20885OTE:
ifKi proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP - OVERSIZE LOAD PERMIT
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: 3/1/94
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PUffgaE qF PP VJTP, �6TJO 55,2Mobe Eigiftlnnnt
DESCRIPTION OF CONSTRUCTION
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
Sketch (attach construction plans if appropriate)
Haul Route: Ave 48th And Adams to
Washington, Washington to Ave 52 East
to City Limits
Haul Date: 3/2/94
Pilot Car Required
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 Road, Murrieta, CA 345-1778
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 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 I I 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 $ 10.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ 10.00
Received by Date
PERMIT NO.
2088
PERMIT VALIDATION
2088
DATE APPROVED 3/1/94
EXPIRATION DATE
3/2/94
DATE ISSUED 3 1 4
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
G
MAR_ 1—SO4 TUE 9- 3 3 N U E V'O ENG I NEER I N G R.@ 4
wtb
With proper validation
thls form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION IENCROACHMirNTI
Comp`� Tragi o.. C;-; A& ( z ZL d e� n ()e.rr, ,,,L' -r -
For the construction of public or private curbs. driveways, pavements, sidewalks, parking IQ,%, sewers, water mains
and other like public works Improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE.-
Subdivision Improvement Permit - Class IIi
Minor Improvement Permlt Class IV
LOCATION OF CONSTRUCTION
664et address or Descriptlon of Locatlonl
LL
PURPOSE OF CONSTRUCTION Sketch (attach construction plans If appropriate,
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 ail bi
4 A-(3 Vr)c,!1ci k r\,cP n,
to C� it i, -t->
o struct on, materials, and deb: Is, backfilling, corn- �`
paction and placing permanent resurfacing acid/or replacing Improvementsl ` Cot -A-
in consideration of the granting of this permit, the applicant hereby agrees to:
Indemnity, defend and lava the City. Its authorlaed age i", offiears, represanlativel and Impteye k hlrmlH/ from and against any and all
penalties, liabilities or to,$ resulting from claims Or court action and $riving out et any ieeident, loss Or damega to persona or property
happening or occurring as it prortlrrtatl result of any work undertaken under the permit
Notify the Administrative Authority It least twontgr{nlad Dursuar►t to this $ppNatlon.
yfou► 14+1 hours In advlrtea Of the tints MOM Work will he started.
Comply with ell rpplicabla Gty O►dln/ncee. the terms and Conditions
La Oulnta and to pay for inv additional replacamant necapary se the
of Applicant (please pri
of Contractor and Job Foreman
tractor's License No.
the permit and all appileatle rules and regulatlons of the Clty of
ult of this work.
, A n I r,
of Appliceni or•A9ent
- Business Address
Telephone No.
=S?�.LA"fit da _
E less Address Telephone No,
On F e
City Business License No.
pplicaot's Insurance Company
Policy Number
EES: Subdivision Improvement Permit -Class III
Public Imorovein.nte. sot _e
i
f
t
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