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NOTE: y
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
,, 31, 1991 Subdivision Improvement Permit —Class IIIMA
>
DATE: '' Minor Improvement Permit Class IV
_LOCATION OF CONSTRUCTION `
(Street addressor Description of Location)
MOVE EQUIPME2�'1' U
' 'PURPOSE OF CONSTRUCTION Sketch (atta'ch construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 8240 DOZER HAUL ROUTS;
. CITY LIMITS ON WASHINGTON S/B T0, ”
AVIKI 50 -'
DIMENSION OF INSTALLATION OR REMOVAL 13 H'* 13' •9n V E/B APPROXIMATELY 1/2 MILE >
97.00O.LB
'HAUL DATE: 6/3/91
SIZE OF EXCAVATION, IF NEEDED•
' (PILOT ,OAR RRQ1iRED)
'APPROXIMATE TIME WHEN WORK WILL BEGIN ,
'APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all "obstruction,'materials, and debris, backfilling, com J
paction •and `placing permanent resurfacing and/or -replacing improvements) ^
F `In' consideration of the 'grant yg 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 an d.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. _
f 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.
d S gnature of A�pplicant(oA Agent a
'PICONX TRUCKING 39723'OLD CARRIAGE RD_MURRI19TA, CA 92362_ (714) 677»:8196
Name of Applicant (please print).- ,Business Address Telephone No.,
NUEVO : ENGINEP. NG,'1I14C ' -79-811 COUNTRY CLO 'DR„ "BERMUDA DUNES A0-1778
Name of Contractor and JoS, Foreman ' ' Business Address r 'Telephone No.47
'
ON rILB ON flu
r
Contractor,s-License No. City Business Licerise No.
ON FILE V ON PILE ,
Applicant's Insurance.Company r Policy'Number '
FEES: 'Subdivision Improvement Permit'— Class III t 14
t.. Q
�
...
Public improvements: 3% of estimated construction costs 1 18 Rsh° 12TRTA�5131-9i MOO -,7
�'.
Private, improve ments: 3%of estimated construction costs' ,
4 Minor Improvement Permit - Class IV: See attached schedule
Inspection Fee $' , _. PERMIT=VALIDATION
1116 . .
Permit Fee PERMIT NO. '
Penalty5-31-91
Cash Deposit -Surety Bond DATE APPROVED
itrequired �: EXPIRATION DATE 6-03-91
10.00 - 5-31-91
TOTAL: $ DATEISS ED
t
Receipt No.
By
Received by Date 10t inistrative Authority
Recorded by TELEPHONE: (619) 564-2246
4.
NOTE:
With proper validation
this form coristitutes 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
MAY 31, 1991 Subdivision Improvement Permit — Class III
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 824C DOZER HAUL ROUTE:
CITY LIMITS ON WASHINGTON S/B TO
AVE 50
DIMENSION OF INSTALLATION OR REMOVAL 13' H, 13' 9" W E/B APPROXIMATELY 1/2 MILE
97,000 LB
HAUL DATE: 6/3/91
SIZE OF EXCAVATION, IF NEEDED
(PILOT CAR REQUIRED)
APPROXIMATE TIME WHEN WORK WILL BEGIN
-APPROXIMATETIME 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(o, Agent
PICONI TRUCKING 39723 OLD CARRIAGE RD MURRIIETA, CA 92362 (714)_677-8196
Name of Applicant (please print) Business Address Telephone No.
NUEVO ENGINE.".ING, 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 III 1g 60 '' 2-31-91 10
Public improvements: 3% of estimated construction costs• 40'460 1 T�rA�.g10
1 .00
Private improvements: 3% of estimated construction costs 116
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
10.00
Permit Fee PERMIT NO.
Penalty DATE APPROVED 5-31-91
Cash Deposit -Surety Bond
if required -03-91 DATE 6-03-91
10.00 •41! A , „w ,,,;t;rn, 5-31-91
TOTAL: $ DATE ISSUED
Receipt No.
I
• I
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
{
NOTE:
W;th proper validatir,tt
this form oofastitutes air
encroachmelit perrttit
FR I 1 1SS NUEwO ENG I NEEtWNG
CITY OF. LA OIUINTA
APPLICATION F011 PERMIT
1'111BLIC VVOnKS CONSTRIJtCTiON (ENCROACHMENT) .
P _0 2
For, the cx)nstrrnaioo of public or private Curbs, driveways; pavements„ sidewalks, parking tors, sewers, water mains
and other lime pi,t,lic works improvements in connection with MINOR IMPROVEMENTS and'APP1i0VEb Stlf)f)IVISIONS
�Stabdivislon Improvement Permit Class. Ill'
DATE: ,l �� �.C1_1 .- Minor Improvement Permit Class IV ..,-----�
LOCATION O,F CONS1 RUCTION
(Street address or Descrlptlon of t_osetionl J
PURPOSE OF CONS17AUGTION e P ;�, ,0/�1'�
Sketch (attach eonatruction plans if appropriate)
DESCRIPTION OF CONSTRUCTION [bid
�fll
Al
DIMEE ....5�" LLATtON OR REMOVA t r ��(wYYt C%y� VVI l r�
L
SIZE OF EXCAVATION. IF NEEDED
Fy
APPROXIMATE TIME WIIEN WORK WILL BEGIN
map
p
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRI,ICTION COST a �.` } .100 1 r
(including removal of all obstruction, materials, and deb. -12, backfilling, coact
paction and placing psi rnanent resurfacing and/or replacing Improvements)
In• chnsideration of the granting of this permit, the applicant hereby agrees to:. Q,
Indarnnrfy; defenrj end save the City. Its authorized agents. officers, represeaa*at Ives and employees, haunless from end agau»r any ehd all
penalties, liahilltiPs or loss resulting Prom cairns. at court action ind arising out 'of any accident, 1013 or damage to pertnns nr property
happening or 00a,rring 93 a proximate reiult of env worts undertaken under the permit granted pursuant to this appticatlon.
Notify the Adrnir,;%itative ,Authority at least twenty-four (24} houri In advance of the time whan work will be started,
Comply with 811 snnticabte Clty Ordinances, the terms and conditions of the permit rand all eppllcable runes end regulations of the City of
La Quanta and to ,r.Ay for any additional replacement necessary as the 'retult of this work,
Signature of A lice or Agent
lsc
Name of Appli(.ant :((trite print} Business Addtess Telephone No.
.79—_811 crolli-ty .Glut)
Name 64 Contractor and :lob Foreman
9usietess Address Telephone No.
O._1e
'1.._. Ori N'iTe
Contractor's.__License PIs'.. �'� -- •_. •.=,
City .Business License No,
Applicant's insurance Contparty�__....�._-
_ Policy Nuniber
�-•"-►-ti•...-�—..ter--'-'• - � _
._ _. -....: .�_'�-•c—s�,orfr r.. .rte. :t-rpt•.-•+r�rvr-rer;..�.a,�i.✓.
Subdivision improvement Permit — Class III
Public immovemenis: 3% of estimated construction costs
Extended. Page 2.
.1
;, • , ... ......:......Y,�..,�o W, eaum construction costs
-Private improvemensof estlrconstruction
,3%
t �a ,"Milmplovernent Permit Cles's IV: Sj�j0.
ee �� �� '�/�SO '
Y«•
attached schedut®'
nspec11on Fee. R ` ' $
-- ----
'
PER
ERf MI,TN AIIdATIOt� ,
'ermit Fee.
,. _1
T, ,._
enalt " .
t r?l:FtMITrIVp,a + .'
$hl. Deposit •Sin0rY fin:li9cl�ti
DATE APPROVE D
're red
Rt —•----�--� * ....................
.... ...... 1E3tPl,ii°ATI0N DATE
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DATE`tSS,UEp
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