2031NOTE:
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
JANUARY 1,1010
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIPMENT
DESCRIPTION OF CONSTRUCTION 623 SCRABER
14H, 12 W, 80,000 LBS
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
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:
Sketch (attach construction plans if appropriate)
HAUL ROUTE: Ave. 58 to Madison,
Madison to AVe. 54, AVe 54 to
Jefferson, Jefferson to North City
Limits
A 1
PILOT CAR REQUI7r J AN 0 4 1994
HAUL DATE: 1/4/94
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.
JQ
Signature of Applicant or Agent
PICONI TRUCKING 39723 OLD CARRIAGE RD. MURRIETA$ CA 92362 (714) 677-8196
Name of Applicant (please print) Business Address Telephone No.
NUEVO ENGINEERING, INC. 79-•811 COUNTRY CLUB DR., BERMUDA DUNES, CA 345-1778
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 FILE
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 10
Penalty
Cash Deposit -Surety Bond
if required `
TOTAL: $ 10
Receipt No.
Received by Date
Recorded by
2431
PERMIT VALIDATION
PERMIT NO. tl1�'tLtS 2031
DATE APPROVED I- 17 -94
EXPIRATION DATE Off --WEE 1/4/94
DATE ISSUED r ��
By
Administrative Authority
TELEPHONE: (619) 564-2246
m
3
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'fly.; •
'�JAN— 3-94 MON i 1_ 29 NUE: V O ENG I NEER I NG R 02
NOTE:
With proper vatidatioil
this foln,-cilstihltes ;111 CITY OF LA OUINTA
clreloaehn,crrq to:tnril
APP TONSTRUCTION
CATION FOR PERMIT
PUBLIC WORKS (ENCROACHMENT)
For the constratf;tintl of public or private cufhS, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public watks ilttptovemetlts in connection with MINOR IMPROVEMENTS.and APPROVED SUBDIVISIONS
DATE_A/_-__-�_�-_I�q
LOCATION OF CONS I-IlUCTION _
(Street address or De$crintion of Loratlon)
PURPOSE OF CONSTRUCTION ------- MOVE
DESCRIPT10,19F CUJ410N000
DIMENSION OF INSTAI.LAT ION OR REMOVAL.
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WIIEN WORK WILL BEGIN
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans If appropriate)
UUL ROUTE: Ate , V\Aa is6 A i
4o
APPROXIMATE TIME OF COMPLETION _
ESTIMATED CONSTRUCTION COST $ t
(Including removal of all obstructinn, materlals, end d ris, backfilling, com- HAUL DATE : l ( �t
p►ction and plachtg 11rrmarmnt resurfatinry anti/or regi acing Improvements)—
in consideration of thu yrnntinq of this permit, the applicant hereby agrees to;
Indenmiry, drfvno ,lift �,;tva thr City, ll^ ?ttthoti,?rd aq,nts, ntfirnrs, represimunilvcs and rtmployees, Ilarintess (torn and annlnst nny sml all
benallirts, linhilitivi r,r 1css resulting from claims or c urt action and arising out of any accident, toss or danoge to persons or pioperty
happOning Or vrC.iriuwrl ae in ptgwimate result Of any ' rk undertaken under the permit granted pursuant to this application.
Notify the Adit,ini5it,10vti Atithotpy at least twenly•for 124) hours In advance of the time when work will be started.
i"nngtly Willi, it ;uarlir'.,1dr, (:icy (ltrfin1trrrs, ihr Irrms.and cnn$I(ions of the permit and all applicable rules and regulatiot,s of the City of
1_a CJulnra ants to imy fol illy additional replacement ecessary as the result of this work.
Signature of Applicant or Agent
PICONI TRUCKING39723 OLD C"RTACR Rn- W.lttlaT17TA ANA 012111c1% IV11% A-Im
Name of Applicant (psll-ase print) �V
NUEVO ENGINEERING. INC.
Name of Contactor 110 J,11) Foreman
ON FILE
Contractor's License Nn. �~
ON DILE
Applicant's Insurance. Company
Business Address
Business Address
FEES: Subdivislon Improvement Permit —Class III
Public lmprovemetits' 3% of estimated const uction costs
Private improvernet,ts; 395 of estimated conste�euction costs
Telephone No.
Telephone No.
ON FILE
City Business license No.
ON FILE
Policy Number
Minor Impiovonimit Permit – Class IV: See at
Inshectinn Fe.o
Permit Fey �o —
Cash t)eposit Snlply 13(sntl
it required__�-_–�---
7 o w.
Received by _.._..---.._ Date
-
schedule
Extended Page 2.1
PERMIT VALIDATION
PERMIT NO, C).L _ _
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By —
Adminlftrative Authority
TELEPHONE: 16191 564.2249
0