2007"NOTE:
With proper validation
this form constitutes an
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
Subdivision Improvement Permit — Class I II
DATE: 12/10/93 Minor Improvement Permit Class IV
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LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION NOVB EQUIPMW
DESCRIPTION OF CONSTRUCTION PAMM - 11'6"A,
84,000 LBS — 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)
HAUL ROUTE: FM AVE 48 To
HIGHWAY 111 ON WASHINGTON STREET
HAUL DATE: 12/1f/93
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:�
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities or loss resultingfrom claims or court action and arising out of an accident, loss or damage to
9 Y g p�rsons or property
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.
1`
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 N=0E STREET, 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
City Business License No.
ON FILE ON FM
Applicant's Insurance Company Policy Number
14
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
10.00
$ 10.00
Received by Date
PERMIT NO
2001
PERMIT VALIDATION
2007
DATE APPROVED 12/10/93
EXPIRATION DATE 12/13/93
DATE ISSU I D 1;/10/93
By
/Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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! GRANITE CONSTR. CO. 6199220159 P.01
Gnnnr
conmucinon
compwi va
,TO: J/ ( •DATE : e i
COMPANY NA14E : N FAX NO:
FROM:
Z51- / /f FAXED BY :
CITY OF LA QU [NTA
PAGE I OF
IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (619)
CONTACT SENDER AT (619) 775-8302.
s
is
a
DEC 1 01993
PtMLIC WORKS
342-75041 PLEASE
.^
Palm Sprin3s Branch
P.O. Box 9011
Palm Descrt, U 9MS-9011
Phonic 619/360-0500
FAX 619/3604570
f '
i
y GRANITE CONSTR. CO. 6199220159
NOTE:
With proper validation
thla form Constitute* an
emoaChrnent oarmri CI1`Y OF LA QUINTA
APPLICATION FOR PERMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P.02
For the contitruetion of pupllc or prlvata curb$. 0rlve-Myt. Pivamenti, ;Idewalks, pafting lots, ;*wars. vratar maim
and other Ilk$ oublio work; improvenunts In =nn*=on.wlth MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
•• � / it �►e .
DATE: Subdlvlsion Improvement Parrrttt — Clau III
Minor Irnprovgment Parntrt Clean IV
LOCATION OF CONSTRUCTION •
(Sum m*uvu or Deempuon or
Ir
PURPOSE OF CONSTRUCTION Sk��latuch n;tructlon plans if a
Dfxvpriau 1
00
D>:SCIPTION OF C20 StRUCTION _ _ _ � " sp
DIMENSION OF INSTALLATION OR REMOVAL 7v
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN W08K WILL 8EGIN
A,PPROXIMATF TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
"t"cltrd'ng r'nvval of all Obstruction, material;, and door!;, backfilling, port-
Pacnon and plating permanent resurfacing and/or replaicinp improvrmenta)
7Y�,�.�.•
In cons101ratlon of the granting of this permit, the applicant herebV agrees to.
lhow sty, d$ftm aro ewe tna City, Its INMO tad aoartt U. oflben, 110"Atatrres and Mlplovea. harmless Isom and *da,nN &M *std all
OwAltlat• lubilltla er IOD Moulting fra* Velm; or s"rt wt,on and arts,na out of env aCi�derrt, lote at ttaaraq$ to t»rwna a prvverll
happan,nd or 000urr04 N a oreaw"M rMrI of arty wort t►► *as*n vnoer t!t$ PvmnOf 11h AMvm
fNotlty the Adm,nmr*tM Auow, tt lees; fl purwant to mks rtmwati".
N rv4ntV-lOYr t241 hOur9 In aWVartca e4 the tlma wRen --Oris will to r46ew&
La Oul t a all eoor I*r N O lik" nes, w r*m ane Condltkwt at 11111 t M11 and all aV I"Uq role$ ant nrqu*U",a of d» CJtV or
V Oulnta and m O+v for ort- oddltkann npcao ym
Weis" as the rMit of trrtarpra+
it .r /")
-41"tura bf Applican r AV"
Applicant (pleat' t!,!sir
int) @e Addrus
,a— _ �� Telephone No.
Name of Contractor 2andob Foreman
oont'llctor" Llcarim No. ,
Butanes* Addrasa Telephoto No.
City Susinass Llaant'd No.
14 0 iunt'; Insurance Company
Policy Number
MW
a
r,
i
Extended Page 2.1
Su®aivision Improvement Parmlt — C1314 111
Public improvements: 3% Of estimated oonstrurtion cosU
Prlvitm'improvements: 3% of srtimted wnstruct,on cosq --
Minor Improvamant Permit -- Clau IV: Sea atUCNd dCtledvllR
MWtion Fee
arml3 Fes
fAN�►
W Depeslt•Surety Bond
requlted
TOTAL.:
act►pt No. .
SWV44 by ..._...�..-.�..._ Date
;coraid by
11
PERMIT VALIDATION
PMAMIT NO.
DATE APPAuVED
EXPIRATION DATE -5.YIY r Y .rte. i
DATIi is *uBo
By
Adminlstnuv• Authotlty
TELEPWnun. sagn, ema