19951
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
DATE
11/30/93
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 11M EQDIPNSDT
DESCRIPTION OF CONSTRUCTION 14G, 1110'ORGRADIRE
9.10"6, 15'4"8, 43,000 LBS -
DIMENSION OF INSTALLATION OR REMOVAL
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)
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
In consideration of the granting of this permit, the applicant hereby agrees to:
HADL ROHM: SOUTH ON WASHINGTON
STREET FSOIK NORTH CITY LIMITS TO
EISA AND AVE. 50 Ill?SRSECTION
BADL DATE: 11/30/93
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 (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 P.O. BOX 9011. PALK DEMM, CA 775-8327
Name of Applicant (please print) Business Address Telephone No.
Sm
Name of Contractor and Job Foreman Business Address Telephone No.
6'
ON FILE
Contractor's License No.
ON VILX
City Business License No.
ON FILE OA VILR
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:
Receipt No.
Received by
$ 10.00
Date
1995
PERMIT VALIDATION
PERMIT NO. 1995
DATE APPROVED 11/30/93
EXPIRATION DATE 11/30/93
DATE IS UED 11/30/93
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
With proper validation
this form conttituus an
encroachment Parma
GRANITE CONSTR. CO. 6199220159 P.02
CITY OF LA QUINTA
APPLICATION FOR PERMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT►
Por the consrtruction of Puts11c or private Curbs, drlvrMYs, pivomentt, sidewalks, puking lots, IfWM1, Vats: mains
and other like Public works improvenwntt In connecuon with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
A�A'_5�SubdlYltion Improvement Permit -- Claa Ila
TE' MInGr Improvement Parlttit Clsst IV
CATION OF CONSTRUCTION
(sum scocint of 04"npuon of Lo"U"I
PURPOSE OF CONSTRUCTION
VTION OF
..n " ._
MENSION OF INSTALLATION OR REMOVAL
I�OF EXCAVATION, IF NEEDED
,.... 866_p, wenn pie -
���(etUch G4119UVCtlon plans If apprMiatal
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
(ln"ding ftnx vol of all obstrumion, materials, and debris, backfilling,
on and placing Permanent resurfacing and/or teptacing improvemanu
�nCMI'dlfton of the granting of this pxrrrllt, the applicant hereby &gri fl to:
1AditWIl`r, diff"d arq IM the City, st1 tUfnofsled agtntt, offloert, rwrtrttntstrwt enc tnlpl eye harmitsw from •h0
Denastsee, "Militim a sop setuitirq from aasrrtt of eoun M10A " arlu edeom Irw .nd ei1
haPWgrq or ooe "'ho el a orsn"'Ot♦ �n of Afrf warts ^1 out a ani tr%r%jed t. nu ,% OafMpo to santt0tli 0f OrOOeMY
Notlry the Admin,tttvirve AudtW11V At ►east twentty +our Ise � Yr�M t111 POArlft QAMb pyrwant to tt1�1 �Al11ia0t1011.
iav%nGI of the 1lrtty when woHt will ba itertOsf.
f:& OUI wsa all op4yfor N QjtkWrlhe, the t* to ang cond"10t1t Of the parmn end ala "licable rVles ctrl r�9ttktbM Of t!!a CItY Of
l� OulAq etw to t>,y for stmt eddltlor>+I A� 11 " tha tesuit of Met MM .
r
came of Applicant (pluee print)
I of Contractor and Job Foreman
Llum No.
licant's Insurance Company
f"&-' Suoawtsion Improvement Permit � rlat. III
us(rwa Addfou Telephone No.
Butinau Addrsts Telephone No.
_-ezA Az�
City $usiness Llano No,
Policy Number
•cca: auoaFvisian improvsmt♦nt Permit — Clau !11
Public improvemenUt 3% Of 6stimand construction Costs
Pr!vou improvements: 3% of estjm4Wd wnatructlon c01r3
a Minor Improvement Permit — Clesi IVs $ee AlUChed schedllll
11134cttan Fee $
®rmit f et -- ----1 b
inalty
Ish Ofpostt•Stire ty Bona
requited
tsetpt No,
aivo by . G�ti �w
lultw by
Extended Page 2.1
PERMIT VALIDATION
PERMIT NO,
GATE APPR41YEtJ 3�'
EXPIRATION DATE - 30 — 3
DATE ISSUED 30� 93
By
Adminlura►uvw Awtrlartry
TELEPHONE-. (6191 664,2240
GRANITE CONSTR. CO. 6199220159 P.01
rjnnnrr�
Consyumon
COMPRnuMIM
.
TO: L -DATE:
COMPANY NAME: yLv / FAX NO:
FROM: �Z�/!� / FAXED BY: % S :r%��'l�_r.':�- •/'
PAGE 1 OF
IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (619) 342--7504, PLEASE
CONTACT SENDER AT (619) 775-8302.
is 775,5'3>�
16
u
Palm Springs Branch
P.O. Box 9011
Palm Desert, CAS 94455.9011
Phone 619/3604500
FAX 619/360-4570
0