2011er
riNOTE:
With proper validation
thlis 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: 12/15/93
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION NOVB BQmPMW
DESCRIPTION OF CONSTRUCTION PAVER — 11'6"W.
84,000 LBS — ALL ELSE LEGAL
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 I II
Minor Improvement Permit Class IV
In consideration of the granting of this, permit, the applicant hereby agrees to:
Sketch (attach construction plans if appropriate)
HAUL ROUTE: SO= ON JEFFERSON ST.
FROM BUY 111 TO AVE 50, WEST TO
EISENHOM, NORTR.TO SINALOA ST.
HADL DATE: 12/15/93
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 38-15.5 MONR:OE ST., 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 r ON FILE
Contractor's License No. City Business License No.
ON FILE ON FILE
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
10.00
$ 10.00
Received by Date
2011
PERMIT VALIDATION
PERMIT NO. 2011
DATE APPROVED 12/15/93
EXPIRATION DATE 12/15/93
DATE ISOE 2/15/93
Bycv—
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
u
9
IAA
NO��s •
With DrOW validation
tnla form conctitutea an
erwaechrT4m permit
Of the oonatruction of public or Private curbs, drivr&$Yt. Pavoment7,
end other tike public works improvertrntx In connection with MINOR IMPROVEMENTS ends "PROVED SUS 8wauw mains
01VIS ONS
GRANITE CONSTR. CO.
6199220159
CITY OF. LA QUINTA
DEC "
C114Y OF LA QUINTA PUBLIC
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P.02
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LATE: ��' .5-- Subdivision improvement Permet — Clap III
LOCATION of CONSTRUCTION Minor Improvemant Parnlrt Clan IV
.
Is~ Immu of Oeewptipn of Lmou",
/Y J
PURPOSE OF CONSTRUCTION
Sketch Ntuc h C4nj"cllon Plant If eppropiNul
ut:WfttPT ON OF C2NSTRUCTION
49
DIMENSION OF INSTALLATION OR REMOVAL
SIXE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
PROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
iIncJkrdirp removal of All obatrut.Ilon, metefialt, and debris, backfill'
M"GR and plaoinq permanent reswfidng and/or reptaslnq imprOvem, enu
n CM11101fition of the Vanting of lhta p>ermlt, the applirAnt haroby ioray l0:
lt4m itV. dtlend aro save the City, Its s'YQloPa" +Dema, cHltary, rswr»sntatrvet Old W4, ees. hannle0t Irom bf10
peneltiefl, I+abllitu+s a lOq rtsyulr►a Iran heat. oe ca+n wtbn Q1► �i 1rt1r end all
h4PW4h2 tN OmMiq M a Arear mm �n cf " v mnc u erl4w out ct cram aCt�dtrtt, sos or age to neswnt ct progrev
NOUN tree AMun,ttntme Audwi et 1.sa< �+d++�teA �naer tree wRnn grent.d prrsu►na to Im1& 6OOsatlpq.
N �enhr•fouf 4241 hown in O&SM of the %in* "on v+oA Moll ba nwtq,
C4rlepr tenth all ►OWIObOto Ghr Q/dllfeflOM, lid grtTM enc CCntlllbne el the Wert►A and ell WOiiosble Flrlet arx! rrgylatbpry 01 the City of
V Ot+lna end ea peY for smr eddltlonet , u the result of MA tMorAh
lame of ApplicAnt (01
lame of Contractor
ontrattor's L,um No.
Pplicant'1 Insurance Company
Sior►etura of -Applicant' of AQant
Busineu Addram
City Eusinass Llcenm No.
Policy Number
Extended Page 2.1
svtiry ivumoer
�8j ��ueaiwsion Improremont Permit—Class
Public improvemeppt 3% of 41stimttad construction co�u
Priwu improvemeiitst 3% of ortinutw Construction coiq /
Minor Improvement Pmrmit — Ciau iV: See otUCNd sCtledWv
04ctton Fe•
I Fit
oltb
DePesit•Surety Bond
squired
TOTAL;
Pt No.
s
�o
s /v
ive0 by Din
;a�raed ay
PERMIT VALIDATION
PiDAMIT NO,
OATS APPRQVI;p /Z
EXPIRATION OATS -- .
DATE f8 Woo
By
Admityetntivs Authority
TELEpwn"c. ia. nt ,^A ^^A^
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GRANITE CONSTR. CO. 6199220159
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TO: -DATE:
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FROM:
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FAX NO:
FAXED BY; /�/j//J`/�`� �7�'�;1 �� •/.'
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PAGE -1 OF .
IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (619) 342-7504, PLEASE
CONTACT SENDER AT (619) 775-8302.
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71,�3�
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Palm Sprin3s Branch
P.O. hoz 9011
Palm Desert, U 9TZS-9011
Phone 619/3604500
FAX 619/360.4570