1926NOTE:
x
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
10/13/93
LOCATION OF CONSTRUCTION 48TH AND ADAMS
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQT
DESCRIPTION OF CONSTRUCTION 9150
14'6"H, 13'6N, 55,250 LBS
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 10/13/93
APPROXIMATE TIME OF COMPLETION 10/13/93
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
Subdivision Improvement Permit— Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
HAUL ROUTE: HWY. 111, WASHINGTON,
TO 48TH ADD ADAMS
HAUL DATE: 10/13/93
RED
PILOT CAS:BILE
RQUI
A 1
0 C,T 13 1993
In consideration of the granting of this permit, the applicant hereby agrees to: I By tv l,/ I
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all f
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
PICONI TRUCKING 39723 OLD CARRIAGE RD., MMMETA, CA 92362 (714) 677-8196
Name of Applicant (please print) Business Address Telephone No.
NUEVO BNGINEBSING, INC. 79-811 COUNTRY CLUB DR., BERMUDA DUNES 345-1778
Name of Contractor and Job Foreman Business Address Telephone No.
ONB FILE
ON FILE
Contractor's License No.
1946
City Business License No.
ON FILE ON F
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 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 10'00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
Receipt No.
$ 10.00
Received by Date
PERMIT NO
PERMIT VALIDATION
1926
DATE APPROVED 10/13/93
EXPIRATION DATE 10/13/93
DATE ISSUED /0 -
Administrative b
TELEPHONE: (619) 564-2246
tFiority
Recorded by 11