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1845
NOTE: With proper validation 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 August 20, 1993 Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Fiesta and the Wash, La Quints (Street address or Description of Location) PURPOSE OF CONSTRUCTION Mayo Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION D81 Haul Router Ave. 58, Madison 106" H, 14' W, 85,000 lbs. Ave. 54, Jefferson ending at Fiesta and DIMENSION OF INSTALLATION OR REMOVAL the Wash. SIZE OF EXCAVATION, IF NEEDED Haul pates 8/23/93 APPROXIMATE 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 Quinta and to pay for any additional replacement necessary as the result of this work. — /12 1 (; e 's " Signature of Applicant or Agent Piconi Trucking 39723 Old Carriage Road, Murrieta, CA 92362 (714) 677 8106 Name of Applicant (please print) Business Address Telephone No. Nuevo Engineering, Inc. 79-811 Country Club Drive, Berauda Dunes, CA 345-1778 Name of Contractor and Job Foreman Business Address `j Telephone No. On Pile Ceti Vf i L. Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I I I 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 1© Penalty Cash Deposit -Surety Bond if required TOTAL Receipt No. $ /('-'3 Received by Date Recorded by 1845 PERMIT VALIDATION PERMIT NO. 1 19 y S DATE APPROVED gin o 19 3 EXPIRATION DATE X31 3 DATE IISjS�UED X51 ao 19 By Administrative Authority TELEPHONE: (619) 564-2246 SNO,r; I +,r' %I II Q,/1 i„ry• , 1 ,fit!' l i'.— r r' } I ..... • + .. � _ _ Z,hl). o Id I rug 746- r i ! 1 • -. ..t } r ,r- ,, r r r is , :r. r. t 1 n 71 -_ � •• �r,-i . s} 1 �..1..- _ -, ,,fir, � ' .�� L � I ,� •��_ ._ _._ ^. af r�L R11 Ir-I� ,r. r�i+�,,. , i, -_:.�! •^Ji 1y'•, 1 --- - _ � - . r - �r`1 SNO,r; I +,r' %I II Q,/1 i„ry• , 1