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r - r
NOTE:
With proper validation
this form constitutes an
encroachment'permit CITY OF. LA QUINTA
APPLICATION FOR PERMIT
PUBLIC ,WORKS CONSTRUCTION (ENCROACHMENT)c� tis
OFA .
For the construction ofpublic or private curbs, driveways, pavements,' sidewalks, parking lots; •sewers,. water mains,=
-and other like public works improvements in conne,ctl'on with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS -
/May ;14, 1991 Subdivision Improvement Permit — Class I I I ;
DATE: Minor;lmprovement Permit Class IV
LOCATION OF CONSTRUCTION
"(Street address or Description of Location) ,
PURPOSE OF CONSTRUCTION move equipment Sketch (attach construction plan's if appropriate),,t,,;6•`
DESCRIPTION OF CONSTRUCTION 16G blade ��
Haul •;route
'
AV e' 50 w/b to Washington n/b,to Hwy 11":
DIMENSION,OF INSTALLATION OR REMOVAL ''1V6"' H; 10'' 611 tijw Haul 'date; 5/14/91 f i
' 83, 500 ' lbs t
i ``;SIZE.OF,'EXCAVATIONjF NEEDED V ,
APPROXIMATE TIME WHEN WORK WILL BEGIN }}
"APPROXIMATE TIME'OF COMPLETION
ESTIMATED CONSTRUCTION COST $
'(Including removal`of'a11.obstruction,'material s, and debris, backfilling, com
A paction and placing •permanent resurfacing and/or replacing improvements)
In- consideration ofthe' -granting of 'this permit, the applicant hereby agrees to:
Indemnify clefend•and save the City, its authorized 'agents, officers, representatives and employees, harmless from and against any and all
penaI ies,,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 (2.4) 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.Trti'king 39723•'�Old Carriage`Rd.. Murrieta, CA`92362 )714) 677-8196
F 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.
p>i►. 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 — Ciass 111
Public. improvements': 3% of estimated construction costs
,.. _:11:04.
Private improvements: 3% of.estimated construction costs
Minor Improvement Permit —Class IV: See attached schedule
Inspection Fee' $ PERMIT VALIDATION'
Permit Fee. /0' d PERMIT NO.
Penalty DATE APPROVED. '
_ Cash Deposit -Surety Bond
if..required EXPIRATION'DATE
/ v
TOTAL: $ { !J J / y
' DATE.ISSUED
.Receipt No.
By.
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246 -
' i` - � •'r.• .`..: ._._t �,1 - _ ! .. ` _. `. is .f.i .t:..—.�+'«-• �.r...'�'^i `_•+. r
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: May 14, 1991
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION move equipment
DESCRIPTION OF CONSTRUCTION 16G blade
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
DIMENSION OF INSTALLATION OR REMOVAL 1116" H, 101 6" W
83,500 lbs
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
Haul route"
Ave 50 w/b to Washington n/b to Hwy 11:
Haul dater 5/14/91
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.
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.
Qn 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 II I
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
Recorded by
101 d '1
Date
1104
PERMIT VALIDATION
PERMIT NO. �JaIt/
DATE APPROVED / 4/
EXPIRATION DATE - /4/- 91
DATE ISSUED c� 9
By AA
Administrative Authority
TELEPHONE: (619) 564-2246
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
Subdivision Improvement Permit — Class III
DATE:. l Minor Improvement Permit Class IV.
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION,' eou [ Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION `e
C��NIl�. ,
ou
DIMENSION OF INSTALLATION R REMOVAL 1
(� u�
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
i
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debs•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, liabilities or lost resulting from claims or court action and erillinr.,out of any accident, lost 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. Quints- and to pay for any additional replacement necessary as .the result of this work.
Signature of Appiic�ljlt or Ant
..Pi gni Y31urking _ .30123, 0 1 1 d CarriaV.- Rd -� D[lirri,Pj-_a CL 02262 6ZZ-81 (
Name of Applicant (please print) Business Address Telephone No.
Nuevo Engineerinir. Inc-, 79-811 Country Cliih nr..Aermijda bi-nes,, X45-1778
Name of Contractor and Job Foreman Business Address Telephone No.
On File
Contractor's License No.
On File
City Business License No.
Otl`Fi 1 P On. PiP
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.
nspection Fee $
'ermit Fee
'enalty ,
:ash Deposit -Surety Bond
required
TOTAL: $
lecelpt NO., `
leceived by Date
lecorded by
PERMIT VALIDATION .
PERMIT NO.
DATE APPROVED
EXPIRATION DATE.
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564.2246