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1111NOTE: 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 Subdivision Improvement Permit — Class:111 DATE: May 22, 1991 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION .(Street address or Description of Location) PURPOSE OF CONSTRUCTION Move equipment Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION scraper Haul route: CiT LtNe9"fes' '''DIMENSION OF INSTALLATION OR REMOVAL 10- W S/B on Washington to Ave 50 E/B approx'1/2;miles lbs. ,SI . SIZE OF EXCAVATION, IF NEEDED Haul Date: - 5/23/91 APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ,e 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 an and'all Y 9 Y 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 A6lican r Agent c Piconi Trucking 39723.01d Carriage Rd., Murrieta, CA:92362 714 677-8196 Name of AptPlicant (please print) Business -Address Telephone No. Nuevo Engineering, Inc. 79 811 Country Club Dr. Bermuda Hunes 345-1778 Name of Contractor and Job Foreman Business Address Telephone No. on file f i A Contractor's License No. City Business License No. on file on .file Applicant's Insurance Company Policy Number P — FEES: Subdivision Improvement er mi t Class I II Public improvements.:. 3% of estimated construction costs " ` 0 2 5b 5-22-9i 10 .. i� ,051 ��� i1��lTA� i SO•.00 Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ PERMIT VALIDATION Permit Fee PERMIT NO Penalty Cash Deposit -Surety Bond if., required TOTAL: $ Receipt No. Received by Date Recorded by DATE APPROVED EXPIRATION DATE DATE'ISSUED By r Administrative Auth6riiy. TELEPHQN,E: (619) 564-2246 !8' h !8' 1 NOTE: With proper validation this form constitutes an encroachment permit y.t" •: ✓�� .1 �� d f r$ t 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 22, 1991 LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Move equipment DESCRIPTION OF CONSTRUCTION 523 scraper DIMENSION OF INSTALLATION OR REMOVAL , 1 110,000 s. 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- action and placin permanent resurfacing and/or replacing improvements) Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV Sketch (attach construction plans if appropriate) Pg In consideration of the granting of this permit, the applicant hereby agrees to: Haul route: Fe cAA G tT`( Li *,%1 T5 S/B on Washington to Ave 50 E/B approx 1/2 miles Haul Date: 5/23/91 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. o�n�� I aaLTI 1 Signature of Ap , licant,or Agent Picoa 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 Bunes 345-1778 Name of Contractor and Job Foreman Business Address Telephone No. on file Contractor's License No. on file on file City Business License No. 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 Penalty Cash Deposit -Surety Bond if. required TOTAL: Receipt No. $ /Q . ec Received by Date Recorded by f 805i��1�01i 17AL5 f22-91 i0. QA 10 PERMIT VALIDATION PERMIT NO. DATE APPROVED _ �JJ 91 EXPIRATION DATE DATE ISSUED -5-4) zo/gj By Administrative Authority TELEPHONE: (619) 564-2246 NOTE: With proper validation this forrnp),ristitutesan, 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 (�) Q Subdivision Improvement Permit —Class III DATE: / 1 Minor Improvement Permit Class IV .LOCATION OF CONSTRUCTION (street address or Description of Location) - PURPOSE OF CONSTRUCTION 'Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION , dash DIM N O INSTALLATION OR'REMOVAL ' _ SIZE OF EXCAVATION IF' NEEDED S . I APPROXIMATE TIME'WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ , (Including removal. of all obstruction, materials, and debris, backfilling, corn—,. 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 authorlZed agents, officers, representatives and employees, harmless from and against my 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 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 l.a Quints and to Day for any additional replacement necessary as the result of this work. 0 L.lo j 'W !1A7 40_4 :.Pi ('nni ` r-unki ng 3Q723 n1 d C2 r 3gr� PH T Miirri,Pta � rA 92��2 (Zl.h)n. -ZZ-81;16 Name of Applicant (please print) Business Address Telephone No. Nuevo Engineering, ' Tn6,, 79-811 CountLy 01 iih Dr. Rer'muda. Dunes, X45-1 778 Name of Contractor and Job Foreman Business Address_ ,Telephone No. On File On� File Contractor's License No. City .Business License No. On Pi 1 e C)ni].P ' Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class Ill Public improvements: 396 of estimated construction'costs , Private improvements: 3% of estimated construction costs Minor. Improvement Permit — Class IV: See attached schedule nspection Fee $ I� 'ermit Fee 'enalty :ash Deposit -Surety Bond ' required '.TOTAL: $ leceipt No. ' leceived by Date iecorded by PERMIT VALIDATION PERMIT NO. " DATE APPROVED EXPIRATION DATE DATE ISSUED By I I Administrative Authority TELEPHONE: (6191564.2246