1121NOTE -
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.11l
DATE: 6/6/91 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 IUl, "ROUTE:
IENSION OF INSTALLATION OR REMOVAL 11' 6" H, 10' W S/B ON WASHINGTON TO AVE 50
J
11,00 LBS E/B APPROX 1/2 MILE
HAUL DATE: 6/7/91
-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- 005182 10 "2443 06-05-91. 14
paction .and. placing permanent resurfacing and/or replacing improvements) Q CASu 1 TnTAI i 1 a': 00
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. t.
Comply with all _applicable City Ordinances, the terms and conditions of the permit and all applicable. rules and regulations of the City of �.
t
La Quinta and to pay for any additional replacement necessary as.the result of this work.
an*11-M] L v, n,
P
� Signature of Applicant or Agent - -
PICONI TRUCKING 39723 OLD CARRIAGE RD MUR FTA: rA 99369 71A-677_R10�,
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 Busine'ss.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 VALIDATION
Permit Fee 10.00 PERMIT NO: 1121
Penalty6/6/91
Cash' Deposit -Surety Bond DATE APPROVED'
if•required EXPIRATION DATE 6/7/91
TOTAL: $ 10."00 DATE I U 6/6/91
Receipt No.
B
Received by Date Administrative Authority,
Recorded by TELEPHONE: (619) 564'-2246
r� t .� s 1 y 1 '$ i i i �
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I
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
Subdivision Improvement Permit — Class II I
DATE: 6/6/91 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 HAU, ROUTE:
I ENSION OF INSTALLATION OR REMOVAL 11 6" H, 10, W E/B ON WASHINGTON TO AVE 50
11500 LBS /B APPROX 1/2 MILE
SIZE OF EXCAVATION, IF NEEDED HAUL DATE: 6/7/91
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com- p05182 10 2443 06--05-91 14
paction and placing permanent resurfacing and/or replacing improvements) 40 rASzH 1 TOM S i (Y. (10
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 or Agent
PICONI TRUCKING 39723 OLD CARRIABE Rb' 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 III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs .
Minor Improvement Permit — Class IV: See attached schedule
wrt
PERMIT VALIDATION
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
10.00
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
PERMIT NON 1121
1 6/6/91
DATE APPROVED
EXPIRATION DATE 6/7/91
DATE I SU 6/6/91
Administrative Authority
TELEPHONE: (619) 564-2246
! .4, "
JUN— 6 7'9 1 THU 1 9 NUEVO ENGI NEEVNG
NOTE: JJ
With proper walirfalin"11
this fon" constit(il!el air
encroadiment pet Alit CITY OF LA QUINTA.
APPLICATION! FOR PERMIT
i PUBLIC WOnKS CONSTRUCTION (ENCROACIIMENTI
i .
For theC: �;u++r t ren of public 'of I pIrivatte curbs, driveways, pavements, sidewalk's, parking lots, sewers•. watet mains
and other Iilic p+,lilic.works improvements in connection with MINOR IMPROVEMENT'S and APPROVED SU1301VISIONS'
P _ 0
' Subdivision Improvement Permit — Class III
-----
DATE:L✓ Minor Improvement Permit Class IV'
LOCATION OF C�NStAUCTIO' N d '
i
15treat addresf or Delcription of Locstlonl--�...._
PURPOSE OF COASTSUCTION' Sketch (attach construction fans if a
P pproprietel
DESCRIPTION 04 CONSTRUCTION � Had AuXD.
DIMENSIO(OF IbSTA(LATION OR REMOVAL—LL'
SIZE OF=EXCAV�TION, IF NEEDED
APPROXIMATE MIME WHEN WORK WILL BEGIN
APPROXIMATE IME OF COMPLETION =— —
ESTIMATED CO STRUCTIONCOSTS
(Including remove of all obstruction. materials, and debAs, backfilling, com :
pactlon and placir g permanent resurfacing.,and/oe replacing Improvements) �...._ _
In consideration Olt -the granting of this permit. the, applicant hereby agrees to: —.__-
Indemnify, ddari(I Ord save the City, its suthdrlied agents, officers, repietentatives and employees, hamaless tiorn and agnum any std all
penalties, liebilIries or lots resulting Itom claims of court action and &rising .+put of any accident, loss or darrisge to pertnns or propa+ty
happening or Arrurri6g as a proatinlat& result of spy work undertaken under the permit granted pursuant to this appliretion.
Nati}y the Adfnir,i,naNNe Authority et Peat twenty -fort► 1241 hours in advance of the tin"t'whtln, work will be slerted.
comply With,t !n'-pliceble City 0 dinancet, the'tarms and conditions of the permit and all applicable piles and regulstiont of the Clty of
La Quints s, • to pay for sny additional replscernent ner.atsary as the result of this work,
Signaturs QfA A'An n i nt A
t�a niva. L . �;T. �iil r'r'�•'�_�i f!Q ! i
Name of Appiicant printf
Business Adwdrfe1ss,``, Telephone No,
Name of Contractoland ,lob ForemanAddres's'
i Buslness Telephone No-
Contractor's Lite;) fJn � City Business License No. -
.�f)11._.E'.i l.r._ i
Applicant's Insurl4r) Cgn,parly U.t�_—..._..-...._
Policy Number
•'�'Ln- �T..a-. fid. �.�[a• ,
FEES: ' Subdivisloti Improvement Permit ---Class U(
Public ii1provernents: 3% Of estimated construction crit((
Extended Page;: 2F.1'RN=1
Private
�P:�ltll COSt4
onst►uction
:1
t
,t ,a ,� t Yy .s Jr i •'�" ^, s
i
p ovcrnents: 3% �P Qstl
r rconstructiori costs
y
'`Minor Imp ov`ement Permit - tr9ch�d ,,
,. t Cless !V: Se® et schedute
= NO ,gi n
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ispectiorl Fee. M 4 $
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PERMIT. VAbDATION
errnit Fee
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'`DATE APPROVEb
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TOTAL:
EXPIRATION _ ATE / ..
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;leceiptNo.
E ISSUED �.----_,..-�����/
DATlecelveOy
pate,
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tecorded by h r `�
AdrniniStretive Authorltyx
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TEREPIIONE:
IH_19) 564 2248
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