1848NOTE:';!!
,With proper validation
this form constitutes an
encroachment permit
CITY OF LA QU_INTA
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: 8/24/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION The Pyramids
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Eguigme►nt
D SCRIPTION OF CONSTRUCTION D8 Dozer Cab & RippArs
w/Blade attached. 15' H, 1416" W, 90,000 lbs
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
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:
ROUTE: Northend of Monroe Sty
Indio Blvd, Jefferson,
Miles, Washington to Ave
48
DATE: 8/24/93
PILOT CAR,REQUIRED
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.
Signature of Applicant or Agent,
Channel & Marlow LowBed 8466 E. Amberwood 'Anaheim 92808 (714) 921-8440
Name of Applicant (please print) Business Address Telephone No.
Nuevo Engineering 110�
Name of Contractor and Job Foreman Business Address Telephone No.
On File
Contractor's License No.
On Pile
Applicant's Insurance Company
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
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
10.00
$ 10.00
Date
On Pile
City Business License No.
On Bile ► =
Policy Num
AUG 2 4 1993
184
PERMIT VALIDATION
PERMIT NO. 1848
DATE APPROVED 8/24/93
EXPIRATION DATE 8/24/93
DATE ISSUED 8/24/93
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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