2173c 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
DATE: 5-13-94
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment
DESCRIPTION OF CONSTRUCTION 623 Scraper
DIMENSION OF INSTALLATION OR REMOVAL 14111 11'81, W
80,000 lbs
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
Haul Route: Ave. 48 & Adams to
Washington North to City Limits
Haul Date: 5-16-94
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:
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 Q4) 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 on file
Signature of Applicant or Agent
Piconi Trucking
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 On file
Contractor's License No. 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 $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
10.
$ 10.
Received by Date
2173
PERMIT VALIDATION
PERMIT NO. 2173
DATE APPROVED
EXPIRATION DATE
5-13-94
5-16-94
DATE 5- 3-94
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
MAY -1z—<=)4 PRI 1z:04 N U E V O ENG I NEER I N G
NOTE:
With proper validation
this form constitutes an
encroachment_ permit CITY OF LA OUiNTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P. 101
For the construction pf 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 — Cle:s III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION _
(Stieet address or Detcrlption of Locatlonl �' ,,
PURPOSE OF CONSTRUCTION �L—�-���me-� „s Sketch (attach construction plant if approprilite)
OES I2'1� N OF CONSTAU TION y am'.r---+— tf - -- - _ - 1
j. it
DIMENSION_^OF INSTALLATION OR REMOVAL `� H ,! �gW
ado v v o L_6 S
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
c M L jy� to wo;lf nqtyn
tD �� h .LtrYU�C�
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(including removal of all obstruction, materials, and debAs, backfilling, cam•
paction and placing permanent retyrfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Indernnify, defend and cave the City, lit authorlied agents, officers, representatives rind employees, harmlels from and sgelnst any and sit
penallies, liabilirles or loss resulting from Claims or court action and arising out of any Accident, loll or damage to persons or property
happening or ocrurring at ■ proximate result of any work undertaken under the permit granted pursuant to this applkollon,
Notify the Administrative Authority at feast tmnty•four 1241 hours In advance of the rim! when work wilt be started.
CChlpty wish all applicable City Ordinancss, the terms end conditions of the permit and lit applicable rules and regulations of the City of
La Dutnte and to pay for any additional reprecement ntcassary as th! r t of shit work.
'L qlas
Signa re of Applicant or Agent
Narne of Applicant 1please print) Business Address
Telephone No.
Nuevo Enel
Mame of Contractor and Job Foreman Business Address Telephone No.
On F11e 0 Fi e
finntririnr41 ironro life . _ ._ ._THP10
AriNticant': insurance Company
Policy Number
FEES: Subdivision Improvement Permit — Class III T
Public improvemetitt: 3% of estimated e6nstmetinn P.9ate
• '/
1
1
i
1
c
•✓ 3L_
` WWI ?% nnV'UYClllumv: 470 or estimated construction Gists
Private Imp►ovements: 3% of estimated Construction costs
Mino� r Improvement Permit — CIAss IV: See attached schedule
1,=15ection Fee 3
'ermit Fee
'enalty
:ash Deposlt•Surety Bond
' required
TOTAL: s
lecelpt No.-
lecelved by ^._ Date
Worded by
Extended Page 1,1
NO
PERMIT VALIDATION
PERMIT NO. 2 I ? —5
DATE APPROVED `' —
EXPIRATION DATE '5l /&
DATE ISSUED 5-I.f -- "? L/ .
13y _
Administretive Authorlty
TELEPHONE: 16191664.2240
I
f
'
. 7
.d
NOTE:
With proper valldation
this form constitutes an CITU OF LA OUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, perking Iota, sewer,, water mems
end other like public works Improvements In connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subd ivlsion Improvement Permit — Class 111
DATE: 3-19-94 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Desorlptlon of Losatlon)
PW RPOSE OF CONSTRUCTION va nt Sketch (attach construction plena If appropriate)
DESCRiPT10N OF CONSTRUCTION 623 Sc'.v^oar Haul Routat Ava. 48 b Adam, to
Washington North to t 2C _ T_4 -4:t
DIMENSION OF INSTALLATION OR REMOVAL 14 K I1 8 W
80.000 iba
Haul Dates 5-16-94
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF. COMPLETION
ESTIMATED CONSTRUCTION COSTS
(Including removal of all obstruction, materiels, and dobrl,, backfllling, com-
Pebtlon and placing permanent resurfacing and/or replacing improvements)
In consideretlon of the granting of this permit, the applicant hereby agrees to:
Indemnlfy,•defand and save the City, its suthorland agents, offlaers, reOrasgntetivos and employees, harmless from and against any and ?11
penaltlas, Ilabll lties or loss ra sultlna from claims or court action and arising out of any accident, loss or damage to persons or property
heppenln* or ocou rrIng e. a Proxlmate result of any work undertaken under .the permitnted
pre pursuant to Trite aPPllaetlOn.
Notify the Adminlserative Authorlty at least twenty-four (24) hour. in .dye nee of the time when work will be started.
Comply with all appllosble City Ord)nansaa, she term. and conditions of the permit end all applicable rules and reaulatlon. of the City of
V Qulnte and to any for any additional replacement necessary as the result of this work.
S:Lwnazura on YYia
Signature of Applicant or Agent
Riooal TrucicYna
Name of Applicant Wastes print) Bualneee Address Telephone No.
Nuevo 2nc. 79-811 CouaLry Club Dr. Sarmtsda Dtaaaa 3431778 _
Name of Contractor and Job Foramen Business Address Telephone No.
On P11a On 911a
Contractor's License No. City Business License No.
On YYia Oa 2Y1a
Applloant'e Insurance Company Polley Number
FEES: Subdlvrslon Improvement Permit — Close 111
Public rmprovements: 396 of estimated construction costs
Private improvements: 3% of ost)mated construction coats
Minor Improvement Permit — Claes IV: $ea attached schedule 2173
Inspection Fee S PERMIT VALIDATION
Permit Fee -10• PERMIT NO. 217Q _
Penalty
CashOepoal t-SurDATE APPROVED 3-13-94
' at' Bond
TRANSMISSION REPORT
THIS DOCUMENT
WAS SENT
** COUNT
# 1
*** SEND ***
(REDUCED SAMPLE ABOVE)
NO
REMOTE STATION I.D.
START TIME
DURATION
#PAGES
COMMENT
1
6193451778
5-13-94 3:03PM
1'04"
1
TOTAL 0:01'04" 1
XEROX TELECOPIER 7020
N
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
DATE
5-13-94
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment
DESCRIPTION OF CONSTRUCTION 623 Scraper
DIMENSION OF INSTALLATION OR REMOVAL 14'H 11'8" W
80,000 lbs
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
Haul Route: Ave. 48 & Adams to
Washington North to City Limits
Haul Date: 5-16-94
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:
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 on file
Signature of Applicant or Agent
_Piconi Trucking
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 f ile
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 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 10.
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
Receipt No.
$ 10.
Received by Date
Recorded by
2173
PERMIT VALIDATION
PERMIT NO. 2173
DATE APPROVED
EXPIRATION DATE
5-13-94
5-16-94
DATE IS UE 543-94
By
Administrative Authority
TELEPHONE: (619) 564-2246
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