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1112Mr• NOTE: With proper validation this form constitutes an CITY OF LAS, QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS /CONSTRUCTION (ENCROACHMENT) For the construction of public . or private curbs, driveways, pavement's, sidewalks,: parking lots, sewers, water mains and other like public works improvements in connection with MINOR'IMPROVEMENTS and APPROVED SUBDIVISIONS Mays: 22o y1991' - - Subdivision lmprovement Permit — Class III DATE: -Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description Af Location) PURPOSE OF CONSTRUCTION move equipment Sketch.(attach construction plans if appropriate) R ''DESCRIPTION.OF CONSTRUCTION 16G Blade Haul Route",. ' ' 'From,city limits on Washington *DIMENSION OF INSTALLATION OR REMOVAL 11' .6" 'H,`10' 6't W 's /Y. to Ave '50 e/b approx..-1/2 mile 83,500 lbs. 3 k -Haul date: 5%23/9^1 SIZExOF'EXCAVATION; IF NEEDED ' APPROXIMATE TIME WHEN WORK'WILL BEGIN A., APPROXIMATE TIME OF COMPLETION J ` ESTIMATED CONSTRUCTION COST. $ (Including removal of all obstruction, materials, and debris, backfilling, com- paction om 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, itsauthorizedagents, officers, representatives and employees,•harinless 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: f h ! 2 L14Q 6 b L�'' L 0 A - Signature of Appy nt o gent - Piconi Trucking 39723 Old -Carriage Rd. Murileta,`CA•92362 (714}677-8196 ' Name of Applicant,(please print) ...'Business Address z Telephone No. _ Nuebo Engineering,'Inc 79 811`Couniry 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. 12 Public improvements: 3% of estimated construction costs :•... �; __ _ . 'Private improvements: 3% of estimated construction costs 8pp ii p -►_ F i1511 % 1 i2 i5g TQTALS-1 � 9i 10:00 0 -Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ PERMIT VALIDATION Permit Fee PERMIT NO. ' Penalty � / 91 Cash Deposit -Surety Bond DATE APPROVED f if required EXPIRATION DATE TOTAL: $ ,� DATE ISSUED Receipt No. 7/t, By Received by Date Administrative Authority Recorded by .TELEPHONE: (619) 564-2246 NOTE: With proper validation this form constitutes an encroachment permit CITY OF LA QUINTA APPLACATION FOR PERMIT PUBLIC WORKSICONSTRUCTION (ENCROACHMENT) P 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 22, 1991 Subdivision Improvement Permit — Class I I I DATE: 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 16G Blade Haul Route" From city limits on Washington DIMENSION OF INSTALLATION OR REMOVAL 11' 6" H, 10' 6" W s/b to Ave 50 e/b approx. 1/2 mile 83,500 lbs. Haul date: 5/23/91 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) 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 Appli ant d gent Piconi Trucking 39723 Old Carriage Rd. Murrieta, CA 92362 (714)677-8196 Name of Applicant (please print) Business Address Telephone No. Nuebo 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 Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by $ � / 4. 0?1 Date 1112 1Q0"HAAO i2 MAP -1311--91i0.00 SO PERMIT VALIDATION PERMIT NO. DATE APPROVED -5/ .a.3 EXPIRATION DATE DATE ISSUED { By Administrative Authority Recorded by II 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 Locationl PURPOSE OF CONSTRUCTION Sketch lattach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION LOU dl(1717i ��.� DIMENSION OF INSTALLATION OR REMOVAL l 1t Gti ' �I ,r� SIZE OF EXCAVATION, IF NEEDED FL V� 6V APPROXIMATE TIME WHEN WORK WILL BEGIN , APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ 5(2 ./including removal of all obstruction, materials, and debris, backfilling, com- - 3 1 ,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 proximity. result of any .work undertaken under the permit granted pursuant to this,application. Notify the. Administrative Authority it least twenty-four1241 hours in advance of the time when work will be started. Comply with all applicable City Ordinences,"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 4f ilica4i or Agent Pi -oni T)2ji(,kinQ Y P n I d Carr; a gP Rd )j�(irrri•a; a PA q?2h� C71 4) 67Z-81 6 � r --s v i Name of Applicant (please print) Business Address Telephone No. Nuevo Env—ineeringi Inc. 79-811 ,o untrv- Cluh Dr. RQrmiida Dunes, X45-1778 Name of Contractor and Job Foreman. Business Address Telephone No. On File On File Contractor's License No. City Business License No. O Fi1P on. Ei1P 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: $ teceipt No. leceived by Date lecorded by PERMIT, VALIDATION PERMIT NO. i DATE APPROVED _ EXPIRATION DATE DATE ISSUED By TELEPHONE: (619) 664-2246 Administrative Authority