2032,yam
OTE:WNOTE;-
With
ith proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
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 3, 1994
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIPMENT
DESCRIPTION OF CONSTRUCTION D6 Dozer
10 H, 11' 10' W, 40,000 LBS
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
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)
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
In consideration of the granting of this permit, the applicant hereby agrees to:
Sketch (attach construction plans if appropriate)
HAUL ROUTE: AVE. 48 TO WASHINGTON
TO NORTH,CITY LIM
D Q �
IJ 1N04.,Q94
BY
HAUL DATE: 1/4/98
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 wor< 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. ! )
i
Signature of Applicant or Agent
PICONI TRUCKING 397 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 ON FILE
Contractor's License No. City Business License No.
A ON FILE
" ON FILE
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111
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 1t
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10
Receipt No.
Received by Date
Recorded by
2032
PERMIT VALIDATION
PERMIT NO. 12=& 20322
DATE APPROVED
EXPIRATION DATE 1/14/94
DATE ISSUED " L)' L
By
Administrative Authority
TELEPHONE: (619) 564-2246
um
I'
r: J 3- _4 _. M, C7 t'. 1 1 3 1 N U E V O ENGINEERING
NOTE:
With proper vaiidalitttt
this folm ^snstitutrs rut
Cl*?Y OF LA OUINTA►
f;nl;todl,"INu4i1t Oratnit
APPLIATION FORPERMIT
PUBLIC WORKS C NSTRUCTION (ENCROACHMENT)
For th(rnrrihur;lif!n rIf l,t MiC Ut .IslivBte ct.
and other like public walks improvements in co
LOCATION OF CONST llt)GTION
(street address or Descrlptinn of Location)
PUnPOSE OF CONS fRUCTION
DESCRIPTION OF CONSTRUCTION b
_.i' l . tt-
MOVE E(
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
,APPROXIMATE TIME WHEN WORK WILL BEGIN
'APPROXIMATE TIME OF COMPLETION
.ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and d(
paction and placing 11etwaneiit resurfacing and/or rep
In consideration of tlu: grn!ttioll of this p+rtrlit, tilts a
P _ 0 1
driveways, pavements, sidewalks, parking lots, sewers, water malas
ion with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class III
Mlnor Improvement Permit Class IV
Sketch jattach construction plans if appropriate)
HAUL ROUTE: A e— o
is, backfilling, com- HAUL DATE:
'ing improvements)
Ilicant hereby agrees to:
Indrinnify, riviri0 nnti '.avrr Iltr City, it, nutltr1rl11A aqr? it, officrrs, r?piesrnintives Pnd rntployres, ftartnleu 110111 Plitt nQllnst ltly And all
pa,10100t fipbilitir; lir Inst resulting ftom eiiifrll or eciurt action and arising out of any at;cident, loss or damage to persons or prolle'rty
hArpi.)III119 Or ofrurtim) as a nlouimnte result of ally wok undertakers under the permit granted pursuant to this application,
Motily die Adminishrilivr Authoilty at least trienly-tour (241 hours in advance of the time when work will be started.
c11if1llly with ,It ;'Pt1lir,dll,! 0ty Clrrtimmta;e, fire Wr ms o11d conditions of the permit and all applicable rules and regulations of the City of .
(A (uintn "1111 to 11av 101 nay additional replacement necessary as the result of this work,
PICONI TRUCKING _ 3
flame of Applicant print)
NIJEVO.�ENGIf1FP:WINGt , INC. J
dafne of Conttactot and firth foletttart
ON
,ontractor's License No. ^ ~~µ
ON FILE _
nppllcant's It Corilpilly
'EES: Subdivision -lnlprr vetttc+lt Permit —Class III
Public ilnpinvr lrtr!rtts; 3% of estimated consto
Private iniprovetrlPnts: 2% of estimated constr
Signature of Applicant or Agent
Business Address Telephone No,
Business Address Telephone No.
ion costs
tion costs
ON FILE
City Business License Pio.
ON FILE
Policy Plumber
t, "A a?
lk
y�
MM"'Or Intpiovm►+ent Permit — Class IVi See atta
•tspretion Fra $ ....._ _
imalty
ash Deposit Su+nty i1mill
IWAL: R._..
ac�liit No.
Date
rrn1(led by---..._.._
schedule
Extended Page 1,1
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
Administtative Authotity
TELEPHONF: (619) 564.2246