1827NOTE:
'%Wifh 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 lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: YOMM 8/4/93
LOCATION OF CONSTRUCTION Dal Webb
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV-
Date
V
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 824 Dozer
15' High, 14' Wide, 109,000 lbs ROUTE: Ave 58, Madison, Ave 54,
Jefferson, Country Club
DIMENSION OF INSTALLATION OR REMOVAL
DATE: -11200. 8/6/93
r
x
SIZE OF EXCAVATION, IF NEEDED t
APPROXIMATE TIME WHEN WORK WILL BEGIN PILOT CAR REQUIRED
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: q
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 o
r
Si nature of Applic nt r Agent
Piconi Trucking 39723 O1dCarriaae Rd Murrieta (714) 677-8196 1
Name of Applicant (please print) Business Address Telephone No.
Nuevo Engineering Inc
Name of Contractor and Job Foreman Business Address Telephone No.
On File On File
Contractor's License No. City Business License No.
On File On File
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule 1 827
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:,
Receipt No.
Received by
10.00
$ 10.00
Date
PERMIT VALIDATION
PERMIT NO. 1827
DATE APPROVED
8/5/93
EXPIRATION DATE 8/6/93
DATE ISSUED 8/5/93
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
10'00
10.00
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With proper validation
this form constitutes art `
encroachment permit CITY OF �A QUINTA
tj
APPLICATION FOR PERMIT �
r PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) � .L�
For the canstrurtton of Public or private curbs, driveways, pavements. sidewatks, narking lots, sewers. water rnairts
and other like public works improvements In connection with MiNOR IMPROVEMENTS and APPf30VE0
SUBDIVISIONS
DATE: -8/4/93 ��--
Subdivision Improvement Permit — Class I11
- Minor Improvement Permit Class IV �~
LOCATION OF CONSTRUCTION Del Webb —"""----
(Street addrets or, 0ascriptlon of Location)
PURPOSEOF CONSTRUCTION Move Equipment �.. Sketch (attach construction plans if approprlote)
DESCRIPTION OF CONSTRUCTION . 524_pozer
' UGH, 14-1 WIDE, 10 0O.lbs. Ave. 58, Madison, Ave. 541,
Jefferson, Country`Club,
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NCEOEO Haul Date: 8/6/93
APPROXIMATE TIME WHEN WORK WILL BEOIN ` n tQily�
APPROXIMATE TIME OF COMPLETION ..,.,.., — \ vu� Ci
ESTIMATED CONSTRUCTION COST $
_
(lnctuding removal of all obstruction, materials, and deb: it, backfilling, com-
paction and placing permanent resurfacing and/or replacing Improvementsl
in consideration of the granting of this permit, the applicant hereby agrees to,.
Indemnify, defend and saw the City, its autherhed agents, officers, representatives and employees, harrnlest 110rrs and aonsr any grid oil
penalties: liabilhies or loss resulting from claim or court action and writing out of any accident, lost or damage to persona or property
happening or occurring as • proximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Aaminlstrative Authority et least twenty4our (241 hours In advance of the tirr» when work will be started.
Comply with all applicable City Ordinances. the terms and.condltions of the permit and all spplleable rules and reputations of tha Clty of
t a Qulnta and to pay for any additional replaeerrient necessary a the result of thb work.
Signature of Applicant or Agent
Pi rig 14
Name of Applicant (please print) . . I fig
Business Address Telephone No. i
Name of Contractor and Job. Foreman
On File
Contractor's License No,
Business Address
Telephone No.
On File
1 City Business License No.
Applicant's insurance Company '
=71 Policy Number
FEES: Subdivision ImproveMent Permit —Class IIi -y
Public Improvements: 3% of estimated construction costs
Private Improvements: 3% of ettirri ted construction costs
Minor Improvement Permit — Class IV: See attached schedule N
i ttspection Fee a
PERMIT VALIDATION
''ermit Fee !Tj
'enalty
'ash Deposit -Surety Bond
' required
TOTAL:
$
lecelpt No.
tecelved by Date
tecorded by
N'
PERMIT N0,
DATE APPROVED ' J Ct
EXPIRATION DATE
DATE ISSUED
By
--------------
tiAdministrative Authority
TELEPHONE: (619) 564.2248 r
1 J���