1836w
s
3
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 lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit— Class III
DATE: 8/13/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Move Equipment The Pyramids
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 824 Doter Sketch (attach construction plans if appropriate)
15High, 140 hide, 109,000 lbs
DESCRIPTION OF CONSTRUCTION ROUTE: La Quint& portions of
Jefferson, Ave 50
DIMENSION OF INSTALLATION OR REMOVAL DATEf 8/16/93
PILOT CAR REQUIRED
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
j APPROXIMATE TIME OF COMPLETION?993
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-SY
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 Quinta and to pay for any additional replacement necessary as the result oft is work.
Signat re of Applicant 01
gent
1'iconi Trucking
Name of Applicant (please print) Business Address Telephone No.
Nuevo Engineering
Name of Contractor and Job Foreman Business Address Telephone No.
On File
Contractor's License No.
On file
On file
City Business License No.
On fila
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
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond ..
if required
10.00
TOTAL: $ 10.00
Receipt No.
Received by Date
PERMIT NO
1836
PERMIT VALIDATION
1836
DATE APPROVED
8/13/93
EXPIRATION DATE 8/17/93
DATE ISSUED 8/13/93
By 5t��
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
NO I E:
With proper valldatlorl
Ibis form constittltt.s aii
encroachment permit
IL 0 : 24 UES{ NG I NEER I Na
CITY OF LA CUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION jENCnOACIIMENT)
P _ 04
For the cgimri)cttoil rtf public or private Curtis, driveways. Ilavements, sidewalks, parklnq lots, sewp.rt, vvltpr 111,11111
and gthf!r Hk,,pijblic works impicivements in connection with MIN0I1 th9l'TIO EMENTS.at,d APPtIOVEI) 900131VISIONS
Subdivision Improvement Permit — Class Ili
DATF,'-8/13/93 Minor Improvement Permit Class IV
LOCATION OF CONSYnUCTION - The Pyramids, La Quinta
(Street address or Llescription of Locallonl
PURPOSE OF CONSTRUCTION Move Equipment
DESCRIPTIQN OP CONSTRPC O 2 oxer
15 High, 14 �icte, , s .
DIMENSION OF INSTALLATION OR REMOVAL .�.�
SiZE OF EXCAVATION, IF NEEDED
APPROXIMATE TiME WHEN WORK WILL BIEGIN..
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST'S
lincluding removal of alt obstruction, materials, and debAo, bat:klilfing, corn.'
paction and placing permanent resurfacing and/or replacing Improvements)
in consideration of the granting of this permit. the applicant hereby agrees
Sketch (attach construction plans it approprlate)
ROUTE: La Quanta portions of
Jefferson, Ave. 50
Haul Date: 8/16/93
R:o� c.�-",t �
to:
Indemnify, delenr) arvd save tine Clty, its authorized agent9, offica(t. repretenlarfves and amplovess, harmlest from and agairdt Ing ♦nd ell
penettiet, liabilities or Ione resulting from clairtiy or Court action and arising out of any accident, toss or damage to pertornl or property
t,appening or occurring at a prorrimara fetult of any woroc undertaken under the permit granted pursuant to this application.
Notify the Adrrninittrativo Authorlty of feast twenty-four 1241 hours In advance of the tirns when work will be started.
Comply with all rapplicabtl City Ordinances, the tatmo iod conditlons of the parrrmtt and Ill appllchbll fulet Ind regulations of the City pf
La Quints and to pay for mY additional replacement ntr-assery ea file result of that work.
Signature of Apptir$nt or Agent --
Name of Applicant (please printl t rsl.a T
BUSinen Addresss'i 1�1 t'
Telephone No.
-'_`�:'i'll.LSCSZ~j'cL1L�.i t /1)—ij I I (`n 11r11r� (''I u}r t7Pr ttc�rrnrvi
Name of Contractor and Job Foreman
Business Address Telephone No,
Contractor's License No.
n File
City Business License No.
—Uri Ei In - —__
Appflcant's insurance Company
Policy Number
FEES: Subdivision Improvement Perir►it— Class
Public Imptovements: 3%. of estlmated construction costs
t
�"-, , i .1