1105?
"NOTE" T
With proper validation
this form constitutes an
encroachment permit CITY OF LA QUINTA
APPLICATION -FOR PERMIT
PUBLIC •WORKS CONSTRUCTIONENCR
J+m�a.d
( OACHMENT �•_
1 .� w
OF
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
May 14", 1991 Subdivision Improvement Permit — Class III
-DATE: Minor Improvement PermitClass IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION move equipment" Sketchlattach construction plans if appropriate) .'.
DESCRIPTION OF CONSTRUCTION 824C dozer... Haulroute•
Ave 50 w/b . to Washington n/b - .` -
DIMENSION OF INSTALLATION OR REMOVAL 13 H, 13'9" Haul date:
W to Hwy e
97,000-'&bs : 5/14/91
SIZE OF, EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
.APPROXIMATE TIME OF COMPLETION
"ESTIMATED CONSTRUCTION COST $
(Including removal ofall 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 payfor 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 f ile on, f ile
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 05
Minor Improvement Permit — Class IV:.See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee /0,00 PERMIT NO,
.. Penalty� L
Cash Deposit Surety Bond DATE APPROVED
if. required. EXPIRATION, DATE
TOTAL:. $ ' :DATE/O..
ISSUED,
Receipt No.
' By
Received by Date Administrative Authority
Recorded by TELEPHONE:.(619)564-2246 .
A
=NOTE!
With proper validation
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
1
May 14, 1991 Subdivision Improvement Permit — Class I I I
DATE: Minor Improvement Permit Class IV f
LOCATION OF CONSTRUCTION !_
(Street address or Description of Location)
PURPOSE OF'CONSTRUCTION move equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 824C dozer Haul route:
Ave 50 w/b to Washington n/b
DIMENSION OF INSTALLATION OR REMOVAL 13' H, 13'9" W to Hwy 111
97,000 mbs
Haul date: 5/14/91
A.
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION ti
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.
A,.
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 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
Inspection Fee $
Permit Fee � ) • 00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
Recorded by
1105
PERMIT VALIDATION
PERMIT NO.
l
DATE APPROVED
:S 9/
EXPIRATION DATE
`L�_ 9
`DATE ISSUED'`"
4 f "�
Administrative Authority
TELEPHONE: (619) 564-2246
1 •,_a
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 111
DATE: /tip/ 'r: - Minor Improvement Permit Clasi IV
'LOCATION OF CONSTRUCTION
ISt'reet address or Description of Locatio�nni�•
PURPOSE OF CONSTRUCTION ( � ��' Sketch (a"a.ch.construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIME ION OF INSTALLATION OR REMOVALIT 13 127 Uu�
Dcy)1 t`�5(�"
zh
SIZE OF EXCAVATION, IF NEEDED %
TBEGIN
APPROXIMATE TIME WHEN WORK WILL i.
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST.$ / 1141
(Including 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, harmleis from and against any and all
penalties. liabilities or loss resulting from claims or court action and sri2i.wl,out of any accident, lou 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 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 Ouinta and to pay for anv additional replacement necessary as the result of this work.
U
..Pionni Tt'.1]cking --3,0723 01d ('arriapra Rri•� jl�L,rr;ctaT-f!A 9226 (Zlll) 66Z_7�-81
Name of Applicant (please print) Business Address Telephone No.
Nuevo Engineering, Inc. 79-811 Co antsy C1 uh lir. RPrmiida Dlines,� X45-1778
Name of Contractor and Job Foreman . Business Address Telephone No.
On'File.
Contractor's License No.
On File
City Business License No.
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
Penalty `
:ash Deposit -Surety Bond
required -
TOTAL:
lecelpt No.
leceived by Date. `
lecorded by
N° //(/
PERMIT VALIDATION '
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By.
Administrative Authority .
TELEPHONE: 1619) 664-2246