1108r
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA l/
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 15; 1991
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIPMENT
I
DESCRIPTION, OF CONSTRUCTION D6 DOZER
DIMENSION OF INSTALLATION OR REMOVAL 101H, 1111011W
70,000 LBS
SIZE OF EXCAVATION, IF NEEDED
Subdivision Improvement Permit — Class 111
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
HAUL ROUTE;
AVE 50 W/B TO WASHINGTON
N/B TO CITY LNITS.
d
HAUL DATE:
fe- ___-
5/16%91 ':
APPROXIMATE TIME WHEN WORK WILL BEGIN
-" U
APPROXIMATE TIME OF COMPLETION` ��
ESTIMATED CONSTRUCTION COST $ 0
(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.
hLien
Signature of Appl c nt or gent
Piconi.Trucking 39723 Old Carriage Rd. Murrieta, CA 92362 714-677-8196
Name of Applicant (please print) Business Address Telephone No.
Nuevo Engineering, Inc. 79811 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 111
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:
$_ /0. OCa
Receipt No.
Received by Date
1108
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
n'��\
. �• , � -�
,� +� _ r
;r
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITYQUINTA
LA O F
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
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIPMENT
DESCRIPTION OF CONSTRUCTION D6 DOZER
DIMENSION OF INSTALLATION OR REMOVAL 10'H, 11'10"W
70,000 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-
paction and placing permanent resurfacing and/or replacing improvements)
Subdivision Improvement Permit - Class I I I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
HAUL ROUTE;
AVE 50 W/B TO WASHINGTON
N/B TO CITY LIMITS.
HAUL DATE:
4"*w
5/16/91
°'�-_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.
r
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.
0 ' V "" ) � , Y
c nt
Signature of Apo oro' gent
Piconi Trucking 39723 Old Carriage Rd. Murrieta, CA 92362 -714-677-8196
Name of Applicant (please print) Business Address Telephone No.
Nuevo Engineering, Inc. 79811 Country Club Dr., Bermuda Dunes 345-1778
Name of Contractor and Job Foreman Business Address Telephone No.,
e
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
/0.00
Penalty
Cash Deposit -Surety Bond
if, required
TOTAL:
Receipt No.
Received by Date
Recorded by
1108
PERMIT VALIDATION
PERMIT NO. po e
DATE APPROVED
EXPIRATION DATE
DATE ISSUED��r, - /s
By tY.I�.C�t�CJ / .l,��ti�Gt��-
Administrative Authority
TELEPHONE: (619) 564-2246
th proper validation
•
Is form,�qnstivjtes an CITY OF LA QUINTA
croachment 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
TATE: Minor Improvement Permit Class IV' ...__
,OCATION OF CONSTRUCTION
,Crest address or Description of Location) ,( p
URPOSE OF CONSTRUCTION �u J �I Sketch (attach construction plans if appropriate(
)ESCRIPTION OF CONSTRUCTION }-,',Q •'
)IMENSION .OF INS ALLATION OR REMOVAL
7o,h> - - N Lou .
;IZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
cl,i
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and deb,-is,.backfillmg, com-
paction and 'placing permanent resbrfacing 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 Ap i nt Agent
r Tr-urki nr, RQ723 01 d _C.a --v- J_ arc j3rj � jy[t�rri•ata � ("A o9 P (71 11) 667'1-8 I ;i6
arae of Applicant Ipiease print) Business Address Telephone No.
= i3�45-1778
ame of Contractor and Job Foreman Business Address 'Telephone No.
On File On File
ontractor's License No. City Business License No.
Ori P! l e fin . Pi 1 P
pplicant's Insurance Company Policy Number.
EES: Subdivision Improvement Permit — Class 111
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated. construction costs NO
Minor Improvement Permit — Class IV: See attached schedule. 1�I U
spection Fee $ ( PERMIT VALIDATION
rmit Fee
PERMIT NO.
nalty
sh Deposit -Surety Bond.. DATE APPROVED
squired EXPIRATION DATE
TOTAL: $ DATE ISSUED
ce)pt No.
By
calved by Date Administrative Authority
corded by TELEPHONE: x(619) 664.2246