2005O• 3'0
NOTE:
4
Wath proper Validation a
dis form constitutes an
encroachment permit : • ao CITY OF LA QUINTA
•' c�' ' *APPLICATION FOR PERMIT
P4UB0 00
L°IG WORKS• CONSTRUCTION (ENCROACHMENT)
°p v o o .c)
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For the con structiop of public or private curbs, *driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvoments in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
toe
Subdivision Improvement Permit — Class I I I
DATE: December 8, 1993 • Minor Improvement Permit Class.IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location) •
t
i
e Equipment
PURPOSE OF CONSTRUCTION MovSketch"(attach construction plans if appropriate)
l/
DESCRIPTION OF CONSTRUCTION . 450 Mitsubishi Haul Route: From Washington Street,
Excavator, 1210 '3s , 160_,000 lbs. All else legal east on Avenue 50 to Madison Street
DIMENSION OF INSTALLATION OR REMOVAL
Pilot Car Required
SIZE OF EXCAVATION, IF NEEDED
Haul Date: 12/9/93
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 perrrrit, 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
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 Company 38-1.55 Monroe St., ZNdio, CA •7.75-8327
Name of Applicant (please print) Business Address Telephone No.
Same
Name of Contractor and Job Foreman
On File
Contractor's License No.
On File
Business Address
Telephone No.
On File
City Business License No.
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
Inspection Fee $
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 0 �" b
Receipt No
Received by Date
PERMIT NO
2005
PERMIT VALIDATION
2005
DATE APPROVED
EXPIRATION DATE
12/8/93
12/9/93
DATE ISSUED 12/8/93
--'Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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With WOW Validation
this form constitutes an
sncxucfhmsrtt puma
GRANITE CONSTR. CO. 6199220159 P.02
CITY OF LA QUINTA
APPLICATION F4R PEFINiIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or prryata curbt, drlVVHtYt, PAYGManti, Ildewalks, parking lots, I***,, wratar rthalnt
and other like public works inhprgvemenu In canntcuon with f.tINOR IMPROVEMENTS and APPROVED SunDIVI13IONS
DATE: -
Subctivlsion Improvernent Psrnut — Clau 111
Minor (mprovomont Ptrtttrt Class lY_
LOCATION OF CONSTRUCTION
rStraet addrtasa Or Deacrtptian at LooetloA)
u1mlkN5IQN QF INSTALLATION OR REMOVAL,
SIZE OF EXCAVATION, IF NEEDED
Skrdtc h (hutch c4natruRlon plant It &pprpViatA)
Wa4'1' .1fa, a; �'-' ;" , -
APPROXIMATE TIME YMEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ma I IMATED CONSTRUCTION COSI" S
(Including ranxwsl of all obttrut:iton, malatials, Ind debris, back fIIling 00rf1•
O tion and pllcing permanent resurfacing and/or raplaclng imprpyt hffftUl ///�
In c"isldlffltiOn of thl granting of ►hila Pffmlt, thl applicant hfiraby l9f1ms to: •� - .W
lWamrt1tY, defend Ino stvr the City, its nmonsed Iyanu, cmkmi ►#tr*esnatrvsl Ino err4l
ptthatties, liabilities a top retyltine fra+n pelrtn er court ett►on �a0a• harrnl� from Ino paiMt Inter and all
haPW Ing or ow rti t k1LM Obs of If1Y r& t&d t. ion ar to It to patlona or prOV'rtY
nil M 1 pr0><tntaq rYtyft of sty wort una�M•ur� the Parma pnhtae pursuant to tth�t 6PPlio•110A.
Notch the Agit►�n,ttratr� Auti►oriry at lass nwntv•lout 12x1 hp� ut eGtvarw Of tete 11" when work will ba shirtoss.
eNote all ►ppt"" Ctry 0►dlnamM, the tartm aro eonctttbrha of tete oarmn Ind all 4KI a We am r>oyVi.ilortl Of the CJtY Of
4 (luirttts and to MY for arty eddltl mm nptaeaat'*"t n)oeetary N the result of tAr1 WW%. Nlet
Nan'he of Applicant (pialN
dame of Contractor Ind
Cont1Jl=r'1 Ltunss
11C.Int's InsurAKc* Company
Buiin,asl Address
a