12481--------------------------�' + --------------------------------------------
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 II I
DATE: October 9, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION =
r
(Street address or Description of Location; ,
PURPOSE OF CONSTRUCTION — rove equipment Sketch•(attach construction plans if
. p appropriate) ,
DESCRIPTION OF CONSTRUCTION D6 Dozer HAUL ROUTE:
Hwy. 111 to Washington S/B to
"f Avenue 50.' E/B on Ave. 50 1/4
DIMENSION OF INSTALLATION OR REMOVAL 10' H., 11' 10" W mile,.
70.000 lbs'. s
HAUL DATE: 1`0/9/91.,
SIZE OF, EXCAVATION, IF NEEDED
' APPROXIMATE TIME WHEN WORK WILL BEGIN Pilot car required.
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.
. � ...�/' _• �C /ice •
S�ature of Applicant or•Agent r
Piconi Trucking' 39723 Old Carriage•Rd. Murrieta: CA 923621 (714) 677-8196
Name of Applicant (please print) Business Address Telephone No. ,
Nuevo Engineering Inc. 79-811 Country Club Dr. Bermuda"Dunes, CA 34571778 -
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 isoQ, 2SA
4I A(i0- 09-9i10.00, to
Public improvements: 3% of estimated construction costs '
Private improvements: 3% -of estimated construction costs 1248/.
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 10.00
Permit Fee ` ^.
Penalty
Cash Deposit -Surety Bond
if required
Receipt No.
Received by
Recorded by
Date
PERMIT VALIDATION
PERMIT NO.
1248
DATE APPROVED 10/9/91
EXPIRATION DATE 10/9/91
DATE ISS ED 10/9/91
By AlZfAn P
Administrative Authority
TELEPHONE: (619) 564-2246
i
F
• �,
�_y
NOTE•=
With'p'roper validation
this form constitutes an
k,ncroachment 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
DATE: 10 /9/91 Subdivision Improvement Permit - Class III
Minor Improvement Permit Class IV =
LOCATION OF CONSTRUCTION
(Street address or Description of Locatlonl
----------------
I.
PURPOSE OF CONSTRUCTION I Move Quinment
DESCRIPTION OF CONSTRUCTION D6 Dozer
OIMENSIOIy,QF 1ju,S0TgffION OR REMOVAL 0 W
SIZE OF EXCAVATION, IF NEEDED'
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST is
(Including removal of all obstruction, materials, and deb:•is, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
Sketch (attach construction plans if appropriate) .
•HAUL ROUTE:
Hwy. 111 to
Washington S/B to_
.Avenue 50.
E/B on Ave. 50
.1/4 mile.
HAUL,DATE:.
10/9/91.
r
I'► !�� Cfb �-
-2 Ec�t.� t 2i,t�
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 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
La Ouinta and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
Pi 0On i . �,
-- i rl t c' 1- n � '� Q 7 fl.-.-ldr.�.rrZ -
Name of Applicant (please print) -
Business Address Telephone No.
- -
Name of Contractor and Job Foreman-
• Business Address
1778
On File Telephone No.
Contractor's License No. On File
0F1 City Business License No.
Applicant's Insurance Company F1 I
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 % I%
'enalty
:ash Deposit -Surety Bond
' required
TOTAL:
leceipt No.
lecelved by
Date
lecorded by
�0
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED 101 (,(:I
EXPIRATION DATE Jd _7 l 9/
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564.2246