1828NOTE:
With proper validation
this form constitutes an
CITY:OF LA QUINTA
encroachment permit ,
APPLICATION FOR PERMIT
PUBLIC WORKS-COIgSTRUCTION (ENCROACHMENT)
Ir �
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 III
DATE: 8/5/93 Minor Improvement Permit Class IV
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LOCATION OF CONSTRUCTION Del Webb
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment I
d
DESCRIPTION OF CONSTRUCTION 623 Scraper,
14' High, 10, Wide, 180,000 This
DIMENSION OF INSTALLATION OR
. . SIZE OF EXCAVATION, IFJNEEDED
AL
APPROXIMATE TIME VOHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTR CTION COST $
(Including removal of al obstruction, material and debris, backfilli g, com
paction and placing per \anent resurfacing and r replacing impr ements)
In consideration of the ;ting of this permit, t e applicant ereby agrees to:
ROUTE: Ave 58, Madison, Ave 54,
" ` , Jefferson, Country Club
DATE:
8/6/93
Indemnify, defend and save he City, its authorized agents, officers, representatives and employees, harmless from and aggVhst any and
penalties, liabilities or loss res ting from claims or court action and arising out of any accident, loss or damage to persons or prop
happening or occurring as a proxi ateresult of any work undertaken under the permit granted pursuant to this application.
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Notify the Administrative Authority at .east twenty-four (24) hours in advance of the time when work will be started.
Comply with all applicable City Ordinances,
La Quintaiand to pay for any additional re
Piconi
terms and conditions of the permit and all applicable rules and regulations of the City
rWie+yt necessary as the result of this work.
Signat'ure-oLA-pplicant or Agent
Name of Applicant (please print) `��. �' Business Address
Nuevo Engineering, Inc
ne No.
Name of Contractor and Job Foreman it 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
ii
FEES: Subdivision Improvement Permit — Class I II I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
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Minor Improvement Permit — Class IV: See attached schedule 18.28
Inspection Fee $ PERMIT VALIDATION
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
Receipt No.
10.00
'f
'I
$ 10.00
�I
Received by Date
�1
Recorded by
PERMIT NO.
1828
DATE APPROVED 8/5/93
EXPIRATION DATE 8/8/93 ►
DATE ISSUED 8/5/93
By /
Administrative Authority
TELEPHONE: "(619) 564-2246