14987
N07E
TVith proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
U,
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
Q 4
July Subdivision Improvement Permit — Class III
DATE: 29, 1992 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _Move equipment - Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Paver 11'6" aide, 84,000
wetMt, all else legal. ROUTE: Durango to Carranza to
Eisenhower -and Madrid.
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
MOVE DATES 7/30/92
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.
Signature of Applicant or Agen
Granite Construction 775-8302
Name of Applicant (please print) Business Address Telephone No.
P.O. Box 9011 Palm Desert, CA 92255
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111
Public improvements: 3% of estimated construction costs t 1
Private improvements: 3% of estimated construction costs 1 498
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
10.00
$ 10.00
Date
PERMIT VALIDATION
PERMIT NO. 1498
DATE APPROVED 7/29/92
EXPIRATION DATE
DAT I SU 7/29/92
By
Administra a Authority
TELEPHONE: (619) 564-2246
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