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14624OTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For theconst _ rn of _ construction , public or private wcur•bs, drivew"ays, pa'vemencs,��id,"walks;';.parking: lots;^ •sewers;"`water mains `hand'otherV'like06blieworks-improvements�in-connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit— Class III DATE:. June 12, 1992 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Move Equipment DESCRIPTION OF CONSTRUCTION 623 Scraper 14' High, 10' Wide, 110,000 lbs DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attach construction plans if appropriate) Haul Route: Washington to Fred Waring (East) to Adams (South) 1/4 miles Haul Dateo 6/15/92 b p i 8118 J1 ?Q 13 � OTA^i `^p� 10.00 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)lc_ l IQ�QrG�'fL.CU��� 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 Carriage Rd. Murrieta, CA (714) 67.7-8196 Name of Applicant (please print) Business Address Telephone No. Nuevo Engineering, Inc. 79-811 Country Club Dr. Bermuda Dunes,.CA 345-1778 Name of Contractor and Job Foreman Business Address Telephone No. On File Contractor's License No. On File City Business License No. On File On File Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class III Public improvements: 3°k of estimated construction costs Private improvements: 3% of estimated construction costs f `st1, Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. 10.00 Received by Date Recorded by 14,62" PERMIT VALIDATION PERMIT NO. 1462 DATE APPROVED 6/12/92 'y EXPIRATION DATE 6/15/92 DA E SSUED _ 6/12/92 By Administrative Authority TELEPHONE: (619) 564/2246 NOTE:,-'' With �Aloper validation this form constitutes an encroachment permit 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 MINO! IMPROVEMENTS and APPROVED SUBDIVISIONS CITY OF LA QUINTA; APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) � DATE: June 12, 1992 LOCATION OF CONSTRUCTION Move Equipment (Street address or Descriptlun or t-ocatlonl PURPOSE OF CONSTRUCTION 623' Scraper DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL 141H.1 10 TW 110 , 000 )LBS . SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV Sketch (attach construction plans if appropriate) HAUL ROUTE: Washington to Fred Waring(EAST) to Adams (South)'about k -mi . 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 t happening or occurring as a proximate result of any work undertaken under the o Demons or property 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 Quints and to pay for any additional replacement necessary as the result of this work. e of Applicant (please print) e of Contractor and Job Foreman On File tractor's License No. FEES: nt's Insurance Company Signature of Applicant or Agent s-- i n Ear. -t L Business Address 6 Telephone No. —fjtry ('1 uh Dr RPrTYIuda n Business Address 177 8 Telephone No. Subdivision Improvement Permit — Class I11 Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule ction Fee $ rmit Fee nalty sh Deposit -Surety Bond required TOTAL: $ ecelpt No. Led by Date by A On File City Business License No. Policy Number N0 PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: (6.191564-2246