Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2094
tr. ..._ x W ,. NOTE 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 Subdivision Improvement Permit — Class I I I DATE: 3-9-94 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Move Equipment (Street address or Description of Location) PURPOSE OF CONSTRUCTION Have Equipment DESCRIPTION OF CONSTRUCTION 225 Excavator DIJIENSION OF INSTALLATION OR REMOVAL 10115' wide All else legal SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attach construction plans if appropriate) Haul Route: Ave 58th east to Madison north to 54th west to Jefferson north to Ave 50 west to Washington north to Ave 48th Haul Date: 3-9-94 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: .p MAR 0 9 1994 D Indemnify,defend and save the City, its authorized agents, officers, representatives and employees, harmless from and again t any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to person or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. '1 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. gnature of Applicant or Agent Piconi Tracking 77580 Robin Rd 345-5212 Name of Applicant (please print) I Business Address Telephone No. r i Name of Contractor and Job Foreman i Business Address Telephone No. on file Contractor's License No. on file City Business License No. 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 $ Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. 10 $ 10 Received by Date 2094 PERMIT VALIDATION PERMIT NO. 2094 DATE APPROVED EXPIRATION DATE 3-9-94 3-9-94 DATEISS ED 3-9-94 By Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 NOTE: With proper validation this form constitute 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 milins. and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS' —9—�f DATE: Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV Tis LOCATION OF CONSTRUCTION CL t ctC � — 60 EF(--� U -I IStrtlet sodre» or Description of Locationl PURPOSE OE CONSTRUCTinlu m OUP - DESCRIPTION r/P_ DESCRIPTION OF ,C % r, to, r _ DIMENSION OF INSTALLATION OR REMOVAL /a'S' L IA -z' S!ZE 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) /V/ 6 0-9— �% C` 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 said all Penalties, liabilities or loss resulting from claims or court action and arising out of any accident. IOU or damage to pentons or preparty happening or occurring as a proximate result of env work undertaken under the permit granted pursuant to this application. Notify the Administrative Authority at lean twenty-four (24) hours in advance of the time when work will be started. Comply with all applicable City Ordinances, the terms and cOnditione of the permit and all appliable rules and regulations ofthe Gty of a La Quints and to pay for any additional replace lent, ne8efy as the result of this work. Sketch (attach construction plans if a DprOplrwd� 6 - -QE— Q tto-y, y - /Vo R 7-,7-/ o til n v � 1`�b SO o VJ A4 S H i A) 6- �7'D d A(© r -�-h OA/ K / 1/ c, 7a /t/ 7ZI A-& —�= l� /4/V 04-10 C� (AJ 7-1-� Name of Applicant (please print) . fl 1 Name of Contract and Job Foreman � 7, Ie -- Contractor's License No. Signature of Applicant or Agent 7 6 rB /�✓ � (o HCl ��--5 i '� Business Address Telephone No. Business Address Telephone No. -0 Aj -4 L e_ v'- City Business License No. Applicant's Insurance Company is AJ Policy Number FEES! Subdivitinn Imnrnvement Permit —(:lass Ill