1733NOTE`
With proper validation
fo.�m9constitutes an
•
encroachment permit
1 '
CITY OF LA QUINTA
APPLICATION' FOR- PERMIT
PUBLIC WORKS CONSTRUCTION .(ENCROACHMENT) .
t'
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 1I1
DATE: 5/6/93 Minor Improvement Permit Class.IV,
LOCATION OF CONSTRUCTION La Ouinta
(Street address or Description of Location)
'`'PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 623 Scraper
14'High, 10'Wide, 80,000# ROUTE: Washington,* Ave 50'
..
Jefferson
,DIMENSION OF REMOVAL
INSTALLATION R
0 O O AL
HAUL: 5/7/93
,,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 `
paction and placing permanent resurfacing and/or replacing. improvements)
'In consideration of the granting of this permit, the applicant hereby agrees. to:
u 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 propefty
•
16ppening or occurnn as a proximate result of any work undertaken under the Permit 9ranted pursuant to this. application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started. `•? p
r Comply with all applicable City Ordinances, the terms and conditions of the permit, and all applicable rulesand.re'gulations of the City, of ,
La Quinia 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 92362 (714) .677-8196
' Name of Applicant (please print) Business
Address Telephone No.
-""
t ,
' Nuevo Engineering Inc 79-811 Country. -Club
Dr Bermuda Dunes 345=1778''
Name of Contractor and Job Foreman Business
Address Telephone No. ,.
.
On Pile
On File.
'Contractors License No.
°'" City Business,Lieense No. I
,
On File •
.. t•
On File
Applicant's Insurance Company `
Policy Number J
;l
FEES: Subdivision Impr'ove'ment Permit = Class I II'
Public improvements: 3%of estimated construction costs
x 5cc�� pp b
'�? tA��I]TA�:
9,3,: x<, , •i '
tpc0t1
Private, improvements: 3% of estimated construction costs
•
.
+. Minor 'Im.provemenf Permit —Class IV: See attached'schedule.
,
Inspection Fee A$
PERMIT VALIDATION
Permit Fee 10.00PERMIT
NO. 1733' t
enalt +..
I`} Y,
.
DATE APPROVED 5/6/93 •
Cash Deposit -Surety Bond
if required
EXPIRATION DATE�IS/7/.93
TOTAL: $ 10.00
h" ' S 6 93 1
DATE'' SSU . D _ / /' ./' r
.
4Ri t`No
... ecep
'.Received b �
y Date
By
/ j Ad/ lnlstrative
uthorlty
s .;,Recorded by �'
fi
TELEPHONE:'(6 9) 564-224
.u:
i
t.
1 . t,' ;Ak4i.S:M •• '`U -�. NeKH�-'
.t.F��' M`RMS(�._. .. ..
r a.q-•`e� = 6— -9Z T H U 110 ::31 N U E V O EMG I NEER I N G P. 02
NOTE:
With proper validation
this form oonstitutes an
'encroachment permit
CITY OF LA OUINTA
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 APPROVER SUBDIVISIONS
DATE.
�5 6 Subdivision improvement Permit — Class IIIw
,.. Minor Improvement Permit Class IV .�
LOCATION OF CONSTRUCTION La Quinta
Istieet address or Description of Locations
PURPOSE OF CONSTRUCTION ._ Mnve Fg. ment
DESCRIPTION OF CONSTRUCTION 62 Scra er
r10tV. 80,1000 lbs.
2
DIMENSION OF INSTALL ATION OR REMOVAL ..,�
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plant if appropriate)
Route: Washington, Ave. 50,
Jefferson
Haul Date: 5•/7/93
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ '
(Including removal of all obstruction, materials, and dab,, -Is, backfilling, com=ma
pactlon and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, defend and taus the City, Its authori2ed agents, officers, representalivet and employees, harmless from and against any and sit
penalties, liabilities or loss resulting from claims or court action and arising out of any eceldent, loss or damage to persons or property
happening or occurring as a prorimete result of any work undertaken under the permit granted pursuant to this application.,'
Notlty the Administrative Authority at least twenty-four 1241 hours In advance of the time when work will be storied,
Comply with all applicable City Ordinances, the terms and conditiono of the permit and all applicable rules and regulations of the City of
U Ouihta and to pay'for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
' � �f 7�'L�77 k l n6r_ng�92342'
Name of Applicant Jplease print) Business Address Telephone Np, h d-
NUeyo Engjaeej!ing_ Inc. 22-811 Coun ry-01iij) Dy,_ Berrfflidn Dune 34_34'�-1'778
Name of 'Contractor and Job Foreman Business Address Telephone No.
On File _ On File
Contractor's License No, City Business License No.
s
Applicant's Insuranca Company Policy Number
FEES: Subdivision Improvement Permit — Class IiI
Public improvements: 3% of estimated construction c-1scs