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1778NOTE: With proper validation O/4 2 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 DATE: 6/28/93 LOCATION OF CONSTRUCTION The Quarry Subdivision Improvement Permit — Class II I Minor Improvement Permit Class IV (Street address or Description of Location) PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 824 Dozer Route. Jefferson (N City Limits) 15' High, ti Wide, 109,000 ilbs to Ave 54 to Madison to Ave 58 to The Quarry DIMENSION OF INSTALLATION OR REMOVAL Date 6/28/93 SIZE OF EXCAVATIONjF NEEDED pilot car require>!t APPROXIMATETIME 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. I 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 necessaray s the result of this-werk Signature of Applica t r Agent Piconoi Trucking 39723 Old Carr"ge Rd Murrieta (714) 677-8190 Name of Applicant (please print) Business Address Telephone No. Nuevo Eng Inc 79-811 Country Club Bermuda Dunes 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 111 Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit --Class IV: See attached schedule Inspection Fee $ Permit Fee 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date Recorded by 1.778 PERMIT VALIDATION PERMIT NO. 1778 DATE APPROVED 6/28/93 EXPIRATION DATE 6/28/93 DATFFJ.S. UED 6/28/93 By Administrative Authority TELEPHONE: (619) 564-2246 -1; '4 NOTE: With proper validation this form constitutes 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 loss, sewers, water mains and other like public works improvements in connection witli MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS DATE:Subdivision Improvement Permit — Class III �1-}.0 '�� Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION — mhe 0 tarry Golf Course . La Quinta IStieet address or Description of Location) PURPOSE OF CONSTRUCTION -- Move Equipment DESCRIPTION OF CONSTRUCTION — 824 Dozer I,' High, 14' Wide 109,000 lbs DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attach construction plans if appropriate) Route: Jefferson St. (N—City Limits) to Ave 54, to Madison St., to Ave. 58, to The Quarry 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: Date: 6/28/93 Pk.,o-17 CA4Z- Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any end 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 Quints and to pay for any additional replacement necessary as the result of this work. Signature of Applicant or Agent Pi tenni _�I "iirki n(yr �g723 fu rl rarsiagp P Mttrri,at ('n Name of Applicant (please print) ' x"-' _Q 3h2_ (71h) n-77 l'1 Business Address Telephone No. NUeyn Engineering Tnn 7(i_S2i •P_ - Name of Contractor and Job Foreman v Business Address On File Contractor's License No. Telephone No. On File City Business License No. Applicant's Insurance Company ' 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 $ Permit Fee Penalty 'ash Deposit -Surety Bond required TOTAL: $ I p leceipt No. leceived by Date lecorded by N� PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE U ' Zi — 9 3 DATE ISSUED By Administrative Authority TELEPHONE: (819) 684.2248