19864 0► .
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
11/19/93 Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION RANCHO LA QUINTA
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION KOVB EQUIPMW Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL 824 DOZER
15% 149W, 62,000 LBS
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
HAUL ROUTE: JEFFMON TO AVE 50
AVE 50 TO WASHINGTON, WASHnMOP
TO AVE 48
HAUL DATE: 11/19/93
21= CAR RFQUIM
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
j
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-?esult 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.
Ovn)-m-i-L 4-Aa
Q r
I Signa%ure of Applicant or Agent
PICONI T'BUCKTNG 39723 OLD CARRUM RD., MUBRIETA, CA
Name of Applicant (please print) Business Address Telephone No.
NUEVO ERIHG, INC. 79-811 COUNTRY CLUB DR., BURMA DUNES, CA
Name of Contractor and Job Foreman Business Address Telephone No.
ON FILE ON FILE
Contractor's License No. City Business License No.
ON FM ON FILE
Applicant's Insurance Company Policy Number '
6
FEES: Subdivision Improvement Permit —Class III
a* 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:
10.00
.4n
$ 10.00 _.
Receipt No.
Received by Date
Recorded by
I�
NOV 19 1993
' Al
PERMIT VALIQA'T42
PERMIT NO. 1986: I
DATE APPROVED 11/19/93'
EXPIRATION DATE
11/19/93
y
DAVE ISSUED 1 19/93
By
Administrative Authority
TELEPHONE: (619) 564-2246