1569`; NOTE:
`11,With proper validation ,
this form constitutes an ' CITYf,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
• -Subdivision Improvement Permit — Class III
DATE:' October 5, 19.92 Minor Improvement Permit Class IV
-LOCATION OF CONSTRUCTION
(Street address or Deschption ofr location) - * e. • ,
.PURPOSE OF CONSTRUCTION KOye R540"at- a Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONST RUCTION'.*`�Barbet Greaus Paver
11'61"' Vida, 84,000 lbs, *Ill*160 ]legal 0a�l1 .Routes 'Washington. to' Avenue
�• f $2 to • Bi.aen&ower to Sonora to DIAZ.
DIMENSION OF'INSTALLAT[ON OR REMOVAL isul ?ate! 10/6/92 ,
SIZE OF EXCAVATION,,l IF NEEDED.
APPROXIMATE TIME�WHEN'WORK WILL BEGIN_
'APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
r(Includi6g 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: F
Inderrmify,-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. v
Notify, the, Administrative Authority at least twenty-four (24) -hours in advance of the time when work will be started.
rIf Comply with all applicable City, Ordinances, the terms_ and conditions of the permit and all applicable rules and regulations of the City of
N La Quinta and to pay for any additional replacement necessary as,the result of this work.
Signature of Applicant or Agent
M1 Granite Const Euetion 'Co%pany P.0; Box 9011 Palm Desert, CA 92255-9011 M-8327
Name of Applicant .(please print) Business Address Telephone No.
Name of Contractor and Job Foreman ;'Business Address , Telephone No.
on Ville 01� rae
Contractor's License No. City Business License No.
On F114. On p'�.le
Applicant's•Insurance Company' +. Policy. Number
FEES:, Subdivision Improvement Permit -Class III 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 VALIDATION
Permit Fee 10.00 PERMIT NO. 1568
Penalty DATE APPROVED 10/5/92
Cash Deposit -Surety Bond 10/6/82
if required EXPIRATION DATE
TOTAL: $ 10.00
Receipt No
Received by Date
Recorded by
DATE ISSUED ! 10/5/92
By Ae:LA� VW`�
Administrative Authority
TELEPHONE: (619) 564-2246
P
n�' 1
OCT- 5-92 MON 14 : 1 4 I MPE:R I AL-
-+i •i. r .J+JI w ,,.. e r r . r r r M
NOTE,
With proper valldoilon
this form caonotitutes an
enceoachrnant permit
CITY OF
SL.Da - C A 7 -C I TY P _ 0 1
Rost -It'" brand fax transmittal memo 7671
Tb From
d of pogaa .
Co.
Co.
Dept.
/ f
Phone N'c t
r 1 SG
�l
FG; N
Fax N
APPLICATION FOR PERMIT
PUDLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, psysmsnt$, sidewalks, parking Pmts, tewars, sveter mains
and Other like public works improvement; In connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE:
Subdivision (mprovemont Permit — Class I II
Minor Improvement Permit Ciao$ IV �....r�._...
LOCATION OF CONSTRUCi"ION
(street address or Doscription of Location)
PURPOSE OF CONSTALICTION ' D, mn tn
DIMENSION OF INSTALLA'
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TiME WHEN WORK WILL BEGIN
Sketch (attach construction plans If appropriate)
iQAL, t... Q c) 4 e ;
4w ��nl�ova� �• � � rZ a c-�
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ _._- - -- _ ..y - _ -
(including removal of all obstruction, materials, and dobrls, backfilling, corn-
paction and placing Parmo118nt resurfacing and/or replacing improvemonts(
In consideration of the granting of thla permit, the applicant hereby agrees to:
Indamnity,-defend and save tho C;ty, Its authorlsod agents, offlcers, representatives and employees, hermlom fromAnd against any end all
penalties, Ilauilitios or ION rosulting from chassis or court action and arlsing out of any accidom, loss or dam*46 to akrsonl or proparty
happening or occurring as al proximate rass+it of any work ondertakan under the permit granted pursuant to thi$ appilc+atlon,
Notify the Administrative Authority at least twenty-four (24) hour$ In edvance of tho lima whon work wlil ,be started.
Comply with NII appllzgle City Ordinances, the term.l and conditlone of the permit and all oppliaebla rules and regulation of the City of
144 Q;uinto and to pray for any addlcipnpl rapiecement nacesaary e8 tido result of this work.
Signature of Applicant or Apra
err i r G-�c'�C��e ea "kt�L� � � C. c
Name of Applicant (please print) Business Addross To(ephono No,
Nome of Contractor and Job
Business Address
alephono
Contractor's License No. City Susinsso Liooneo No.