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1617
,NOTE: Wi#i'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 Subdivision Improvement Permit — Class I I I DATE: December 1, 1992 4('' Minor Improvement Permit Class IV y LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 623 Scraper, 15'6" Haul Route: Washington from Fred high, 11110" wide, 120,000 lbs Waring to Tampico. DIMENSION OF INSTALLATION OR REMOVAL Haul Date: 12/2/92 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPL'e710N 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. l Signature of App cant or Ag n Granite Construction Company P.O.-Box 9011 Palm Desert, CA 92255 775-8302 Name of Applicant (please print) Business Address Telephone No. Sam® Name of Contractor and Job Foreman Business Address Telephone No. On File On File Contractor's License No. , City Business License No. On File On.F31e 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 Minor Improvement Permit — Class IV: See attached schedule Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: 10,00 If $ 1© -go Receipt No. ' Received by Date Recorded by PERMIT VALIDATION PERMIT NO. 1617 DATE APPROVED 12/1/92 EXPIRATION DATE 12/2/92 DAT ISSUED 12/1/92 By '444Administrative Authority TELEPHONE: (619) 564-2246 I p►$'*" IBM 3 NO*4 !h u ------------- .o 01=1 Prlva L.VQ NOILvvfdn G3AOVwv3 V(3 0% 11vibi NgIta011r,t 1IWy3a • 0X uownH M fed �a U4.1ul, 0 1 Its. 11"W � 1x101 n.r�npVa��f oac® Vrrrs 1,90Ora t A" It VOi19rgIW r1n0+14144a1c4=r.eS ,A) ogu - t, d 1�.�O.aw1 •ov, f3/.00 u011J M1111L 010".'u1p SAV -,yyO+tTWr r14.f,� e0 Pr1r4rL1� 10 %C4,44.wMp,yr 2I;Q,�j oN �ruq�� nOU-Ime N!a / 444u0ov nwt4m .��foo 11 nagor t1.wi�� ,'*'3'-n 10,aI1ur f t, ON arus� 1 r,aur,lw� 11"41,01 aor 040 muaw �? 10 4wrp0 Iwrle we+141 tuifepT. as a�ui w46V ,6 twQT401► M� !� Iv�M .W "f A.wrerr ,.iw,p,y--OW900 .,& ; 44 M vA q�i.� p"1 ,•.• N Ail*Ail*K +s w,.�w lour ow e,an-.T' . Oe fl? avr 1sr An ,e ■.ars a,ap A,N w.a4 aA ®.,..ap a a scram 00•� M IfM✓A i/0r` uIW �1MM UrM�reO "�darq or) q wrr�n0 Odrr�V Y�Mdr MI 40", areal f�L9 �r.pY+,•,y y..l �l..s��q r,y4,�a#t r� 44,tbf As � M w wai arf wly mow. .�w „w ouv44 V% OW w..�0 waa o0.1 v«s Lot." ,r >a1 1;o.t)a �Ga,r�j iva,�ada arpl •irwuaQ p,dy ye bu�tlm,A e ------------ '�~ �j (y �Q0'�'+VI4+� �auv sma�w w.uawb buor.a aw uea,ye� v +Q'w+Gvaw'aowaa ua,�,nc,fgp uv )o fa.ay,e� �ulpnpulP S J�o7 NOW�yt5Nq� Q3ivWttS3 NOIL31dWQ� jO 3W11 3:7;N►xOdddr N133171A )ibGM K3!iA4 3w113.tdrolxandd+v f43033Nd1'NOlarnv0x3403ZIS 7VAOroa Ito NoulTrlsNl A NOISN I 3W Q / Nb� h 00 ib N01 I a7 ta°�n+nde uarnn,sx„� yo 01 1at4 , NOQ1-�InVJUN02 14 3SOdIJ11d -...._.•, r � as xus.,.,d ,r ..,e4. s,,,a 4i " Al 4w,y 4w1 tel" NO LWLtUN03 d0 NOI.LY301 !11 ffe� .. Lu.,e� u`4+<„wyQwl vaN,rlpgng ' 3dVQ I$) )w 43AOW I,, uwv It""q �q bwrs,ee WONIM► im u„opxra.uroow•4> fill Jay" Deurpflb oww,B ,a T1pr� )0 uart:rteyywao ewi ie>7 T 0 d tLN3WH2VO :3N3P N0113nktiSjup:) SXMOPA 0n and 11"34 WO4 KOLL IlddV VIN1110 YP do kL,:3 ��'M �rg0u8 v149 oiow A10 Z 6S : Z T an L Z5— T • —GHQ