Loading...
2058x NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) i 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: 2/8/94 LOCATION OF CONSTRUCTION Subdivision Improvement Permit — Class I II Minor Improvement Permit Class IV (Street address or Description of Location) PURPOSE OF CONSTRUCTION Mode Equipment Sketch (attach constructionlans if appropriate) ppropriate) DESCRIPTION OF CONSTRUCTION 637D Scraper 14'8"H,13"W, 115,000 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) _ In consideration of the granting of this permit, the applicant hereby agrees to: Haul Route: ave, 48 & Washington North to City Limits. Haul Date: 2/14/94 Pilot Car Required. 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 a�,the result of this work. r ( ^ /-, Signature of Applicant or Agent v Nuevo Engineering, Inc 79-811jCountry Club Dr, Bermuda Dunes 345-1778 Name of Applicant (please print) Business Address Telephone No. On File 4 Name of Contractor and Job Foreman Business Address Telephone No. On File Contractor's License No. On File City Business License No. On File On File Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit— Class II 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 _ Penalty Cash Deposit -Surety Bond if required TOTAL 10.00 $ 10.00 Receipt No. Received by Date Recorded by PERMIT NO. I FEB 0 S 1994 205 , t_ PERMIT VALIDATION--- - 2058 DATE APPROVED 2/8/94 EXPIRATION DATE 2/14/94 DATE I SU D " 8 �q t By AA &A1W6V10-- ( Administrative Authority TELEPHONE: (619) 564-2246 - _ _ �� .� .. ., � �, .�., ,. �- r � _. .� _ _ _. .. ;;F E — S-94 TUE 1 5: 1 6 N U E V O ENGINEERING NOTE: With proper validation this form txsnstltute$ an encroachmelit permit CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the construction Or public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water and other like public works Improvements In connection with MINOR IMPROVEMENTS and APPROVEt) SU13DIVI remains SIGNS P . 0 Subdivision Improvement Permit -- Class 111 Minot Improvement Permit Class IV LOCATION OF CONSTRUCTION Istiest adetrilee --r— V. Lwnonr PURPOSE OF CONSTRUCTION it I y� DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST S (Including removal of all obstruction, materials, and debi'is, backfilling, cora• paction and placing permanent resurfacing and/or replacing Improvements) Sketch (attach construction plans If appropriate) 4-�a,-L�l 'Rt�-C- . In consideration of the granting of this permit, the applicant hereby agrees to: indemnify, defend elmd lave the City. Its authorlted agents, offlears, representatives "employees, harmless from and sgeintt any and ell penaltlet, fiabllltiat or lots resulting from claims at court actlon and arisins out of any accident, toss Or damage to pentons at property happening or Occurring a$ a proximate Mull of.any work undertaken under the permit granted pursuant to this appfiatlon. Noilty the Adminitlrsilve Authority at least twenty-four 1241 hours in advance of the tires when work will be starved, Comply with all anpllcable City Ordinances, the terms and condition$ of the permll and all applIcable rules and regulatloni of the City of V Quinti and to pay lot any additional replacement necasary as the result of this work. Signature of Applicant or Agent Name of Applicant (please print) _d����"i"�''�"`� Business Address Telephone No. Name of Contractor and Job Foreman Buslnets Address On File Contractor's License No, Telephone No. n Pit City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class III Public Improvements; 3% of estimated eonstructinn r.,ete