1653NOl'g:
With proper validation
this form constitutes an CITY 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
rt
DATE: 1/22/93
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
(Street address or Description of Location)
966 LOADER 10' WIDE
PURPOSE 96 C&STflkgCT - -- a EMTGHT Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
ROUTE JEFFERSON FROM FRED
WARING TO WASHINGTON & return
DATE 1/22 OR 1/23
C> I? A4 O N I.`( t .
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 prop&ty
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`/NA Ga�10E. `l
Signature of Applicant or Agent
GRANITE CONST. CO. PO BOX 9011 PALM DESERT 92255 775-8302
Name of Applicant (please print) Business Address Telephone No.
Name. of Contractor and Job Foreman - Business Address Telephone No.
Contractor's License No. City Business License No. f
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
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
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 1653
1/21/93
DATE APPROVED
EXPIRATION DATE 1/23/93
DAT ISSUE D Yy21/93
.r
Administrative Authority.
TELEPHONE: (619) 564-2246
T H U 1 G- 5 3 t a r mac P_ 0
VOW- wl~ ta•+r1lFppl
•,ver��.�, ar w,f CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTAUClION (ENCROACi{MEM•+
far ihf �'Wvts,pn At outttrc at pr,rr•'N wrI go' vr' If" Wrfrrr"r0. frCf.vlrJ 1. L►►rir^9 lata.
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LOCATION OF CONstRLIrMFtON MIS 1 *"'1D1" P... ckm IV
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PVR►OSE OF CONYMUCnOM
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AP'PAOXIVATT 1UNE*�41LN WORK WILL 1101N. -
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ETTIMAUD CONSTRUMOli COV 8
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pr,rn,l off I PERMIT VALIDATION
P•rN fy se gfAlT ':0�
wA Dfoe„1 SJ�re► �O'r0/ �y
itfoaLrr.e DAT'EAPfROVED�_:(
VOTAI EXPIRATIO/v 0An
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NOTE, - With proper vQ! Satlon
this tp(,m con to an CITY OF LA OUINTA
olahmane p.rmlt
on' APPLICATION POR PERMIT
• PUBLIC WORKS CON8'rRUCTION (ENCROACb M" I0NT)
•
'
For the natruatlon Of Publlo Or Prlv.te —b.. dtly—•Va. cevam.nta. Oct ewe lk., P.rklno lets. • —star —.In.
and ether Ilk. Publlo work. Imptovern.nt. In oonneotlon —Ith MINOR IMPROVEMENTS end APPROVEO SUEDIVIEIONB
Hubd lv Talon improvement Permit — Close It
OATH: Minor Improvement Permit Claae Iv
LOCATION OF CONE7RUC710M
(O[roat a,ld— or Derrlp+)on a --)
PURPOOC TL 966 LOADER 10, WZDZ Hketah (attach conetruatlon plana It a
4g.�T��t ��Jt17�>,�fOSQ—B—tTliS@'AR�� PProPrlaA)
OEOCRIPTION OF CONBTRUOTION ROUTE TZVVZXBON FROM ABED
WAB=1QG TO WASHINGTON 6 t'or—T
OIM0NSION OF INSTALLATION OR REMOVAL DATE 1/22 OB 1/23
male- V-4 a.VLY
81ZE OF EXCAVATION, 1P NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIMH OF COMPLETION
EBTIMATEO CONSTRUCTION COST O
(Inoludlne r vel Pt oil ob•tr(teslen. M.terl.l., and cts—I., b—Itfllllno, oem-
P.—,.n and pi—Ino permanent --faelne antl/ar -pl•olnp ImProv.m.nt.)
In —.W.—Ion of the or.ntlno of this parmlt, the applicant h.r.by or... tol
nd.mnMY1• de.fntl and cava aha OItY. It. autherla.tl .pen[.. oHlo.r., rep re..n and
amploy.e.. harrnl.0 frolr� end so.ln.t env ands II
p.nal.l... lebllhl.. o Itlnp from el.lm. o end arl.Ina[e a.1 .nv ... id—, Io.s or tlemepa to par.en. ar Orae rty
enlnp o rrinp lr . Brow hoot. r. u t .ny werF V�dareeken wn..r the Par—.. atenptl o u thlf .PPllo.don.
Nott ah. A I—Inwoe— � .rt —n—t— (24) h—, In wive... at t rrts —no. w . .111 tarptl.
0 —.1, with .11 .Ppll..bl. OI Ye Cl--... aw .nd e.ntlltl. n. .1 th. p.— .n. all aPpllo.bl. ulq I nd �pylatlpna of the 01- o1
L. Oulno .na .O P.v tar .nv aealtbn.l M.Iamm.n[ n.a..rry .. th. ruult a1 <hh w.rF. /
iiAtA C7ItAGC Y
Blen.tura of ^pplloani or Aoent
CBAZ9ZTE OO1peT. CO. PO SOX 9011 PAXa4 DSBEBT 92255 7758302
Name of Appilant (plea Print) 0uslnau Addrs.. Telephon. No.
Name of Centramor and Job For-- Eu•In•s• Adoneas Telephon•'No.
Contractor'. Line— No. City Bualn.— License No.
^pplla.nt'a Insurance Company Polloy Number
PHHBt Subdivision Imprevemane P.rmn — Clau 11!
Publlo Improvamanv: 396 of uelmead oon•sruetion .Dasa
Prlv.ta Im Provementsl 396 of astlmet.d construetlon cost.
Minor Improvement Mrmlt —cls.. I V 1 Boa .Lashed .ohadule 1653
I n.aotlon Pe. O PERMIT VALIDATION
Permit Pee
Pp RMIT NO. �6
Cash O
CaregO; odoalt-Hurety Bond OAT6 A�Ppnc^'rIOM O^
11 1/23/93
HXPIRATION DATE
TOT- Lt 5 DAT UI�O
R.e.lot No.
R ... lv.d bV bete 5v 7 t Atlmin l.tr.tly. Authorl%V
Raeerded by TELEP)-IONS: (010) 564.2246
TRANSMISSION REPORT
THIS DOCUMENT (REDUCED SAMPLE ABOVE)
WAS SENT
*** SEND ***
COUNT
1
NO
REMOTE STATION I.D.
START TIME
DURATION
#PAGES
COMMENT
1
6193604570
1-21-93 5:42PM
1'07"
1
TOTAL 0:01'07" 1
XEROX TELECOPIER 7020