PERMIT VALIDATION
PERMIT NO. /09L?
DATE APPROVED S—�D t91
EXPIRATION DATE
DATE ISSUEDC
- —
F By
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form constitutes an it
encroachment permit' CITY OF LA QUINTA
APPLICATION FOR PERMIT
IN
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
OATEN co Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION _
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 1ELIVSketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION(X�'
DIMENSION OF INSTALLATION OR REMOVAL
KI ( �
SIZE OF EXCAVATION, IF NEEDED (?L
APPROXIMATE TIME WHEN. WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ '
(Including removal of all obstruction, materials, and debris, backfilling, com
d 1 f d/ I in im r vements)
pactlon an p acing permanent recur acing an or rep ac g p o
In consideration of the granting of this permit, the applicant hereby agrees to:
,,0/ r7 11 /
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities or lou 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 h;wrs in advance of the time when work will be started.
Comply with all applicable Clty 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 Ap icenf eft Agent
..Pi n.nni_". `I rneki ng _ _ 32P'3n1 d C arri age Ed - * M1 It-- ' f!A 22� 69 (7l h) 6677—R1 a6
Name of Applicant (please print) Business Address Telephone No.
Nuevo Engineering. Inc. 79-811 Country Club Dr. Rermiida Dunes,` X45-1778
Name of Contractor and .lob'Foreman Business Address Telephone No.
,On File
Contractor's License No.
On 'File
City Business License No.
Qn File nn. Pile
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
nspection Fee $
Permit Fee
Penalty
:ash Deposit -Surety Bond
` required
TOTAL:. $
leceipt No.
leceived by Date
lecorded by
N° 10 j9
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
? Administrative Authority
TELEPHONE: 16191564-2246