1971a
NOTE:
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ith proper validation ,( ,
t`fiis form constitutes an
CITY OF' LA QUINTA
I
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
DATE
11/15/93
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUINUM t
DESCRIPTION OF CONSTRUCTION 450 MITSUBISHI `
E=VATOR, 1216"6. 160,000 LBS
ALL EE SE LSGAI.
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
t
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ t
(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:
HAUL ROUTE: ON WASHINGTON STRSLT
FROM 111 TO EISENHOWER DRIVE
HAUL DATE: 11/15/93
PILOT CAR RBqunm
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
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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 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. , J
Signature of Applicant or Agent
GRANITE CONSTRUCTION lIDNROE STREET, =10, CA 775-8267
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
A
ON FILE ON PUS
Contractor's License No. City Business License No.
ON PILE ON PILE.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111
s
Public improvements: 3% of estimated construction costs r�
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
971
PERMIT VALIDATION
PERMIT NO. 1971
DATE APPROVED 11/15/93
EXPIRATION DATE 11/15/93
DATE ISSUED 11115,t93
By
A inistrative Authority
TELEPHONE: (619) 564-2246
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With proper validation
this Corm constitutes an
encroachment carmn
GRANITE CONSTR. CO. 6199220159
CITY OF LA QUINTA
APPLICATION FOR 'PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P.02
For the conMuction of publlo or prtvat• Curbs, drlvtways. pavomentt, 11dewalks, parkInto lou, BavrWI, water train$
and other like public works Improvements In conneavon with MiNO� IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: S
Subdiviiian Improvement Permit.. Clan III ��..
Minor Improvement Pamiit Class IV ......
LOCATION OF CONSTRUCTION
V(Street =wn" of Downpligh of t.00etien)
11
DIMENSION OF INSTALLATION OR REMOVAL
..R -ft
$126 OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COSTS
(Including raatoval of all obsruui ton, materials, and debris, backfilling,
Paction and placing oom'
permanent returtadnp and/or replacJnE imprortmenul
In Consldaration of the orantine of title niwmo the
Ski o�tch (•trach OnewRcl.On plant It appropriate)
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, appl, At Aar" Agt6 t to:
Inosntnttf. defeea anp tag me City, HB wtnon:ta •vena, offiopq, rORMAatmt IIIA 6O19yeee harm(
9"witi t, lubiiiti" w los result(" lt*m sums a Coon 64110A VAI arising out of IInv 6 ftl,•loss pew from end a�atMt sny ",III
happening or ooaurring It II oreawim wn *am any wedw%km urtder rh1 permit rertt.e tl
yasm4ge to pettonII at pfow
Neiey
Motlfy the Adm�ntetM Audeortry at lent twlnty-rout 18{1 h6m to atrtrenes of the tlrsy Wfleflpt+nxtans to this IIpOilentlotl.
""y Mtn all &MW*,pte Cry OndinanM. the tan," ane aongltbnII of the � woll b. IIt4fp4u
La Quinn anal to my far sm owltlohel tep{ioelftf9U4 rtapp on ii tha tf th of ern"loll "ltoabl0 lulu kw ra"411ona of the City of
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CcntractoPs Llunsa No.
Burin$ Addrou
Tillnileae Ile
Taiephone No.
f City Butinou Llcanta No,
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Applictnt's Intursnw Company`
Policy Number
FEES: iucGivitlon Improvarnent Permit — Claes ill
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GRANITE CONSTR. CO. 6199220159 P.01
GRnn
consu mon
®ompnny ,
TO: -DATE
COMPANY NA114E : e,,I_ A FAX NO:
FROM /Y���j�-/ Z`' FAXED BY.¢_,z..�f
PAGE 1 OF
IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (6191 34 PLEASE
CONTACT SENDER AT (619) 775-8302.
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Palm Springs Branch
P.O. Box 9011 . ,
Palm Desert, U 9MS-9011
Ptxont 619/3604500
FAX 619/36045?0
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