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1991
NO -i E: With proper validation thisiform constitutes an CITY OF LA QUINTA encr"oachment 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 11/24/93 Subdivision Improvement Permit — Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION HOVE EQMBMT DESCRIPTION OF CONSTRUCTION ROAD WIDHER, 10'W, ALL ELSE LEGAL DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attach construction plans if appropriate) 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: HAUL ROUTE: WASHINGTON STREET AT CITY LIMITS TO $ISENHOM AND AVE 50 HAUL DATE: 11/24/93 Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all 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 124) 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 35-155 MONROE ST., INDIO, CA 775-8327 Name of Applicant (please print) Business Address Telephone No. SAME Name of Contractor and Job Foreman Business Address Telephone No. ON FILE Contractor's License No. ON FILE ON FILE City Business License No. 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 Penalty . Cash Deposit -Surety Bond if required TOTAL: Receipt No 10.00 $ 10.00 Received by Date Recorded by A 1 9qll PERMIT VALIDATION PERMIT NO. 1991 DATE APPROVED 11/24/93 EXPIRATION DATE 11/24/93 i' DATE IS UED 11/2!V93 By dministrative Authority TELEPHONE: (619) 564-2246 With proper validation this form oonrtitutas in ancrosa)mlrnt parmn GRANITE CONSTR. CO. 6199220159 P.02 CITY OF LA QUINTA APPLICATION FOR PERMIT ,PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the Co"truction of Put'lie;or Drtvet§ curbs, drlvtrvraVs. Pavoments, aldewalks, parking lots, 11**o t, water mains +nd Other Ilks Public works improvements In cwnnemon with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS ,r ; o — DATEa Subdlvlsion irmprove"m Ps"nit — Class ill Minor Improvament Farmit Clam IV LOCATION OF CONSTRUCTION (Suwt rroanrea et OeeertpttOn of Waatloftl PURPOSE OF CONSTRUCTION !?T19N OF99NUFlUCTAN OIMENSIQN OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED S a��tattach epnilMinlon plans t spprwiatal 'o st APPROXIMATE TIME WHEN WORK WILL SEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COSI' S 6ACludirtq removal of alt obstruction, mattriAla, and do4fil, badtfillinQ, ppfrr t>lcsien and Dlal:inq ptrmanlnt reaurfidnq lrvdlor reptlCirnq itnpfpvgmenu) �/0?�9, In COf111104 ltion of th# Qnnting of thili pe mlt, the ia1pp1junt horeby ligtfl+ea to: Ind&MAty. defend ant} lour tn! City, its enotonxiso agamu' offkmm, rurrsrnt"n'" ert0 en,i+iovea, hamtla# Irlith inti holm am and all hent++oaltlea, liabilities w IOU resulting from serene w sour w"c" am selling out of env eCtaaant, los or alma" to anona or ""rry p«un9 W owuning Is a orort� I'Min of any "mNndetrsakm unci the Penn" grantee! pursuant to tons apallatldn. Noisily the Aamimmrstro AuvwjTV of kum rwenrtty•four 1241 hOwn m ether ss o1 the tlnw when wort "Ill ba started, emnomy totes all avWloA&a C+1V Ordln&r4K, int tarn" anp ooncitbM of the IDermn Ind sit a"li sewsq &W nrgHlatsoelt Of d1! I:ity ofl La Wines aro to pay for WW Ito"MW rteWtaoerr*m n*tgrV a the rmit of this titers. rtr Nam! of Applicant 11014644 print) Slgnatur! of Ap9Nieant or Agent Telephone No. City 8usinau Licanse No. _ -• �� ..ru.wl Extended Page 2.1 =EEBi' SuDOivision ImprovIlmant Permit — CIA" Ili Public improvemenu: 3% Of estimated construction co:u • Private improvements; 3% Of estlmatArd cunstructlon coat~ fVllnor irnprovement Permit — Class IV; Saa attaCttied iCtlOdlil1 nspealon R.a $ 'ermlt FI»PERMIT VALIDATION 4nalty _ — PERMIT NO, 46h Dapoplt•Surety. ©ono DATE APPAuVED rsquU44 ■Wl ... .. •- .... I M 1 •*ire 6,- tatlpt No. DATE 1$3UED oftivoo by Data 6y Adminlitrative Autherity tcoraed by TE46PNONE; (0121664-2248 GRANITE CONSTR. CO. 6199220159 P.01 GRRi1IT� const ucnon comPnn!j 7['0 : (-z -DATE: COMPANY NAME: /��,,La-� FAX NO: 'FROM:4 FAXED Bw • PAGE 1 OF P f IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (619) 342-7504, PLEASE CONTACT SENDER AT (619) 775-8302. 775 S3>3 /crs� r a 9 .1 Palm Springs Branch P.O. Box 9011 Palm Dew% U 9MS-9011 Phone 619/360-4500 FAX 619/3604570