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1140e. 4 � v 5 �,E , n. ►• •�� i 4 }� �,,:, �� tij • 5F n,„t, .0. ;.�.&.:.1 ,+4 1..i • `•,..J..=-"-- .r . _, t ,~,..c3 _ ...N `a .-...J.;.a„. ; ,y # 5� ' f Y,` q r a-....•.,......tw...:iaw...rc ."ukiL,.. -i-, _�a�S#::,,. is ' NOTE: ` With proper validation '' 2 this form constitutes an - oencroacFiment permit CITY OF :' LA QUINTA APPLICATION .'FOR PERMIT. ' ' PUBLIC WORKS CONSTRUCTION (ENCROACHMENT).�� OF For the. construction of public or - private curbs,, driveways, pavements, sidewalks, parking lots, .sewers; water -mai- ris' ~ and,other like public works improvements in connection with MINOR. IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement( Permit — ClassII I DATE:"/ / Minor Improvement Permit Class,1V LOCATION OF.CONSTRUCTION (Street,address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach. construction plans if appropriate), n E C 41 ( N 0 C T R ION ��'" ��"—' ' �'; • °� v�` wo DIMENSI F INST LL Ti4N ' R REMO' ;'; r' ✓1 UL/„ C^C SIZE OF EXCAVATION, I F NEEDED * Y',`f F, fir. ' .. • /,�. 1 ^`' �G%� /r�/ �I�GV /' APPROXIMATE TIME"WHEN WORK WILL BEGIN _APPROXIMATE TIME OF COMPLETION aly LCd v' ' ESTIMATED. CON STRUCTION'COST $ ' (.Including removal of all obstruction, materials, and debris; backfilling, com action and placing permanent resurfacing and/or replacing improvements) P 9 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 F 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 ofc' �•; s ' , La Quintaand io' pay for any additional replacement necessary as the result of this work. ' ,Fi ' ` f• 21 Signature of pp icant a#i 0 7 r14 k1 3 N me of Applicant( ease print) , .( Name of Contrac and.Job Foreman Contractor's.License No' Business Address Business'Addressphone No. f Telephone No. T • -17 CIO • City Business License No. �- Ap'plidant's•lnsurance.Company r Policy Number FEES: Subdivision Improvement Permit -Class III t °3�,� Public improvements: 3/° of estimated construction costs. Private improvements: 3% of estimated 'construction costs <� p.. T. ". Minor. Improvement Permit—' Class IV: See attached schedule .j : f. - Inspection Fee $ PERMIT VALIDATION Permit Fee' PERMIT NO. 'r Penalty ; LC Cash Deposit Surety Bond *DATE APPROVED if, required EXPI .TOTAL: $ (J D TE ISSU No. Receipt , y ... Received by Date Administrative Authority ,. . ' ,r ecorded by TELEPHONE: (619) 564-2246 ,1 ^. ;yrti, ,.. .. .,�_. .... 'T• - .A ....:.�" � ..�. .....-r--r.�..'� _.r.-..,^.,�`s^v.,,.,ti.sU'E.t-+��n�.�..:t��'..'t^-��, rv.�..w�t4�. ._e..-.,_r�sSC.��`, �v'F, t,, :''-C ... � l . 1 i � 1 � • � . . _ r r � 1 1 � , v !� � .. ' ; i F J • � � \ � l . 1 i � 1 � • � . . _ r r � 1 1 � , v !� � .. ' ; i F J r NOTE - With proper validation this form constitutes an encroachment permit r _ -• ,�. }. Y aaf� w ",�•y��',r,-" �. � ' * ies�., Y '.•.a+!' �:,>�,w r,e�-: 1�`;.2 iRR ,. •• n.- �r � � T.�:..... .�iL.• .�.. a.. ..•...''�„drKiTr..-S. ..nAaS'X � �. _. � �wr`a..d,�.'�.1f:.. 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 ImprovementPermit — Class III DATE: /� % Minor. Improvement. Permit Class IV, LOCATION OF CONSTRUCTION (Street address or Description of Location) ' PURPOSE OF CONSTRUCTION JI C(/ .L• ) rf I Sketch (attach construction plans if appropriate) DESC IP ON OF CON TRU TION f DIMENSION• F INSTALLATION R REMOV Ir (' `�� C r c. a Cj7 lt��t� �'y I. SIZE OF EXCAVATION, IF NEEDEDl� 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: f Indemnify, defend and savethe 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 orproperty 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. uuan,wa , caa Contractor's License No --- City Business License No. aa. •fir• 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 VALIDATION Permit Fee 1-6� `' `-� PERMIT NO. '' .q'LI_ J Penalty DATE APPROVED - A/ If Cash Deposit -Surety Bond itrequired 6 • J� EXPI A�FO'�1-D,ATE TOTAL:. $ I r_ 3! (' Receipt No. s 'tTE IS %,.. By Received by Date Administrative Authority ;t' Recorded by , . .TELEPHONE: (619) 564-2246 • . NOTE: With proper valid this form constitutes an. f, 'CITY OF LA QUINTA . 5 � encroachment permit••- APPLICATION FOR PERMIT i PUBLIC. WORKS CONSTRUCTION (ENCROACHMENT) ` wS For, the- construction of'`public or .private curbs; driveways, pavements, sidewalks, parking lots, sewers; water -ri ains and other like public works improvements in. connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit — Class III DATE: / J Minor- Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) ' fJ )_7/ ,g PURPOSE OF CONSTRUCTIONS (,i�9 �Dr �•L1% 7 / Sketch (attach construction plans if appropriate) U IVJ T ,M—T t6TIL0NrIL.`IVY I DIM SI F INST LL TIQN R REMO SIZE OF'EXCAVATION, IF NEEDED.- (C6 ,✓l -� ` n Aux APPROXIMATE TIME WHEN WORK WILL BEGIN (_-lel `% (_C�� vv V"`,� nn APPROXIMATE TIME OF COMPLETION 1 C�;rr7D fL'r1C ESTIMATED CONSTRUCTION COST $` (Including removal of all obstruction, materials, and debris, backfilling, com- n �!- 7/6 /n / 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 rgranted pursuant to this application. ,Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started. ' r 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 pp icjan�t p _ Z \ �� l ' i bj'oi ALl ��'_ N e of Applicant a print) Business Address, Telephone No. Sq 7 I4 � Name of Contratacand Job ForemanBusiness Address ��elephone No. C�. Contractor's. License Nom— City Business License No. - j Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit - Class (III �. Public improvements: 3% of estimated construction costs v " 3 1 40 Private improvements: 3% of estimated construction costs ' I Minor- Improvement Permit — Class IVi See attached schedule i j Inspection Fee. $ PERMIT VALIDATION i Permit Fee PERMIT NO: 14 n Penalty 'y h i Cash Deposit -Surety Bond DATE APPROVED if -required.,.. , EXPI Q I 'TOTAL: $ . 0 6� 7 D TE-ISSU Receipt No. , By Received by Date Administrative Authority Recorded by TELEPHONE: (619) 564-2246 NOTE: JUith proper validation .. -- his form constitutes an CITY OF" LA QUINTA mcroa'chment permit APPLICATION FOR . PERMIT PUBLIC WORKS CONSTRUCTION.. IENCROACHMENTI. For the construction of public or private curbs, driveways, 11 pavements, sidewalks, parking lots, sewers, water mains and other like public works improvements in connection with MINGR,IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit — Class DATE: M)nor Improvement Permit Class' IV LOCATION OF CONSTRUCTION IStieet address or Description of Location) PURPOSE OF CONSTRUCTION -1-! 1�1Y�- Sketch.(attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION � � neo l�c� _ .. DIMENSION. OF INSTALLATION O_R REMOVAL � � NQS SIZE.OF. EXCAVATION, IF NEEDED 5 I r r APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION'1 Old •, . Ij q,4 8 /q J ESTIMATED CONSTRUCTION i;;OST $ �/(�(,(,(�C R (Including rernoval of all obstruction, .,Materials, and deb; is, 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 authors:id agents, officers, representatives end 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 et" 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 x la Quints, and to pay for any additional replacement necessary as the -result of this work. L ,re n Signature of li or Agent Pi onni_.. 'Pr_I j{ kind _ -' 3Q7?3 0 1 d C(.rriar, e' Rd • , t11i1rri.a (:'A Q22FP (.�711L) Name of Applicant (please print). Business Address Telephone No Nuevo Engineering. Inc. 79-81-1 Country C1uh Dr. Rermuda Dunes- L15-1'77.8 ,Name of Contractor and Job Foreman Business Address Telephone No. On File On File Contractor's License No. City Business License No, 011 File nn F'i1P Applicant's Insurance Company ,Policy Number FEES: Subdivision Improvement Permit — Class III Public improvements: 3% of estimated construction" costs Private improvements: A of estimated construction costs . ` Minor Improvement Permit = Class IV: See attached schedule l� 0 nspection Fee $ I PERMIT VALIDATION 'ermit Fee I PERMIT NO.. 'anally DATE APPROVED :ash Deposit -Surety Bond � � ` `required EXPIRATION DATE TOTAL: $ DATE ISSUED ' leceipt No. By. leceived by Date Administrative Authority lecor'ded by TELEPHONE: (619) 564.2246