2074c -
NOi
~'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
2/22/94 Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION _
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Eq*ipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 623 Scraper
141H,11'8"W, 80,000 lbs Haul Route: Ave448th And Washington
to Ave 52 To Jefferson, Jefferson
DIMENSION OF INSTALLATION OR REMOVAL to Ave 54. To Madison, to Quarry
Haul Date: 2/22/94
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:
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.
Signature of Applicant or Agent
Piconi Trucking 39723 Old Carriage Rd., Murrieta, CA (714) 677-8196
Name of Applicant (please print) Business Address Telephone No.
Nuevo Engineering, Inc
Name of Contractor and Job Foreman
On File
Contractor's License No.
Business Address Telephone No.
On File
City Business License No.
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 $ 10.00 1I
Permit Fee _
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by
Date
2074
PERMIT VALIDATION
PERMIT N0. 2014
DATE APPROVED 2/22/94
EXPIRATION DATE
2/22/94
DATE ISSUED 7.1 4
r ti+
BY
�A,,�
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
�0
FEB -22-94 TUE 9: 2:3 U E V O G I NEER I NG
s
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
R _ 0:3
For the construction of pubile 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
r� (y� j Subdivision improvement Permit — Class III
DATE q4
"L`�_._ - Minor Improvement Permit C1a:s IV
LOCATION OF CONSTRUCTION
iStreat address or Description of Loeatlonl
PURPOSE OF CONSTRUCTION QU ?i i t ClrZne n� Sketch (attach construction plans if appropriate)
DESCR�P�ON QF �?NSTRUIQTION r
h- i t r i i'l n A^ 11"C;_
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, 1F NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
(Including removal of all obstruction, meterlals, 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:
to \j e- son,
A
indemnity, defend and sive the City, III eutharited agent$. Officers, repre$entativel and ernptevees, harmless from and against any and all
Penalties, liabilities or loss resulting from claims or court action and stioing out of any accident, lou or damage to persons or property
happening Or or,,currhill a$ a proximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Administ(ative Authority at least twinty•four 1241 hours In advance of the time when Werk will be stated.
Comply with all applicable City Ordinsness, the terms and conditions of the permit and ail applicable rules and regulations of the City of
La QuInts and to pay for any additional replacement necessary as the of this work.
Signal u of Applicant or Agent
Name of Applicant (please print) Business AddressTelephone No.
NuPtrn "n,ginee ing. Tne, 7q—�11 Cotlntrx 4:11 „ Dr Rorm�rri �e"� ilr 1778
Name of Contractor and ,lob Foreman Business Address Telephone No.
On File__
Contractor's License No.
On Mc�,
City Business License No,
Applicant's insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III
',Public Improvements: 3% of estimated construction casts
'{ Private Improvements: 3% of estimated construction costs
Minor Improvement Permit ,- Class IV: See attached schedule
r'spection Fee $
b
'ermft Fee
'analty
:ash Deposit -Surety bond
'required
TOTAL: t
tecelpt No.
tecelved by Date
tecorded by
Extended Page 3.1
N to
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED 2 - - LZ — q �
EXPIRATION DATE . 2 ,� Z Z `(
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 664.2246