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1080i NOTE: With proper validation this form constitutes an encroachment permit CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) OVE TZl p o JE.2s iZ E 4,0.4,D PeeM i T 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: 4-24—CH LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION ON MOUE. EQUIP DIMENSION OF INSTALLATION OR REMOVAL 50, 000 L135 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 RDUTF, V 5tiMbTOM 4 FRED WAII NG T4 50--b E/i) APPIZUX //2 v►4ILE. APPROXIMATE TIME OF COMPLETION 4AUL DAVE ! -+"Z5- 91 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. d Signaiure of 4pplic0t or Agen MUM ENGI NEERMC-7 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. ©M FJ 1,E Contractor's License No. City Business License No. ON FI L E_ Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class III Public improvements: 3% of estimated construction costs 10_005190b iA�A04-24-91iQ.0(� i0 Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ Permit Fee iU .0b Penalty Cash Deposit -Surety Bond if required TOTAL: $ Receipt No. Received by Date PERMIT NO PERMIT VALIDATION /000 DATE APPROVED EXPIRATION DATE 11-24-- 9 4--25-81 DATE ISSUED 4� 2¢r 9 �-- Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 NOTE-: With proper validation this form constitutes an encroachment permit CITY OF LA, QUI'NTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCR`OACHMENT) 04 E: 72/P o d6e: 1; iZ E 4,o4,1> Aeo," l T 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'll DATE: 4`2.4 • C1 I Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION -(Street address or Description of Location) PURPOSE OF CONSTRUCTION M D V E. EQUIP Sketch (attach construction plans if appropriate) . ,DESCRIPTION OF CONSTRUCTION Qb DOZ EK NAU.L RDUT� 1�) I�T 1� • SWEEPS FOOT UUA5H ! NXiT010 � FAZED WAQ DIMENSION OF INSTALLATION OR REMOVAL 101 1 V1 TO 50 iia APP? -DX 112 v17 iLE 60; 000 035 SIZE OF. EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN c APPROXIMATE TIME OF COMPLETION 1��At)L D�1T L".Z S' 9.0 ' 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 arisingout 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 Applica 1t or Age MU.EVO &JIGINF-ERIMG 15 3'45- 1778 °r Name of Applicant (please print) Business Address --Telephone No. Name of Contractor and Job Foreman Business Address.,-- Telephone No. UlU • Fl LE Co'ntractor's License No. City Business License No. ON F! L E Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit - Class I II Public. improvements: 3% of estimated construction costs 00518 i 04-24-91 10 Private improvements: 3% of estimated construction costs 10 GAS'i�:$f AL 1 10. UO Minor Improvement Permit - Class IV: See attached schedule 'Inspection Fee $ PERMIT VALIDATION ' Permit Fee 1U •ad �O �d Penalty Cash Deposit -Surety Bond if,required TOTAL: $ 1,11100 Receipt No. Received by Recorded by Date PERMIT NO. DATE APPROVED 4- EXPIRATION DATE `4 - ZQ` 9 DATE ISSUED By `''�f' `•?` - U Administrative Authority TELEPHONE: (619) 564-2246 i •' 1 40TE: W0,prope"r validation his form constitutes -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 mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Gj Subdivision Improvement Permit — Class II I DATE: / - Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Oescription of Locstionl PURPOSE OF CONSTRUCTION "Vo �� � - - Sketch (attach construction plans if appropriate) DESCRIPTION OF CO UCTION DIME ION IOFFIINSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN IN wo APPROXIMATE TIME OF COMPLETION )�C 15-9 ESTIMATED CONSTRUCTION COST $ t (including removal of all obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvementsl 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 1241 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 Quints and to pay, for any additional replacement necessary as the result of this work. 40 0 t Signature of AIM licant Agent Nuevo Engineering, Inc. 79-811 Country Club, Bermuda Dunes 619-345-1778 Name of Applicant (please printf Business Address Telephone No. of Contract-PTand Job Foreman s Lice Business Address Telephone No. City Business LicenS]�,�No. ! 1 7 n 'Applicant's Insurance Company Policy Number ES: 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 Fee $ mit Fee .....,r ish Deposit -Surety Bond required TOTAL: $ pt No. by Date by N4 lo, 8 o PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority' TELEPHONE: (6191564-2246