1979` r
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 I I I
DATE: 11/17/93 r' Mi nor'ImproGement Permit Class IV `
LOCATION OF CONSTRUCTION r` ' E ! r t. �` +
tr -
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION HOVE Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION GRMER 10%
84.000 LBS, ALL ELSE LEGAL HM ROUTE: CORNER OF AVENUE 50
AND EISHNHO ER. — BORTH ON
DIMENSION OF INSTALLATION OR REMOVAL VASHINGTON TO CITY LDWS
HAUL DATE: 11/18/93
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
j
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
r
La Quinta and to pay for any additional replacement necessary as the result ofthiswork. /
Signature of Applicant or Agent
GlRANITE CONSTRUCTION 38-155 NONROE ST., INDIO. CA 775-8327
Name of Applicant (please print) Business Address Telephone No.
SANE
Name of Contractor and Job Foreman Business Address Telephone No.
ON FM 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 I I 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.
10.00
$ 10.00
Received by Date
Recorded by
179
PERMIT VALIDATION
PERMIT NO. 1979'
DATE APPROVED 11/17/93
EXPIRATION DATE 11/18/93
DATEISSGED ,/17/93
By7�6P�7
Administrative Authority
TELEPHONE: (619) 564-2246
1 '
NOTE:
With proper Validation
this form oonnitutet an
"nCr640111 nertt permit
GRANITE CONSTR. CO. 6199220159 P.02
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of puollc or prtvgte Curtis, drlvrMevt, Pavomenn, sldswalkll, puiting lou, joyAn. water nwins
and other like public worsts improvements in cannscuon with MINOR IMPROVEMENT& and APPROVED SUBDIV1$IONS
,v
DATE:
Subdlvl"ion Improvement Permit — Clea III
Minor Improvement Permit Gast IV ..,... ,_,
LOCATION OF CONSTRUCTION
($user addnu e1 0aeeTlptics of Laeuml
PURPOSE OF CONSTRUCTION
R
DIMENSION OF INSTALLATION OR REMOVAL„
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
"4udinq renwval of all obstrur.Kton, materials, and debris, badtfilling, corp.
Wtion and pigging permanerst returfadng and/or replacing improvemanul
Sketch WftMetlon plans it appropriate)
In conslderstion of the 4rantlnp of thlt permit, the applicant herby sotill g to:
Indef"Ity, del". ane Hwa the city, +tt eseoton:ed bpan, afflem, ►tpRMetatrwe enc imps
R+aanaeaey, I�pelitiea or los ntyltieM frprt► aetrro Or CbuR ert+on end grfai ova", memim frons &rod /0,M 1rt11 end allhePPsyt+n0 a oacunlne el 1 prORerrtey "W" of any wont y M out of any eCWdint. Itis or damage to atMorN or pro0eitn
ndaium under the p"mft granted pursueet to thg eoolh atioat.
Notify the Adrn+nmr"trve Authohty tet W= ft*MtV-Pour 1241 hours in advuire of the tin* wheel wdfft will to S%6es Y
COMOUy w►rh all eflR "bis City Ordutartas, the tames ane oondit" of the !.rater ane Ali aolicwe neve VW rwayknlorte of tRe Clty of
4 oulns WW to pay for am additional npWavrom nweemv ea the rliult of this wort.
of Applicant (pleeN print)
YOM# of Contractor an4 Job foreman
�onvaetorrs I.itente No.
B"nou Address
Telephone No.
Bus+neu Addrea Telephone Na.
' M
City Butinau Licana No.
kPolic,ant't insurance Company ung
a
Policy Number
. - ,�
tt ,Y W i
Y, w � ,.M ,
i. 0. ti ��
3yF .iFi� ' •df i
Extended Page 2.1
EEB: Suoo i
w sion Improrfinent Permit -•Chu 411
Public improvementa: 3% pf estimated conttruction cosu
Pr(wu improvemer►ts: 3% of estimaced construction cosco
Minor Improvement Permit — Ciau IV: See atUgmd tchedule
,sp.caon F.* s
trmn fee
malty
w Depout•8urety Bono
requital
.TOTAL: s� �
0
PERMIT VALIDATION
PERMIT NO. ..._...,_r...
DATE APPRQV69 .--�� 7 9�
EXPIRATION DATE
DAVE ISSUEo —�� �� �. Y3
by
AdministmMs Authorlty
TELEPHONE: 0191664-2-246
GRANITE CONSTR. CO. 6199220159 P.01
IGRRnrrE
consrRurnon
oomPRny mxx
TO: / ( -DATE:
COMPANY NAME FAX FAX NO:
/7
FROM:
�/'l/ 12 / �' FAXED BY :
PAGE 1 OF
IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (619) 342--7504, PLEASE
"CONTACT SENDER AT (619) 775-8302.
fcc X To
Ilea 5 cl::5
77S 535
Palm Springs ®ranch
P.O. Box 9011
Palm Desert, U 9MS•9011
Phone 619/360-4500
FAX 619/360.4570