19751
NOTE:
_* h proper validation
1tiis form constitutes an CITY OF LA 'QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
I
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 AVB EQUIPPIENT
DESCRIPTION pF CONSTRUCTION GRMEB 1OwV,
84x,000 LBS — ALL ELSE LEGAL
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit —Class I I I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
HAUL ROUTE: AVENUE 50 TO
EISENHDVER
HAUL DATE: 11/16/93
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
i
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.
Signature of Applicant or Agent
GRANITE CONSTRUCTION 38-155 MONROE, INDIO, CA 775-8327
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
ON FELE 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 111
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit -Class IV: See attached schedule
P, . Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
10.00
TOTAL: $ 10.00
Receipt No.
Received by
Date
1;975
PERMIT VALIDATION
PERMIT No.
DATE APPROVED
1975
11/15/93
EXPIRATION DATE 11/16/93
DATE IMIED 141/15/93
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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GRANITE CONSTR. CO. 6199220159 P•01
Gnnnr
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com ucmon
CompAnj
TO: L I -DATE: Z71Z
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COMPANY NAME: _-� � �� . FAX NO:
FROM:
FAXED BY:
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PAGE 1 OF
IF YOU EXPERIENCE ANY DIFFICULTIES.FROM FACSIMILE (519) 342-7504, PLEASE
CONTACT SENDER AT (619) .775-8302.
r
Palm Springs Branch
P.O. Boz 0011
Palm Desert, CA VMS -9011
Phone 619/960-4500
FAX 619/3604570
0
c
N0ft
With proper validation
this form 006ttttuua an
anaaaChn,iorn permit
GRANITE CONSTR. CO. 6199220159
CITY OF LA CUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P.02
For the oonatruction of public or prtvsta curot, drlvvrsys, Rvoments, tldawalks, parking lou, t+wen, vratsr malns .
and Other like public works improvements In 00"Mon with MINOR IMPROVEMENTS and APPROVED SUBDIVISION6
.r
Z.,s� •
00,
DATE; Subdlv{eion Improvment Permit . Clea III _
Minor Improvement Pimlit Clan IV
LOCATION OF CONSTAUCTION
1 1-4 www"r w venrnption of Loofumi
I PURPOSE OF CONSTRUCTION
Ski (attach CALM uetlon plane It spproViatal
�c tr t un F
t;UNIFETRUCTION r
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEOED
APPROXIMATE TIME WHEN WORK WILL BEGIN
A"ROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST i
(1hWuding removal of All oortrutn,on, matifbls, and debris, backfilling.
Aaj�� / � �� r✓
O tion artd plating permanent rLawfadng and/Or replacing impfaramentai
In tnnstderation of. the granting of thin pcmlt, the applicant hereby apr� to:
Indw"Ity, defend &no sws the city, its evatorized b"np, o}t
parultlet< luDfJitia Or IOie relultlfte frpnt aeina ►s"e"nt'' l aid "OloVeee. hattttlew Irnnt snit IMeeihtt a+w and all
Mppett►ne or ooaurrU?e N a proserrry �n of e w mase ar+d arlsirte out of iAt+ 11"Nsi t. lora or �a9s to permw or We0•ity
yrwerta+t44 unlet the OAK Granted Pursuant to tMis Ipollntipt.
Notify the Adnunktretn�e Aud►W,ty Qt le•et twatevf•uf tZal hour �
C&"ay Mtn all fmim iy Gry ortftf4 1, tn, tar O Ina 41 howl
i Of the �tof t e tIn* wi1vn WOHt veil ha rtwg0,
Le Oulnta am to "If for 2;W `ddltkmw npWastywhon "wry u the result Of this rrert. �liosote rola VW rowig ong of tifa City of
144me of Applicant
Buslnea Addrau
Rusin" Addr-
ontractor's 1.Itat, No.
City Gutineu Licanw No.
t
pplicent'e Insuranq ComOeny — e!;�� _V<z
PCWICY Number'
.r
Extended Page 2.1
afar r Suooivision lmprovomeht Permit — Cljsy 111
Publlc improvements: 9% Of estimated construction cbsu
VIR -�l PriWta improverrtentss 3% Of estift0d Wn6tryCtior} Cosa
Mlncr Improvement Permit — C14ts IV: See atUgNd sCtedul®
coon Fee S
I fee &0
�h Depoeit•Surety Oond
Tel.+i . ,a..
No.
1 ey oaa
d by
PERMIT VALIDATION
PERMIT N0,
OATS APPRUV6® �
EXPIR®TtAhi MA M. (U
1161
DATE IS3U8DdM
ev
Administmuve ^uthorlty
TELEPHONIxs 1619) 664-2248
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