1906t w S -"1R
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: 9/29/93
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION BOOS BQUIPKNT
DESCRIPTION OF CON;TRIVCTION 623 SCRAPER
15 HIGH, 11 10 WIDE, 120,000 LBS.
DIMENSION OF INSTALLATION OR REMOVAL
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
RODTE: 50TH AND EISELI<HOM TO
WASHINGTON ADD NORTH
OUT OF CM LMTS
DATE: 9/29/93
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debr s, 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 agen_s, 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 wor< 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.
%1A11q X2.9 G f 6/
Signature of Applicant or Agent
GRANITE CONSTRUCTION CO. P.O. BOX 9011, PALM DESERT, CA 775-8302
Name of Applicant (please print) Business Address Telephone No.
SA!!E
Name of Contractor and Job Foreman
ON FILE
Contractor's License No.
ON FM
Business Address Telephone No.
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
Public improvements: 38/o of estimated construction costs
Private improvements: 3% of estimated constr-jction costs
Minor Improvement Permit — Class IV: See attacied schedule
-Inspection Fee $
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by
Date
L` 1106
1
PERMIT VALIDATION
PERMIT No. -� 1906
DATE APPROVED 9/29/93
EXPIRATION DATE 9130[„93
DATE ISSUED 9/29/93 _
Administr tive Authority
Recorded by 11 TELEPHONE: (619) 564-2246
i
----- -- ;------------------. ----- - -
With proper validation
this form constitutes an CITY OF LA MUINTA
encroachment permit
1 APPLICAi'ION FOR P8RM1T
PUBLIC WORIGS CONSTRUCTION (ENCROACHMENT)
For the construction of publio or private curbs, driveways, pavements, sidewalks, parking -101s. sewers, water mains
and other like public works Improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
OATS: o/ w/ofa
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Class 111
Minor Improvement Permit Class IV
(street address or Description of LOOetienl
PURPOS
pE Oft CO FNS -r FILIC�TION 2MVa VA=X1'>1�X Sketch (attach construction plans if appropriate)
D MSC g1(STl AqpCil'l oIt"C6493rM4 O BS- RODT.ss Sows A1QD ZMOMLMOWIM TO
6JA88=B42T035 AMM 170ATB
DIMENSION OF INSTALLATION OR REMOVAL ODS OW CITY LffiTS
DAT!zz 9/29/99
SIZE OF HXCAVATION, IF NEEDED - —'"-
APPROXIMATE TIME WHEN WORK WILL BEGIN woat-It'- brand fax transmittal memo 7671 sof pages
REMOTE.STATICN I.D.
APPROXIMATE TIME OF COMPLETION
eons
E!CONSTRUCTION COST S
(Including romoval of all obstruction, materials, and debrin, bee
paction and placing permanent resurfacing end/or replacing in
COMMENT
apt.
ox �,��"3 0
In consideration of the granting of this permit, the applicant
Indem nllY..defe nd end save the CITY. Its .—herleed agent*, officers, rapresontm%lves and emplovose. harmless from end against env and!11
p.noltl Be. liabilities or io** resulting from claims or OOurt action and arising out of any sooidant, lose Or damage to person. or property
happening or oocurrine — a pro 1-- r uit of any work undartakon under the permit arentad pursuant to this appll"11—.
Notify aha Att—Inl*trotiva AuthorltY K leest twenty-four fi4i hours in d. s. of the time when work —111 ba started.
Comply with ail app11*.1.1. City Ordlnenoos, the term* end=ondltione of the parmit and all sopilaoble rules and regulations Of the CItY of
LO Culnta and %a pay - for, any, addltlonel replacement haoe*sery as the result Of this work. '
T"/iyf� G� ier91 G �'
Signature of Applicant or Agent
Gj A1Q=T8 C0RSTItWCT20N CO :P'0- Box 90x1 • PAX -M DBSBMY CA - 773-6902
Name of Applicant (please print) Business Address Telaphona No.
SAM=
Name of Contractor and Job Foreman Business Addreso Telophone No.
ON PZLB
Contractor's License No. City Business Lleense No.
ON 7rZL8
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Claes 111
Public Improvements: 3% of eotimated construction coats
Private Improvements: 396 of estimated conatructlon Costs
Minor Improvement Permit .-•. Class 1V: See sttaCtiod schedule 1906
Insoactlon Fee $ �I PERMIT VALIDATION
TRANSMISSION REPORT
THIS DOCUMENT (REDUCED SAMPLE ABOVE)
WAS SENT
COUNT
# 1
*** SEND ***
NO
REMOTE.STATICN I.D.
START TIME
DURATION
#PAGES
COMMENT
1
5199220159
9-29-93 1:53PM
'1'15•'
1
TOTAL 0:01'15" 1
XEROX TELECOPIER 7020
8
SEP — 2 9— 9 3 W E D 1 0: -4:2 t a r m a c P. 02
NOTE:
With Prow validat4ft
thlt Mti",06stitutes sn
ehOadtfftent cat"it CITY OF LA QUINTA
APPLICATION MR PERMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
Fot the car:tauotion ofleubllo ar prtwKa C�arfit,
Indatlur Ilk 01tbJia worlta in trotletttehb Irl conth�jpn w • MINOR IMPPIOVI MENTJ� and APP RV s
� Mfatel ff1alM
,r •
>;D SUR01VISIONS
DATE: 9,
LOCATION OF CONSTRUCTION Mlnw Impmvem"t Permit cl.IV
J3wot addrw�e a! Meanpt�o� of (,goQtieit)
$4IvWOA IMPADVO nt Permit w. G4aa III
PUAPOSE OF CONSTRUCTION Ma -0.
DIMENSION Of INSTALLATION OR REMOVAL
s4ottlt lettach oan~"cTion plans If apPropfiatr)
7071tic. j5e,
716 k)a 5k/6, Av /vi,
ft.-.* ---Norik 'ou� d od,
Size OF EXCAVATION, fit IVcEDEW
APPROXIMATE TIME WHIN WORK WILD, 9JeCIN A
� 115
APPROXIMATE TIME OF COMPLEMON
6STIMATE0 CONSTRUCTION COST .$
(Irtaiuding tante►&) of all obMuction Rtetariilt, and cleft{Is; b+ckflddillq, �fff•
paCtiart OW Rlatinil pOrrflaflent +cavrfadh and/or re Ad im
IA Cmlyd"tian of the & pPavtlfnertq)
17rarttinp Of this perlttlt, tf9! a r'
PP want baro" 'ON* tn:
In ►�h, d�tered arm U" ttya C1ry, lto Imew"
par►altiM, icrbilitib or low ►mifi �n°ms, oMJoM. P�PA1O*"4" ate 6
001
M n Qr t>oourttna M a Prq �e 9v Ww "Coh tO 11rltirte Out Of ��• ham+) f►att �Afl �'W��It Am � all
* man nl Any erartt y klgl t+Pwder thf cwnhJt +c&+w+o"to lar of dMM to p�nOt of 0"w;w
N0111v th4 Adm4AMNIPW Autb"ry K 14rt V*4dMtv�fa4r 12AJ 4r%ftwA r a purlal to this "OlinUM
C4MOV Voth All rope a v"" 4f Me tlmi "M M„a ft twill ba t MUC
Lo GwInu cad to ��e lw d�41sh 1, the 4rnt1 And 0000 tkft of the parmN Ind all igaa►Iltiaae eylp
rr+Ntt nagA,q;�y.se Ina rt wit (if this ""t. +'oWte *ft of dta c.tv •f
i I Ms c t^n- l A . �i� �P,tvra attApplkaa, A„�
Namf of Appliant (pluN print)
Name of
and Job foreman
Contra�oes LiWss No.
App114AYs Insuraruy Gema,....
Addrau
$wcinaW ���
Telephone No.
City Eusirtess �Ipllsll Np,
Ropey Number
fNo.
..
� g,..
,r
��
� •� E
°"m` ,!
Extended Page 2,1
F'ftE87 Suoaleivon Improvement Permit �«
io - ., .•y„'•,•, -
Cl
PubIlc Improvements: 3% of estimsto8 oonst►uctlon costs
Prlvdto improvements: 3% o1 eatilMted can
1t1uCtiaA aota
minor .imprpvemant Permlt .� Clesi IV; See eet�d sdsaduie
Inspe6t1or1 Fwr � .
arrmt
Fee � P�IiAA
�epet!t-Surety SON
require4
TOTAL; s
w:eipt No.
iM� by .
wood by
I VALIDATION
PERMIT NO.
DATE AppROVED
EXPIRATION DATE
DATE iUUgo
By
A a+aar,�wo Authority
TELEPHONE: (641684.22"
SEP -29-93 W ED 1 0 :.42 L ar mo.c-
TO:
9
P. 101
�GiRRnn�
oom�nyn
COMPANY NAME: FAX NO:
'FROM:-
FAXED
TtUM:FAXED BY:
PAGE I OF
IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (619)'.342-7504, PLEASE
CONTACT SENDER AT (619) 775-8302,
Palm Springs Branch ,
P.O. Box 9011
Palm Dwrt CA 94455.9011
Phone 619/3604500
FAX 610/3604570