2017NOTE:
'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
r
Subdivision Improvement Permit — Class I II
DATE: 12/20/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description.of Location)
PURPOSE OF CONSTRUCTION MOVE EQHIPMW
DESCRIPTION OF CONSTRUCTION PAVES — 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
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:
HAIL ROME: FROM INTERSECTION
OF SINALOA ST. AND EISENHOWER,
NORTH ON EISENHOWER, NORTH ON
WASHINGTON ST TO NORTHERN
CITY LIMITS
HAUL DATE: 12/20/93
Indemnify, -defend and save the City, its authorized agems, 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.
4L'i )e4c-_.. /7 1'e-1
Signature of Applicant or Agent
GRANITE CONSTRUCTION 38-155 MONROE ST., INDIO, CA 775-8327
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman
ON FILE
Contractor's License No.
Business Address
Telephone No.
ON FILE
City Business License No.
ON FILE ON FILE
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 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
Receipt No.
$ 10.00
F
Received by Date
201 7
PERMIT VALIDATION
PERMIT NO. 2017
DATE APPROVED 12/20/93
EXPIRATION DATE
12/20/93
DATEISRUE 12/20/93
By
or Administrative Authority
Recorded byII TELEPHONE: (619) 564-2246
w GRANITE CONSTR. CO. 6199220159 P.01
GnnnrnE
conslumon
coMpfing'.�
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TO: % ;DATE : _ /� 6-P
COMPANY NAME FAX NO: 171
FROM:
PAGE 1 OF ,
FAXED BY:
IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (619) 342-7504, PLEASE
CONTACT SE9DER AT (619) 775-8302.
Palm Springs Branch
P.O, Boz 4011
Palm DM(t, CA 45455.4011
Phone 619/360.8500
FAX 619/360.4570.
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v GRANITE CONSTR. CO. 6199220159 P.02•
faTlt
With PrOW Validation
thin torn+ aonatltutoa an
enatuohnwnt oarmn
CI1N OF LA QUINTA
APPLICATION FOR PEFMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
Fat the conmuction of pubilc or private curbs, drhI.4440. Nvornents, sldrvvalka, pw*lnq lots, ►avArs. Wow mains
and other tike Public work+ imprOVenwhIe in cams"on with MINOR IMPROVEMENTS And APPROVED SUBDIVISIONS
DATE; : Subdivision improvernrnt Porrnit — C48s III
Minor tntlxovement Partttrt Claaa Id
LOCATION OF CONSTRUCTIOtd
tatre.t,aana� sr S�o�r,at,oh oe Lot+ot►i J(/�
PURPOSE OF coHSTaucTItJN —_
DESCRIPTtP N OF CONSTRIYCTION
DIMENSION OF INSTALLATION OR REMOVAL
Ski r� ch latUch c4utruction pians if apprWiauf
gq4 a�&14u"A ='
0
SIZE ®F EXCAVATION, IF NEEDED 0�/Li-..)
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COSTS
IIncludinq tonvval of all ouUuetion, meteriala, and debris, back filling
P"t"artd pieGng permanent rs►vrtacing And/or replacing improvem+ eatui 4 /o? --0 2,
In cran41043tion of the onnting of thlt pa mit, the applicant hereby to:
INNvi itty, dafew Ing ►eve the City, its swomass apor,tu, oMIoM, rtQretentAirm ono nmol
penaltlat, ivp�litiaz or led rttMltlno ttprh Caisse a Coven ett�n t�rt�et. harseNalt �trom snit 1pr�Mt ►nr srd all
Rappah,nq vy oaaurri V4 arleurM Owl of Inv Wwt M. low or a4e to Der oft of prgwe lry
�a at a Oroaemota mun of arse Warr umdwu&$n under Silo poemsrshled
NORIty Me Admift ttrtn�. A1uduw,•,. .. h..o - -- ._ -. 4 i�ltta►ont t0 Vfil eppllrrtioe►•
- - • — .ar..r� qt ata 1IRw when vv®rft e1ni1 ba aMrieO.
Ca[neMr KnM all eoo+ksae GtY tzrdl+teftm, the tam Ano +lalle at Stir o+re,►R the ali K>Qiieabie rylp &W ngpvGfiyoAt 01 the Gtir Of
La Oulnte and to p" for snr wdh$WW ^ Cor uBltSha result 41 tnA wvrt.
Verno of Applicant (please print)
name of Contractor and
'Ontracwes Licence
BusirWku Addreta
Cirri $Mines Licerw No.
�pplicene'e Insurance Comoany
pollcy Numiaer
Extended Page 2.1
'@ESS au0aiv�sion tmprovttnot Permit — Class ill
Public improvenunta: 3% ®f ett:mat®d construction colts
ws PfiV4te irnproverruditt: 3% of estlaUt.6d ovnl1ruct,on costs _--.
MIn4r Improvernent Petmit -- Clau IV: S®® BMChed tChadule
"Imiton Foe ffi
�n PERMIT VAIIOATION
armit F"
Mehr . P%PIMiY NB.
ash Ospotit•Surety a PATE APPRuirE®
required
TOTAL. s EMRATION GATE
DATIR Ir46►ED
;;*'pt NQ• ....r....irw.rro.®o.
;.lived by�...�.d�,�... �o Dets-- sYa 4
,;oed
AdMINI nave Authority
by
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