2041NOT
With'proper validation
tl 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: January 19, 1994
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit— Class III
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Equipment Move Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 14 G Motorarader Haul RBute: North on Washington Street
9' 10" w , 15' 4" h, 43.000 lbs from Highway 111 to City Ldlmits.�-
Haul before sunrise
DIMENSION OF INSTALLATION OR REMOVAL
Haul Date: 1/20/94
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)
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 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.
LI �A A f �NG Q . ) .0 ,�,,
Signature of Applicant or Agent
Granite Construction Company 38-155 Monroe, Indio 774-8327
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
On FiIP
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 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.
Received by
10.00
$ 10.00
Date
PERMIT NO.
2041
PERMIT VALIDATION
2041
DATE APPROVED 1/19/94
EXPIRATION DATE 1/20/94 x
DATE ISSUED 11/19/94
By— �&�
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
A
s
NOT1 t
With PrOptf validation
thta form eonctttutea An
en9744aAftlern oarR1K
For the eonRrurtion of 00116 Or Wtvate Curbs, drivtt-aevt. 04vementi, tidowalka,
and Water m%s1rW
other Ilt;e "bllo works irnprQvtn*nb in cannamon watt MINOR IMPROVEMENTS andpack APPROVED SUrog S DVI$ ONS
GRANITE CONSTR. CO. 6199220159 P.02
CITY OF LA QUINTA
APPLICATION FOR PERMIT
,PUBLIC WORKS CON-TRUCTION (ENCROACHMENT)
DATE: 4�z Subdivision ImProrement Persia — Cies 111
CQNSTRUCTIO
LOCATION OFf+i
Minor Improvement Parntrt CI4u IV
.
tsu-art aawnre aw OaKs,ot�on oe iropttsrtl .�
PURPOSE OF CONSTRUCTION
DESCR P,•ION OK CON R
DIMENSION OF INSTALLATION OR REMOVAL
$126 OF EXCAVATION, IF NI:E0E0
APPROXIMATE TIME WHEN WORK WILL BEGIN
PROXIMATE TIME OF COMPLETION
' ESTIMATED CONSTRUCTION COST S
Ilrttfuding removal of all o"trutjlon, materials, artQ slebrls,
oesvon and platin badtfillirp, oottt-
4 Permanent raturfedne and/or replacing Improve,, t
"�9�,�lett�clt consuvctlon ytana It app,r�;a
CWalaeritlon of the (renting of ahla perrftlt, the appticant hereby &it"$ to;
'hom M1.N. defww am aft ime City, tt, ayahonrad bo"u, otfkWil, re P Mr,tatrna AM am al
Oerlaltle/, l�abtlitiai Or too ftwilins frsm t *Wm V "WR a batt V4 arlaur» owl of any Wjd4Rt,•le of 4 /tam ane ffla ft atry ane NI
a 000 Mfg M a Arsatrr�ta Town of Inv t' 11 ur+dersataan unaw tie patrfttt rfntw � to tMswM a Prooer<t►
Natry Na ^run,nNtratrv� Aub►ph to firrwant to inn etaofl�ttp►,
h et /.rat rr, mtv•feyr 1241 hewn 'A aoKwa of the lle* *haft V'vok yell ba rwe"I r
Camas► *►tft all ao4'%tcQb96 Cwty Ordln&r4 t. the tot"" brig eondittana of tfla permn grid all
W the
W 04/111111 and m pay for any ealdOtlohel nocac�rr*m nom, Wptrta,ble Nilsaril r utatrOfta el lite C1N of
re�autt tar ma .+ort.
./
"amt of APpitaant (p1jaa print)
s -,i - - -�
Marne of Contractor and ,I b Forernaft
:anuactort /.tuna No.
S7pratWtt of ApgliCan Apt At g -a
Business Aditeaa Talaphorte Na
Business Addroaa Talepftontl No,
CitY Sullineu Lima No.
.I
kPPtiCOnt's inguranca Company t�7t
Policy Number
TO
a GRANITE CONSTR. CO. 6199220159_ P.01
CO-MPANY NAME:
FAX NO:
FROM:
L m FAXED BY:
m-1 r
PAGE 1 OF ,
IF YOU EXPERIENCE ANY'®IFFICULTIES FROM FACSIMILE (619) 342-7504, PLEASE
CONTACT SENDER AT (619) 775-8302.
77S
n
0
Palm Sprin3s Stench
P.O. Box 9011
Palm Desert, C11 PMS -9011
Phone 619/3604500
FAX 619/360-4S70
NOTE:
With proper vellcletlon
this form constitutes an
.,,roach mens permit CITY OF LA QUINTA
APPLICATION FOR !PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) 9III1"'e
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water melns
and other like public works Improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: January 19, 1994
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Cie.. 111
Minor Improvement Permit Class IV
(Street oder... or 0 ... riptlon et Leaatlon)
REMOTE STATION I.D.
START TIME
DURATION
PURPOSE OF CONSTRUCTION Eo uii}mont Move
Sketch (attach construction plena If appropriate)
DESCRIPTION OF CONSTRUCTION
6199220159
Routes
North on W^0t%:L agton Street
9 • 1D•• to _ 1 S • 4'• b _ 4� _ 000 t bei
rrom
731S1'away
111 to City Limits _
DIMENSION OF INSTALLATION OR REMOVAL
Hats1
be£osrs
atanrlaa
Uatti
Deltas
1/20/94
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
' ESTIMATED CONSTRUCTION COST S
(Including removal of all obstruction, materials, and debris, backfilling, com-
pactlon and placing permanent resurfacing end/or replecing Improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify,.defend and save the City. Its .uthorlaed agents, officer., repressntetives and employees, harmless from and ag.inut env and ail
Penalties. Ilebll blas or leu rasul<in. from Clelms o o0urt .Otis, end arising out of env vas ia.m. los. .or damage to Persons or preperty
h.ppening er aurrino os a proximate result of any work undertaken under the permit granted pursuant to this applleatlon-
Notify the Aeiminlstrative Authority at least twenty-four (24) hour• In advance of the time when work will be .tert.d.
Comply with all applicable City Ordinances, the terms and condition* of the permit and all amolleabla rules and reguletlons of the City of
Ls Quints end to pay for any eddltional replaoen unt nese Hary as the result of this work.
L,t-;ci, ra rr.c-
't�i,.,,
Signature of Applicent or Agent
Granite Cottatruation Company 38-155 Xci=a. Indio 775-8327
Name of Applicant (please print) Business Address Talaphone No.
Name of Contractor and Job Foremen Bueiness Addrese Telephone No.
grq .1
Contractor's License No. City Business License No.
Ott Sile On Bila
Applicant's Insurance Company Policy Number
PEEN: Bubdlvlslon Improvement Permit — Clens 111
Publ to Improvements: 396 of astirriated construction Posts '
Private Improvements: 3% of estimated construotlon costs
Minor Improvement P.rmit — Cie.. IV: Sea attached schedule 2041
Inspection Fee ffi PERMIT VALIDATION
Permit Fee 10.00 PERMIT NO. 2041
Penalty
Cash D.poslt-Surety Bond OATS APPROVED 1/19/94
TRANSMISSION.REPORT
THIS DOCUMENT (REDUCED SAMPLE ABOVE)
WAS SENT
COUNT
�# 1
*** SEND ***
NO
REMOTE STATION I.D.
START TIME
DURATION
#PAGES
COMMENT
1
6199220159
1-19-94 4:24PM
1'11"
1
TOTAL 0:01 ' 11 " 1
XEROX TELECOPIER 7020