1967NOTE.
With proper validation
+this form constitutes an CITY OF LA QUINTA
encroachment permit APPLICATION FOR PERMIT
it 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: 11/9/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION HOVE EQUIPHIM Sketch (attach construction plans if appropriate)
DESCRIPTION 10 14G NMRGRADER
9 10 W, 15 4"H, 43,000 LBS HAUL ROUTE: SOUTH ON WASHINGTON
FROM FRS WAMG TO HAY 111
DIMENSION OF INSTALLATION OR REMOVAL HAUL DATE: 11/9/93
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 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, --abilities 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.
61,41 )44a—, /�,& /)
Signature of Applicant or Agent
GRANITE CONSTRUCTION P.O. BOX 9011, PALE DESERT, CA 775"327
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
oil FILE 0 ON FILE
Contractor's License No. City Business License No.
ON FILE ON FILE
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 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: '$ 10.00 s
Receipt No. '
t
Received by ' Date
Recorded by
PERMIT NO
1967
PERMIT VALIDATION
1967
DATE APPROVED 11/9/93
EXPIRATION DATE 11/9/93
DATEISSU D 11/9/93
By
Administrative Authority
TELEPHONE: (619) 564-2246
t
►'fir
Ni.
Wi proper YtlidetiOn
this fora) oanstttutu to
InCrOeohtnertt i5ermn
GRANITE CONSTR. CO. 6199220159
CITY OF LA OUINTA
APPLICATION FOR PERMIT
.PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P.02
For the construction of pupNc at privet• curaa, drivtr+vtyt. pivomenn, 91dawe1k4, parking lou. sewers, wtur mains
Mild other like public work$ Improverttenta in tonnscuaft with MINOR IMPROVEMENTS and APPROViap SUIIDIVISIONS
.r •
DATE: Subdivision Improvement Permit — Cteq i!1
Minor Improvement Pamlit Clam IV `„�....�
LOCATION OF CONSTRUCTION
IStieet oddreu a Oaar,ption of le l
PURPOSE OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
$1211 OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL 8EGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST 8
(Including rtmotral of ail obM(..tlan, rttattriils, and debris, barfe1111ing, coral-
06ction grid pitting Pertriment rrsurfaeing Ind/pr tsplagng improvemen"I
In WS14eriltion of the granting of thin Derma tha
,,,�a�tetuch conatructlan plant it appropeittel
Av
��._
-ZA14
, applicant hereuv agrees to:
Ir►OrttnIfY, defers arty ewe the City, rte edeton:00
Perialtiel, itabaltiee of lea rfwitine front cialfm or & R , :1110" rt, reHrlim but
o ant anl0ioV0ef. hertnie>z tram itvs Mt1lttt lkrr end all
neppauof or ommms a 1 omit eetwn a++e eclair» out of soy 609munt, los or fe e:t*>ona or f+nepeier
4 n of arw worn undwgaM unser the pd mit grtnted ewreu.nt to trice a'a POM CA
Nosity the Adnun,etretrwe Audwnty at Not r0sOnivfout 1241 tteyri ut
c4mmy wart all &M Wv"" of the tiny when work mil ba gt*e"&
idbia Gey trdlrtanw, the unml ant canditiom of the ry
a
04"n sftA ell W6lliotbte n+iee rae qui�eorM of VIS City of
La 0ulnte and to Pty for " additkwAm nep"temem NO"" u the nwle of Mit tweet,
Nerve of Applicant (010610 print)
'Name of Contractor and Job Foreman
Contractor's t.eunle No.
4001icunt'1 Insurance Comps,,,
SIVUtura of Applicant or Agent
Telephone No.
Business Addrou Talephone No,
City Sysinau Llcanit No.
POIICY Number
Extended Page 2.1
Ei:B; Suoa�wsion improvtMeAt Permit .. Gest III
Public improvementtr 3% Of estimated conttructlon cosu
`�o Prlwu improvettmitss 3% Of #rtlftuted cunstructlon cora
Mlnor Improvement Permit — Chis IV: 6016 atuched Whadile
IA
spection Fee S
rmit fa PERMIT VALIDATION
nsity
th Ceieeut•surety Bono
required
TOTAL; s i�
ipt No. '
iv44 by Data
Data
camod by
PERMIT NO, �.,........�.•��..�,,..
DATE APPROVED
EXPIRATION DAT9
DATE ISSUED
dM
by
AdnllnJetraatJvO /luthtuf ty
TELEPMONEt (6151564-2248