1483e;...�e'VrY�..�.z�—�.r.��� ..-...`�.,�,.- r -.-., _ e,-..-, t..>._ � w..e,........•.r.:-�-,r..--4r�;;,r=.---..rw',..—x--.r :..��.�.,., ��
With proper validation
this form constitutes an '} CITY !OF LA, QUINTA
encroach-ment,permit r
- • t APPLICATION FOR PERMIT
,PUBLIC WORKS 'CONSTRUCTION (ENCROACHMENT)
r For the construction of 'public or private curbs, driveways, pavements, sidewalks, parking lots; sevvers, water mains
and other like public works improvements in connection with' MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
~ Subdivision Improvement, Permit = Class III
DATE:, JAY •8-o 1992 A Minor Improvement Permit Class IV
4
LOCATION OF CONSTRUCTION
(Street address or-Description of Loc ation►. s
Nkl' _ %
PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate).,
DESCRIPTION OF CONSTRUCTION, 623 scraper, i5'6" High, .: ,Haul Route: Durango-and Herrera to
1 11'10" Wide, 120,000 lba �. Avenue 52'4nd out of clty'limi's
DIMENSION OF INSTALLATION OR.REMOVAL ° Haul Datei 7/9/92
SIZE OF EXCAVATION,'IF NEEDED -
APPROXIMATE TIME WHEN WORK WILL BEGI N�4 �G '
APPROXIMATE TIME OF COMPLETION 4
ESTIMATED CONSTRUCTION COST $
(Including removal of all•obstructiori, materials, and debris, backfilling, com-
paction
om 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 occurnng.,as aproximate 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. f, `
y • ,,r^• '� Vr �1� F�1� y `fir r.
Signature of•Appl' ri 'or.Agehi !
Granite Conatruction Company, P.09 Box 9011 Palm Desert, CA 92255.. 775-8302'
` Name of Applicant (please print) '-Business Address Telephone No. `
Name of Contractor and Job Foreman Business Address Telephone No.
0i1 Pile '
On Fie
1
Contractor's License No. Cit Business i r • '
Y
s ss L cense No.
On Pile On File
Applicant's Insurance Company ,' Policy Number 1
FEES: Subdivision Improvement. Permit — Class III - t
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 VALIDATION
Permit Fee 10.00
• PERMIT NO. 1483
Penalty
Cash Deposit-Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
'x
$ 10.00
Date
DATE APPROVED 7/8/92
EXPIRATION DATE -7/9/92
DATE SSUED 7/$/92
BY — r
Administrative Authority
TELEPHONE: (619) 564-2246
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