1997NOTE:
'uh
With proper validation
4his form constitutes an
l encroachment permit
CITY OF LA QUINTA
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: 12/1/93
LOCATION OF CONSTRUCTION _
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
HOVE EQDIPIGM
DESCRIPTION OF CONSTRUCTION PAVER 11 "W,
84,000 LBS — ALL ELSE LEGAL
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit.— Class III
Minor Improvement Permit Class IV
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:
EM RODTS: FROM INTERSECTION
OF EISENHOWER AND AVE. 50, EAST
OF AVE. 50 TO WASHINGTON STREET,
NORTH ON WASHINGTON TO NORTHERN
CITY LDaTS
HAUL DATE: 12/1/93
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 38-155 MONROE STREET, INDIO, CA 775-8327
Name of Applicant (please print) Business Address Telephone No.
SAM
Name of Contractor and Job Foreman Business Address Telephone No.
ON FM
Contractor's License No.
ON FIDE
City Business License No.
ON FILE ON FM
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 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
d
5
PERMIT VALIDATION ;
PERMIT NO. 1997 ' -
DATE APPROVED 12/1/93 1
EXPIRATION DATE 12/1/93 r'
DATE IS UE ► 12/1/93
Y.
A
Administrative Authority
TELEPHONE: (619) 564-2246
With propst validation
this form oonst'tutu an
encro4ohrrIam permit
GRANITE CONSTR. CO. 6199220159
CITY OF LA QUINTA
APPLICATION FOR PERMIT
,PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P.02
For the conruuction of pu011c or private curbs, drlMkIY1. Pavements, aldewalks, wain lots, rowers, watar "Ina
and other like public woria improvemarite In tonne,"On with MINOR IMPROVEMENTS and APPROVED Ujl1DIVISIONS
HATE: ��`- Svbdiviiian Improvement Permit — Ctau III
Minor Improvement P,enttit Cla>u IV
LOCATION OF CONSTRUCTION
(street eoantaa or 049Gnpuon of L,ocwmi ,
PURPOSE OF CONSTRUCTION
iP,Ti4N OF CONSTRUCT
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
!APP ROXIMATI: TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COSTS
(Including removal of all obatrut.-tlort, matatials, and debrla, backfilling, Corti.
Faction std piecing Perm&nent resurfacing and/or replacing irnpr0vamanul
TKQ tot, tansy'► c AI"ctlon plans It eWOViata)
�Q�'• 5"moi �"a���
erre �c,ce..�� .�` �Q�► �A'/i
�'-
/o�//�
In cons101Prttion of th1 granting of ;Lhill P"It► thi ippliunt htraby 19(sts to:
Indunnity, defend en4 SM V)a City, rte fumonaed ep nU' ortieera' r2QnMfttatrM grid em01oybaa, harmism from Ynd I4e1Aet arry end all
Denaltul, lubili"s w log t/fyltine rrom ae,rim of noun m,on end ariain� owl of env scCwlent. loci o► tiama9e to pence pr pr Ry
he*�n0 or Omuraina ai a ori►atanate Hewett of env wort vndatatM unWt the aerintt pretwu pursuant io otic eGAljei tou
ko<1N the Aclm,nm»trve AuthorirY 04.
et $"At tv'OntY•four (Til how" in adYanca at the tlnw VAIn vom wil tw mantes.
C*Mgxy vnth all avwks40 City OrdLmancee. the 14M4 and CCrtttltioN of the Wmnr; end elt
4 Ouinte artd to pay for easy edditkmw t u the niult of Mrs NAM,"Ik&We rvia " raWlatsona 4f the GtV of
Noma of AppljMnt (01.414 Print)
Name of Contractor and Job Fwaman
-ontractar's Licar►se No,
4Ppliunt's Insurance Company
&V14tura of Applicant
6tu1rxu Aadtala
OF
elePhorte No.
BusJneu Addram Tale oM o.
� r
City 8Utinau LICarim No. _
Policy Number
Extended Page 21
PollCy Numoor
'6EII SuPOlvislon Imprortment Permit clau III
PuMIC improvemenu: 3% Of Astlmeted Conttruction coat
ri Prlvau improverneou: 3% of e1timet0d construction Cosy
Minor Improvement Permit — Ct&u IV: Seo etUchad tChadule
nsp,rttlon Fee s
�armlt F" _
analtY
ash 06"111-Suraty Bond
\ requlre� -
TOTAL. /D
>taiveq ey
icorced by
PERMIT VALIDATION
pt3RMIT NO,
OATIr APPROVED
EXPIRATION DATEI Z '1 — 9 3
�I I IISI 1 11 I,YI-
bAY
By
AdmtnitMUYo Authority
Tt LEPHnNI~• M101 COA.IVNAn