1937. NOTE:
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
Subdivision Improvement Permit —Class II I
DATE: 10/20/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIPMT Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION PAVER 11'6" WIDE
84,000 LBS — ALL ELSE LEGAL HAUL ROUTE: NOR= CITY LIMITS
ON WASMGTON TO EISEMWER
DIMENSION OF INSTALLATION OR REMOVAL
EADL DATE: 10/21/93
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 10/21/93
APPROXIMATE TIME OF COMPLETION 10/21/93
ESTIMATED CONSTRUCTION COST $ i.
(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 ;e
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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 stated.
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—/N,,4
Signature of Applicant or Agent
GRANITE CONSTRUCTION P.O. BOX 9011, PAIR DESERT, CA 92255 775-8302
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman . Business Address Telephone No.
ON FILE
Contractor's License No.
ON FM
City Business License No.
ON FILE ON FILE
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class II 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
Recorded by
10.00
$ 10.00
Date
PERMIT NO
1937
PERMIT VALIDATION
1937
DATE APPROVED
10/20/93
EXPIRATION DATE 10/21/93
DATE ISSUED&10/201141
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Ad inistrative Authority
TELEPHONE: (619) 564-2246
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With Proper Validatim
this form oarlatitutu an
InoroaehMerd oarotit
CI'rY OF LA GUINTA
APPLICATION FOR PERMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
,
For tIN ooi MuCtion of pWIi; or arNate MAN, drivewsm Iavamento, slalewaik$,
ane other like oubiio tsrorla imorotrartaM in conn"Ition with MiNQR IMPRIO �Ehliliki v N`f8 is low. w ice• ros
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DATE-.-,l�' � 64bdlultac►n Impmwerfwnt permit �. Clap III
..—.�,.w. .�. .�..m.v Amara Irnpwa"nt Permit CIai" IV ,.......�..,.,..,
LOCATION OF CONSTRUCTION
f>SitMt addnwr ar 04""I an 0 LoafgW4
PURPOSE OF CONSTRUCTION -.,+...a .._
DIBAIINSIQN OF INSTALLATION OR REMOVAL
SIX& OF EXCAVATION, IF NELIIE®
AMIII OXIMATE TIME WN9N WO b "I"LL SECrIN
APPROXIMATE TIMG OF COMIPLL ''iONI
C9TIMATEQ C&4TgUCTION COST i
Iinoludinq ttmwwel of all DartnucltioA. matariait, and dabrlt, bA*flll;hC c>v ne
pwcticn 4" 0164102 Nrm#nant MAW1410112 and/or r®plowho Iit+stroaarnanxsl
Sk;!d% (sthmi+ c+oftttaction plans if eppr�xidu)
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In wAsideratiors of she granting of this permit, the atoliunt horttbv $or to.
tnd*m1h. Wend ire ares Me City, gat twtn�0,reb a"ffl*' afOktat, ►Mnn�►eat� � a;K,�yaw. tuirrnlaw froltt ant/
prraltrat, ilabiiitia ar �� rtt�+ging ftom vr►+a, or eaw Mort arl,uM out of am ►�t. eaa os i0arasi Iny snd til
hMapak�� er gom4iitlrlj M Oros r� result aaf irN q►vrtt tirrdN k !► unApr etti Oeyt�l� nlAtM �+* tb ppr% of wvv nv
HatiN tho AMMIn:otnt " A�a"igr at iwa trwt�tttr•rwwt 1$4 0 �r+�ant t4 R1it t04d4�ti ,
l ►,awo ill tdwom Of tht tIr►ep V Asn VoA4% wilt ba r1a7p,,
�4de91rrM ar�d9 all 'pW CrtY l�r�arpa+tigr, ihR ta►rM tiyp OAreplilrrflt pr the �nnn tho alt
LA Wiico4 and to pay for WNftwitionrts � Room" 411true sew it of this uwtt. +Api6arbuta ivir� and rogp+latlsite ofthe C4 at
to 7 .. _ S44tu/e of Applictnt or Alprlt
"'ate of AAp+iam t 1plaaN printf- � � �
�� wJttaat Addrett Tafaphone Na
Nanta of Contractor and Job Fofaman
1361rinAss Addren Tatle orae Na.
Cantrsctar: Doan No.
City �tia t Llcanu No.
AAAlicant't lnsurar�a Comt�sny
...... Policy Number
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Extended Page 2. 1
_. I Wa6y 014umowr
8: �ya�IVISIQrt tmprovem At Perm No
Pu0c Improven"ta: 44 ®stitryeted camtructlon ressq
private improvemmotw; 3% o4 estirttwtit! panetft cvo Coo
Mina? Irnprovwment Permit a Cleo ill:
See SlUdied me wcWte
In�WCt�on lxew s
Parrnrt few
p4mity
®epapt.surety gow
:iP repo{��
TOTAL:
Re01pt No.
R#41v4d by Data
�+eac+degt by
pERN91T VALIOATION
PERMIT NO,
DATE AppRt)V60 D — Z o- 93
EXPIRATION DATE /q - z ( —93
(SATE IS SUED 1112 Z 93
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Administrative Authority
TELEPHONE: (0191604.2298
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`"'OCT -20-93
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COMPANY NAME: YAX NO:
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IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (619) 332-7504, PLEASE
CONTACT SENDER AT (619) 775-8302.
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77� 353
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Palm Springs Branch
P.O. Wx 9011
Palm Desert, CA 9MS-9011
Phone 619/3604500
FAX 619/360.4570