1479NOTE:
With,proper validation
this form constitutes an
encroachment permit
f
..00N 1, NINE,
CITY OF LA QUINTA
APPLICATION FOR PERMIT
$ rubLR: VVUKKJ GUIVJ 1 KUG I IUN (tN(;HUAL;HMtNT)
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 a4APPROVED SUBDIVISIONS
` Subdivision Improvement Permit— Class Ill
DATE:' June 30, 1992Minor 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 225 Cat excavator length .�
legal, 651`weight gross '105,000, width 10 1/2' ROUTE: City limits on Washington
12' high. to Miles Ave.east on Miles
DIMENSION OF INSTALLATION OR REMOVAL to...Adgms, north 1/2 mile
to La Palma.
SIZE OF EXCAVATION, IF NEEDED'
APPROXIMATE TIME WHEN WORK WILL BEGIN DATE: 6/30/92 or 7/1/92 ,;ONB TRIP
APPROXIMATE TIME OF COMPLETION ` UnY,
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements) `
Inconsideration of the granting of this permit, the applicant hereby agrees to, ,
tindemnify, 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
`
John Piconi Trucking 39723 Old Carrige Road Murrieta.•CA (714)677-8196
Name of Applicant (please print) Business Address 1 Telephone No.
Walton!e Backhoe Service -, 77580 Robin -Rd: Palm Desert, CA 92260 345-5212
Name of Contractor and Job Foreman Business Address Telephone No.
One file
Contractor's License No. f City Business License No.
Applicant's Insurance Company ' , Policy Number r
FEES: SubdivisionlmprovementPermit— Classlll - AQ SH S'TUT w �p•04ip
4
Public improvements: 3% of estirnated'construction costs
Private improvements: 3% of'estimated construction costs 1 �} �71
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
10.00
$ 10.00
Date
PERMIT VALIDATION
1479
PERMIT NO.
DATE APPROVED 6/30/92
EXPIRATION DATE 7/1/92
DATE 18SU D 6/ 0/92
By
Administrative Authority
TELEPHONE: (619) 564-2246
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i.
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�a
NOTE:
With proper vdidebow
this form constitute 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
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS-
DATE:
I�,
SIONS"'
DATE:
LOCATION OF CONSTRUCTION - .H DP (Yl
(Strm eddress or DuanPtion of Locetionl
PURPOSE OF CONSTRUCTInIu Mn %/ i =- <Z -
REMOVAL
SIZE
SIZE OF
cn�.I1vM1'Ulm, Ir NEEDED
Subdivision Improvement Permit - Class 111
Minor improvement Permit,Clasa IV
/ A
Sketch (attach construction plans if appappayd',,.
APPRO)CIMATETIME WHEN WOR WILL BEGIN I M (l �S 1v r--
C) k) �-(l ( E -S
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ 0 P- tk-
(Including removal of all obstruction, materials, and debris, badtfilling, corn' • �,-� LA
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, reprauntativea and employlrei; harmless from and against any and all
Penalties. liabilities or loss resulting from claims or court action and arising out of any accident. 1023 or damage to persona or properW
happening or occurring u a proximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at lust 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 end all applicable rule and regulations of Me City OI
V Quints and to pay for any additional replacement neommv as the result of this work.
M
.0 Praf
'tel. l L
Name of Applicant (please print)
Name of Contractor and Job Foreman
.Signature of Applicant or Agent '�/ �p 77 Sl
Business Address
Business Address 11-1
Telephone No.
Telephone No.
Contractor's License No.
tv
r„
?,City Business License No.
Applicant's Insurance Company
Policy Number
FEES_ Subdiuicinn Imnrnvernant Parrnif — rlast III