1739.10
1. NOTE ~ r • � .. :. � �
F ' ,With proper validation
2
this form constitutes an
;encroachment permit CITY. OF LA -'QUINTA
APPLICATION FOR PERMIT'
PUBLIC WORKS CONSTRUCTION(ENCROACHMENT)��
`SOF
For the construction. of public or private curbs, driveways, pavements, sidewalks, parking lots, sevvers',. water mains
and other like public works improvements in connection with MINOR -IMPROVEMENTS.and APPROVED SUBDIVISIONS
Subdivision Improvement' Permit — Class III
•�
DATE: 5/12/93 Minor Improvement Permit Class IV
• -LOCATION OF CONSTRUCTION Palm 'SprinRe
e
(Street address or Description of Location)
eciS;�.r. ',
' PURPOSE OF CONSTRUCTION Move Qquipment
;. Sketch (attach construction plans,if appropriate)
:.
623 Scraper
;
DESCRIPTION OF gONSTRUCTIIPN p
14 High, 10',Wide, 80,0001ba ROUTE:, JEFFERSON -AVE 50-'
.'. - WASHINGTONNORTH .. TO .
'DIMENSION OF'INSTALLATION OR REMOVAL THE CITY LIMITS
HAUL DATEt 5/13/93
SIZE OF EXCAVATION, IF NEEDED
PROXIMATE 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:
••
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 buinta and to pay"for any additional replacement necessary as the result of this work..
F /tel �•!!2c//.CG�c'�_�
Signature of Applicant or Agent
Piconi Trucking 39723 Old Carrigae Rd Vurrieta .92363'(714)• 677-8196
Name of Applicant (please print). _ Business Address Telephone No.
Nuevo Eng Inc 79-811 Country Club Dr.Bermuda Dunes (619) 345-1778
Nameof.Coniractor and Job Foreman Business Address Telephone No.
On E?ike
On File
Contractor's. License No. City Business License No.
1
On File On File
Applicant's Insurance Company , Policy Number
�.
FEES:. ,Subdivision Imp'roveme,nt'Permit - Class III 2-4S: 10
Public improvements: 36/o of estimated construction costs Y
Private improvements: 3% of estimated construction costs +•
• Minor Improvement Permit—, Class IV: See attached scFieduleJ:9
Inspection Fee $ PERMIT VALIDATION-.
Permit Fee 10.00. 1739
PERMIT NO..
'Penalty "
"',,Cash Deposit -Surety Bond'
'A if required
' TOTAL: $. 10:00
Receipt No.
Received by Date
Recorded by
DATE APPROVED'
5/12/93,
EXPIRATION DATE
5./13/93
DATE ISSUED
5/12/93
E
Administrative Authority
TELEPHONE: (619) 564-2246
t3 a -F— a 2*93 WED 9:17 NUEVO ENGINEERING
NOTE:
With proper validation
this form constitutes an
encroachment permit CITY OF Lao QUINTA.
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P . 0 2
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers,
water mains
and other like public works Improvements in connections with fAINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit _ Class 191
DATE: a 12. 149.3 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION _ Palm Springs
(Street address or 0ascription of Location)
PURPOSE OF CONSTRUCTION lment
DESCRIPTION OF CONSTRUCTION _623 Scraper
—„11'•!.2 High, 101 Wide, 60,000lbs-*
DIMENSION OF INSTALLATION 06 REMOVAL
SITE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL. BEGIN
Sketch (attach construction plant if appropriate)
Route: Jefferson, Ave. 50,
Washington, North
to the City Limits.
ate: 5/13/92
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(including removml of all obstruction, matfi0als, and debris, back fill ing,'com-
pactlon and placing permanent resurfacing end/or replacing improvernentsl
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, defend and save the City. its juthoriYed agents, officers, representatives and employees. harmlett from and against any and all
penalties, liabllltiet or lost resulting (torn claim, or court action and writing out of any accident, loft 6r damage to persons or property
happening or Occurrin® at a prOxb►ttat® tensa of any work undertaken under lha permit granted purtuant t0 this application.
Notify the Administrative Authority at Iain twenty-four lial haute In advance of the time when work will be started
Garnpiy with all applicable City Ordinancet, the terms and condltlont of the permit and all aapileable rules and r"utations of this City or.
La Cluinta and so pay for any' eddiftonal japhcement necessary as the result of this work.
Signature of Applicant or Agent
Name of Applicant Iplease print) Business Address 6
Telephone No.
B
Name of Contractor and Job Foreman '
Business Address Telephone No,
On File r
Contractor's License No. -- Qn File
City Business License No, �
Applicant's Insurance CompanTlt
y
Policy Number
-FEES: Subdivision Improvement Permit — Class III
Public Improvements; 3% of estimated conttrtertinn r,,•r•