1103'. .. w. . « .,.. � ..•rn +. .t. ,.. Cw..:.,a.w.' la. :.«� ° �.-4 `tri-rr w....
NOTE
With propeeValidation
this form constitutes an
encroachment permit CITY OF -L`A 'QUINTA
t
APPLICATION FOR PERMIT
f PUBLIC WORKS. CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks,, parking lots, sewers,- water mains,.,i.
and other like public works'improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
...
Sub ivi
sion lm r
ovement Permit —
Class I NMay 14, 1991
DATE:
a..
•Minor.l.niprovement Permit Class•IV
LOCATION OF CONSTRUCTION,
(Street address or Description of Location)
PURPOSE'OF CONSTRUCTION move' edu`iument Sketch(attach construction plans if appropriate) s' t
DESCRIPTIONOF•CONSTRUCTION 623 •scraper. $aul-route; 1
Ave 50W/B to Washington N/B
to Hwy lll.
,DIMENSION OF,INSTALLATION OR REMOVAL 14' H. 10' W 'Haul date 5/14/91
110,000 -lbs
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 t
pact!on and',placing permanent resurfacing and/or replacing improvements) �.
In consideration'of the granting of this permit, the applicant hereby agrees to:.
• iridemnify, defend and save the City, its authorized agents, officers', representatives and employees, harmless from and against any.and all
penalties, liabilitiesor Doss resulting from claims or court action and arising out of any accident, .loss or damage to persons or property
r'happening or occurring as'a proximate result of"any 'work 'undertaken 'underthe 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 Ofdinances, 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.
Piconk'Trucking 39723 Old Carriage Rd Murrieta, CA 92362 010 677-8196
-Name'of Applicant (please print) Business Address Telephone No.
Nuevo Engineering, Inc. 79 811 Country Club Dr., Bermuda Dunes 345-1778
Name of Contractor and Job Foreman Business Address . Telephone Noi . °'
'on file
on file
Contractor's License. No.. City Business License No.
on file' . on file
Applicant's Insurance Company Policy Number ;
FEES: '. -Subdivision Improvement Permit — Class III"
` Public improvements: .3%•of esti mated construction costs „
Private improvements: 3% of estimated construction costs f
Minor Improvement Permit — Class IV: See attached schedule .
Inspection Fee " $ PERMIT VALIDATION
Permit Fee
.PERMIT NO.:
Penalty.. /`% /
Cash Deposit -Surety Bond DATE APPROVED , !:
if,required EXPIRATION DATE S ��� 9
/D . 00 .
TOTAL: $ DATE ISSUED
Receipt No. �.t. ✓`T,�,c.4w�c
By—
Received' by
y_Received'by = Date ;t'.'. y Administrative Authority '
Recorded by. TELEPHONE: (619)$64-2246. r
NOTE:
With proper validation
this form constitutes an
encroachment permit
rg
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
DATE
May, 14, 1991
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit —Class II I
Minor Improvement Permit Class IV
r
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION move equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 623 scraper
DIMENSION OF INSTALLATION OR REMOVAL 14' H, 10' W
110,000 lbs
SIZE OF EXCAVATION, IF NEEDED
Haul route:
Ave 50W/B to Washington N/B
to Hwy 111.
Haul date 5/14/91
APPROXIMATE TIME WHEN WORK WILL BEGIN P
APPROXIMATETIME 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.
Signature of Applicant 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
Name of Contractor and Job Foreman Business Address Telephone No.'
on file on file
Contractor's License No. City Business License No.
on file on file
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 _
_/0- 00
TOTAL: $ /0 • tJr)
Receipt No.
Received by Date
Recorded by
1103
PERMIT VALIDATION
PERMIT NO. Ii
DATE APPROVED
EXPIRATION DATE
DATE ISSUED lq— 9/
.G
'�' Administrative Authority
a
TELEPHONE: (619) 564-2246
NOTE: •
WitfzpropePvalidation
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
l Subdivision Improvement Permit — Class 111
ATE.. 1' Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Locationi
PURPOSE OF CONSTRUCTION Sketch (attach construction pians if appropriate)
DESCRIPTION OF CONSTRUCTION_ /� :.r c. Ci..'..,=
DIMENSION OF INSTALLATION OR REMOVAL 72 7 14710,
J1
SIZE OF EXCAVATION, IF NEEDED Kish
APPROXIMATE TIME WHEN WORK WILL BEGIN ► lJ.
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ Z/ 6 j
. _ Ilncluding 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:
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilltie>i 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 4241 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 app lic Fe- les and ul7s ions of the City of
La Quints and to pay for any additional replacement necessary as the reWlt of this work: n ,f
Signature of Appli jntor Agent ~�
..Pi r.nni Trucki ng 3OZ23 Old Car J—
Name of Applicant (please print) Business Address Telephone No.
Nuevo Engineering. Inc.' 79-811 Country Cluh Dr. Bermuda Dunes-,- X45--1778
Name of Contractor. and Job Foreman Business Address Telephone No.
On File
Contractor's License No.
On File
City Business License No.
On Pi 1 P Cin. Pi 1 P
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,
'ermit Fee
'enalty
:ash Deposit -Surety Bond
` required
TOTAL:
leceipt No.
leceived by Date
lecorded by
No //43
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246
V