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2034NOTE: With proper validation this 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 DATE: 1/5/94 LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Move Equipment DESCRIPTION OF CONSTRUCTION 824 Dotter 13' R, 13'9" W, 67,000 lbs DIMENSION OF INSTALLATION OR REMOVAL Subdivision Improvement Permit— Class III Minor Improvement Permit Class IV Sketch (attach construction plans if appropriate) Haul Router Awe 48th to Washington Washington to City Limits Haul Date: 1/6/94 SIZE OF EXCAVATION, IF NEEDED PILOT CAR REQUIRED 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. ,7 Y1 4 Q a � Signature of Applicant or Agent Piconi Trucking, 39723 Old Carriage ltd, Murrieta CA 92362 (714) 677-8196 Name of Applicant (please print) Business Address Telephone No. I Nuevo Engineering, Inc. 79-811 Country Club Dr. Bermuda Dunes. 345-1778 Name of Contractor and Job Foreman Business Address Telephone No. On Pile On Pile Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class III Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs JAN 0 5 egg Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ �� PERMIT VAL Di4TifliV . Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. —10, 0c) $ 10.00 Received by Date PERMIT NO. — 0.034 DATE APPROVED - I — 9 "'T©1"! EXPIRATION DATE 1 DATE ISSUED 5.7 ( L i By Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 All et With proper validation this form constitutes all ancroachmertt perrrtit WED 1 3: 1 3, NUE V O ENGINEERING CiTY OF LA QUINTA PPLICATION FOR PERMIT .PUBLIC WOR S CONSTRUCTION JENCROACHMENTI For the r:nnsttur:tigrl of public or prlvat� and other like 011blic works improvements ir' DATE:—.L -5 C LOCATION Oi= CONSTRUCTION !Street eddross or bescrfptfon of Locatlonl PURPOSE OF CONSTRUCTION T DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDEO APPROXIMATE TIME WHEN WORK WILL EEG14 P . 0 2 Curbs, driveways, pavements, sidewalks, parking lots. sewers, water mains connection with MINOn IMPigQVEMENTS and APPnOVEI) Stjnt), IISIgNS Subdivision Improvement Permit -- Class IIi —� Minor Improvement Permit Class IV Sketch (attach construction plans If apprdprfatel Ave . wvh -kc) 1 APPROXIMATE TIME OF COMPLETION i ESTIMATED CONSTRUCTION COST S (lncluding removal of all obstruction, materials, an debcls, 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 Lave the City, Its OUthorize penalties, liabilltlts or 1Olt retulting from clairrtt i happening or occurring as a prokima19 retull of lir Notify the Administrative Authority 1111' 10811; twent Comply with Oil Oppitcoblo City Ordinarieos, the to La Auinta and to pay for any additional replace" j renrr i ,, t1�I`J1 C iL LCtj�� Name of Applicant Iplease print) Name of Contractor and Jori Foreman On File Contractor's License No, x_40_._ ,_ Applicant's insurance Company -FEES- Subdivislon Improvement Permit Class (II Public Improvements: 3% of estimated cc $991111, officers, representative1 and employee', harmless from and against any end all court $nlon and ailsinp out of any accident, fall or damage to persont or property work undertaken under the p$rtttit granted pursuant to this application. lour 1241 hours In advance of the time when work will be started. is and conditions of the permit end Off applicable rules end rr9ulollons of th• City of I necessary It the result of this work. Signature of Appllcant or Agent r -,g r Business Address Telephone No, —54 t t I,'_- - - Business Address Telephone No. Costs 0 F I City ftusiness License No, Policy Number ,�� ��� ` ,� �, � �� r� . � %� A r •^^www wo,S a uvtlon costs Private Improvementi! 3% Of estimated coAstruction costs Minor Improvement permit -• Class IV: Sea attached schedule . nspection Fee $ 'ermit Fee (, aneity ath Denoiit•Surety Bond required TOTAL: s D receipt No. 4teived by ------- � Date - fecorded bw _ Extended Page 2.1 N? PERMIT VALIDATION PERMIT NO. DATE APPROVED l ' ' q 1-4 EXPIRATION DATE DATE ISSUED. 9v Administrative Authority TELEPHONE: 16191664-2246 i .TAN= �-- S. WED 13 : 1 N U E V O E N GINE E R I N C P - 0 1 NUEVO ENGINEERING, INC. 79-811 COUNTRY CLUB DRIVE u BERMUDA DUNES, CA 92201 ! 619/345-1778 GENERAL ENGINEERING CONTRACTOR • LICENSE NO. 438834 F. PAX (619) 345-6704 X TRANSMITTAL SHEET PLEASE DELIVER THE FOt.LOWING WAGES TO: NAME (�nr Z3i-ou-)f) FAX NUMBER: LOCATION: A, LIDL18jnl V-yu FROM: .__��_ -Y�_i NUMBER OF PAGES INCLUDING TRANSMITTAL SHEET DATE: , oTIME: IF YOU DO NOT RECEIVE!ALL THE PAGES, PLEASE CONTACT THIS OFFICE Ad SOON AS POSSIBLE AT THE ABOVE PHONE NUMBER. 2 N