1699F
NOTE:
With 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
DATE: 3/19/93
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Paver 11'6" vide
84,000 lbs. All also leftel
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
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:
ROUTE: WASHINGTON MM FRED
WARING TO TAMPICO b TO
EISENHOWER
DATES 3/19/91
N%
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.
TINA G,,PACE V
Signature of Applicant or Agent
GRANITE CONST CO PO BOX 9011 PALS DESERT. CA 92255 775-8302
Name of Applicant (please print) Business Address Telephone No.
SAME '
Name of Contractor and Job Foreman Business Address Telephone No.
ON FILE
Contractor's License No.
ON FILE
City Business License No.
ON FUR
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I 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 Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No
Received by
10.00
$ 10.00
Date
1
1699 r
PERMIT VALIDATION
PERMIT NO. 1699
DATE APPROVED 3/18/93
EXPIRATION DATE 3/19/93
DATE -ISSUED 3/19/93
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
1
NOhp:
With proper v.l Idetlon
thl. }orm mneelitt:.e mn C1TY OF LA OUINTA
omoh man[ p-1,APPLICATION POR PERMIT
PU®LIC W0PiK6 CO(VBTRUCTIOIV (fiNCROACMMENT)
Pal th. mnr truetlan at Publlo or arl..ta Yrbl. dfIV.W.Vt, P.V.m.nse, sld ewelke. PefklnQ lot., ..wer., wimr'melnr
.nd other Ilkepublle work. ImPwvomene. In ao n n.Ptlon with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE, 9/19/93 Subdlvl.len Improvemene Perml!— CJass 111
Minor Imwov.mant Permle Cla. IV
LOCATION OF CONSTRUCTION _
/etrsrt atltlr.ss or Deserlptlen et �er.< n) - -
PURPOSE pP CONSTRUCTION 1� p jw-v t 1 t F. 11 .I.+.tw 6kateh (.tLAh ponpruatlon plu rtt It eppreprlata)
Rp_O. ]�.w_ fit] ,
DESCRIPTION OF CONSTRUC#N , EOUMEI WAS)3INCTON FEOM 3FRED
WAAI)Ao TO TAV SOO i TO
E2BSNHOWEA
DIMENSION OF INSTALLATION OR REMOVAL
HATE! 9/19/91
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN '
APPROXIMATE TIME OF COMPLETION -
EBTIMATED CONSTRUCTION COST S
(Inaludlnp r m vel 01 ell obetruptlon, metprlel.; and debrH, b.ak<llllnp, ov
eo[lon and pl.olnp pefinenern rsur}eolnp rnd/or re pl.elnp lmorev.m.npl
In eoneid.r.tion o1 the pr -1s o} this oormlt, the .p Pllunt n.r.by .pree0 to:
rnd rntl r • CI<V. t eeenta, o ese ete.lev.r. lyrrwlry }rom mnd .p.lnsa a .nd 11
•vlo Clulwu a to Hlo. n, r rp.n o} enV aoeltlent, lets er mope • IrVprepoitV
n. hB I. .rPreulma eros v m nlene. ��urMeB ems, prrml< Ownt.e Pure..nS tp eppllmrtlen- o
1-1 thowHN . 1wbl. pl<v Oralnr ncp` th t.rm41.1 Ita.n I eWeNe o . el.rw wh.n wor. will CHt rf♦tl.
b o} t , t rep.l.Slent .t the a.- at
M Du nu .ntl <. ..v }or env .tldit lee.l r.Plrcem.nlrnempe.rV re [he retLl[ et rtnit • OYMII .ppllubl. rul.r .nd
TINA CGI4AQE V
Blpn.tti— of Appltunt or Agent
Nerve o} APPlleunt IPleue prlrnl Busln.p AddreY Telephone No. -
hlmmm o/ Centreotor end Job Foremen Susinep Addrpes Telephone No.
Gad ELLE - OF trTLs
Contra m LIaP a No. Clty Bui.inea. Llun.e No.
ON rYTLL n
APpllaenc . In.urenoe Dompeny P.Hay Numb.,
PEBBI Subdivision Imprwem.nt P.rml[ — Co.- Ill
►Yb Ho Improvements: 3% 01 eetlmeted mnsVuollon mots
Privets improvomsn<s: 3% o} a •mr<ad oonstrumtlon o—
Miner lmpro..m.nt Perrm1% — CL,, I V< a...tt.w..d .w,.dul. 1699
enrm.tlen Pee B PERMIT VA LIGATION
P.rmit F..
PERMIT NO. 1099
P.n.lty
Cerh peposlt•Ourety Bond GATE APPROVED
3/10/q.a
If r. qulred EXPIRATION OATS
TOTAL: S 10,00
ReeeiPt No. - OA BO �C` 3I1 A/Ae
BV J� • a 0
Reoelved bV Oele Admin lstr.tiva Authority
Rit.otd.d by TELSPMONB: 1070) 564-9410
TRANSMISSION REPORT
THIS DOCUMENT (REDUCED SAMPLE ABOVE)
WAS. SENT I
*** SEND ***
COUNT **
NO
REMOTE STATION I.D.
START TIME
DURATION
#PAGES
COMMENT
1
7143427504
3-19-93 11:43AM
1'00"•
1
TOTAL 0:01'00" 1
XEROX TELECOPIER 7020
d
"
..
i
Y
f
�
s i
Gin=$ uda
Uva NCILvyl4xl
0•'i 111Yb iR
h011vC111IA 1{�'IM?�
a
{�4wn4 N•ro�
oN UJOWSISIL
z1- 14 am"mme
-------------
'Ito&
s4{.rea io
4 -WOO W03
�rti�d
of ILw.04
1��/4�a119we4/1
41,104{0I cwwa&f "8 AI oeV �,.•_ •/ twws.o.awl .a�•�p
nmq `6101slauwam Oak a..
CA Ce
uo{uwsw{ao
fit
WI MQ•tl/ qhs •J ��
!�{.ry 4•f.•v�t t a
ey w{,a>I 71 ,oufuva�
ufW4,ei 44',QL7f�tve� ai OWN
Rho
IR ✓M Yw.N wR {tl rorl•s.iov aw � w 41 aM ,rl"0 n
e...y M {{w am" w mar r ,,�a oe 4w{
'Y'rld+f 4 4M� ��� �r.�„y •.{.a� ww-0y w +ws �w+a.w• t...r �a � ~ e"''w�w'4.'r1► rw y.{�y •
1A earl y Mlrwr• wy �h 'M'm*� M A Oil k..Uae ON VOW W'r 4 W Y'r0 Aw/'�� � .9
nw
W+1.{11.q M IMu�M.�,yal �.M,40 th.,aha i.M 4 . "W ' R MM•'a!1 {A{iw�
IORI,rOQtl hA laujad 44 +� �1n1Kj
/� rQ+rwvo�o{w 6{.v a eia +a voRer,p.ta,W u�
�;77/�' h 4,®Iaw 4►�µ�,,�u y��►,��0 9�a�� ouf uva,.@
auap 'OYrINitCp 'r�.q.9 I%•f 'Bi
s Lsay VOL!JnW14No3 a3Ar�f�tsi
NCu�Ydwpy !d 3W11 lidHlxQdaod
42
-u",,G F '3,. yltnorrill m0 kGttlmrtsru dA NGISH3w��
14GU40yusNoy !o 3So1Yfl0
"r'.----� A'�'�/� �"IMr NdiL7flYlSHoa ip Noit 1rJ01
LWuf� W�I,yMp.q� IIOrYAI�r� .
J e � 3it+A
C1+017�AIQ�� a3nOdddr o�{. �1N�n�nOyaw� eoNiw �,K uoaa.{,vtel w , e
'Rel �ilrtulr yt�,llwpH 'tiW4{bq Yf*M!{O 'todrtf W W q 11 Apw04,M4 iQev 1Ye {1{/t0 OW
to uo•-a�4ry'� rve {e 4
�.>�aw}rrn►oa�+r3► Nai.�n�s*,e� sxeos� �nan� .
IINi!]� b0! !.pf1Y711Qad
r1HinQ io A11� MR-a-
64,4"a,r,i
® d �nw an 1 0Z - 6 I ZIA s6—fes t —Zlti W