2046ITE:.
With 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: 1/26/94
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIPMENT Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION D8L DOZER HAUL ROUTE: AVE.48 &
1219"H 13'8"W 90,000 lba WASHINGTON SOUTH TO AVE.52 EAST TO
JEFFERSON SOUTH TO AVE.54 EAST TO
DIMENSION OF INSTALLATION OR REMOVAL MADISON SOUTH TO AVE. 58 TO THE QUARRY
SIZE OF EXCAVATION, IF NEEDED
HAUL DATE : 1/26/94
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION D;
ESTIMATED CONSTRUCTION COST $ D
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements) D
JAN 4, U IUInd
In consideration of the granting of this permit, the applicant hereby agrees to: i
Indemnify, defend and save the City, its authorized agerts, officers, representatives and em to ee harmless from and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, lossrotdama -4,0 ersons propert
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant Lo thi appli ati)on.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be _stlrted.
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.
r
Signature oflApplicant or Agent
CHANNEL AND MARLOW -i
Name of Applicant (please print) Business Address Telephone No.
NUEVO ENGINEERING, INC. 79-811 Country Club Dr. Bermuda Dunes, 345-1778
Name of Contractor and Job Foreman
On File
Contractor's License No.
On File
Business Address
Telephone No.
On File
City Business License No.
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
10
$ 10
Received by Date
PERMIT NO.
2046
PERMIT VALIDATION
2046
DATE APPROVED 1/26/94
EXPIRATION DATE 1/26/94
DATE IS UE V26/94
By
le Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
N--26-94 WED
NOTE:
With proper valid,20on
this form Constitutes an
encroachment permit
PUBLIC
C31:26 Nuavo ENG I NEER I NG
I
11TY OF LA OUINTA
APPLICATION FOR
WORKS` CONSTRUCTION
PERMIT
(ENCROACHMENT)
P . 0 2
For the construction of public or private cZrbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works Improvements In c innection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
l
Subdivision Improvement Permit — Class 111 ea �.�
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
fStireet address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCimr.
DIMENSION OF INSTA,I*LATION OR REMOVAL
�Si2E OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, mote0als, and
paction and placing permanent resurfacing end/or r
in consideration of the granting of this permit, the
Sketch (attach construction plans it appropriate)
amt torte
Ave -
Is, backfilling, cons -
:Ing Improvements)
t hereby agron to:
indemnify, defend and save the City, Its authorized gents, offiewt, tepresentativas and employees, harmlett front and against any and all
m
penalties, liabilltles or lots resulting froclaims or ourt action and stiting out of any accident, loss or damage to persons or properly
happening or occurring as a proximate result of !nv work undartaken under the pwmlt granted pursuant to this application.
Notify the Adrolnistrative Authority at least twenty four 4241 Moura Its advance of Iha time when work will ba "Orad,
Comply with all ■pprlcabte City Ordinances, the term, and eondltFone of the oermlt and all applicable rule$ and regulations of the City of
U Mints and to pay for env additional replacament_necaosery as the reWit of this work.
�Ao s loo -- -
Vame of Applicant (please print)
Vame of Contractor and Job foreman
On File
ontractor's License No.
On.,Fil.p--
applicant's Insurance Company
EES: Subdivision improvement Permit — Class III
Signature of Applicant or Agent
Business Address Telephone No.
Businest.Address Telephone No.
0 ile
City Business License No,
Policy Number
VIYN 11•
Public Improvements: 3% of estimated cc
Private Improvements: 3% of estlnuted G
Minor Improvement Permit — Class IV: See
,spection Fee $
rmit Fee
natty
sh Deposit -Surety Bond
required
TOTAL: $ /e2
icelpt No,
'Calved by Date_.....
!corded by
uction C-Ists
ruction costs
:hod schedule
Extended Page 2. 1
N0
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUE®
TELEPHONE: (819) 664.2748
Administrative Authority