2006NOTE:
`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
December 9, 1993
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment
DESCRIPTION OF CONSTRUCTION Paver — 11t 6" wide,
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:
Haul Route: North City limits on
Washington to Aioc' mue 48
Pilot car required
Haul Date: 12/9/93 or 12/10/93
ONE DAY ONLY II
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 P.O. Box 9011 Palm Desert, CA 92253
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 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: $ 10.00
Receipt No.
Received by Date
Recorded by
2006
PERMIT VALIDATION
PERMIT NO. 2006
DATE APPROVED
EXPIRATION DATE
12/9/93
12/10/93
DATE ISSUED 12/9/93
By
Administrative Authority
TELEPHONE: (619) 564-2246
Cnij .
f0i11t
Wlth propel validatlOn
this form conttrtutu an
enaUChRlient permit
GRANITE CONSTR. CO. 6199220159
CItY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACNME.NT)
P.01
Fat the' aonruultion of p""C Or Pttrata Curbs, drlvrMys. pdvomentt, Ildowalk4, pVking lots,
and other like puDlio works improv+rntnu In cannactroh withsaWeen. water rnalrte
MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
1r„
OAT E: Subdivision Improvement Permit . Clan ill .._
LOCATION OF CANS quCTION Minor Improvement Parntrt C14" IV
(Street Doan" of Oe.crtpuort o+ L4aUml
PURPOSE OF CON STAUCTI0N
n
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
ROXIMATE TIME WHEN WORK WILL BEGIN
Skotch (atuch t4nc6VUllnionn ppllam if +pproViats)
aeAe
AffROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COSTS `_'/�G�,uG �7�� •�� �/��� Q�
(ItWuding ftrttoval of all oDauut.,t,on, matsfials, and debrls, badtflllino. polo.
on rand placing permanent resurfacing arndlor replacing improvemenul
n Conslgarltion of the Qnntlno of 01i pelrttlt, thlf appliQrt hatreby lotm to:
lwwnn,ty, del" Ino sive the City, m luthontso agents, ofIkem, repramtntativn " emalave". harmlow from Yno ayall+Il arw ww all
Denaltlalj, IVDilitiaa a IOU "DwItIne Irwin eiairta ps noun actlot► aria Irlurq out of Inv solder. los or 44mb" to oorwna or pro"
Aaop«►tinp or oaavtr4h4 a4 or"wrillta fMn of arnv fm YndMAe4n under the pwmn granted Pursuant to trill booNmatiom. rtr
Notify tris Admanaltrauv. Authorary at leas C~tv-toy# (241 hots% ,n aW vsm M the 11" when v k nnll ba stertao.
Cornvey Mntsn all eaa+lcab�a Gtr drdlrtahras. tna tam" ane oon"WO of the armn Ino all a"lingt:►ett
a• rv�o "W rs0(ts of the City or
La Oulnm and to per for w"addltkmw nowcd r*m Mp"s►ry M the rtlHlt 01 Mrt wprt.
n-4 of Applicant (014414 print)
M# of Contractor and Job Foreman
ltractor" Liume No.
PlicAnt'I insuranat Comp4ny
S1on+ture of Applignt or Agent
Busimu Addr4u
Businau Addrou
T4lephone No.
TaNphor* No.
City Butinau L1an14 No.
Policy Number