2050NOTE:
A'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
I97_r99
1/31/94
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIPMENT.
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 35 Ton Crane Washington & Miles
90,000 Lbs, 11` Wide East on Miles to Jefferson
5 Axle Semi Unit
DIMENSION OF INSTALLATION OR REMOVAL
Return on 2/1/94
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.
Signature of Applicant or Agent
GRANITE CONSTRUCTION 775-8327
Name of Applicant (please print) Business Address Telephone No.
On File On File
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 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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
20.00
$ 20.00
Received by Date
PERMIT NO
2050
PERMIT VALIDATION A
2050
DATE APPROVED 1/31/94
EXPIRATION DATE 2/1/94
DATE IS UED 1/31y/94
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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7:43 GRANITE CONSTRUCTION C o P.02
CITY OF LA QUINTA
APPLICATION POA PERMIT
,PUBLIC WORKS CONSTRUCTION MNCROACHMENTj
Fot the oen'VuCtiOn of Pubiic Or Prnrata Curti, drivtWSYS. Pavement/, Ildowelka, p4mlrq lou, sewtan, wotar f 4lns
and other litre nublia works improwanU Its ton Scuon with MINOR IMPROVEMENTS and APPROVED SU801VISIONS
I c Subdivision Improystoont l�artnit 4aCLon III ....�.,�.;...r....
DATE.— `-----ter--� Minor Improvement Pernlit CI
LOCATION OF CONSTRUCTION
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PURPOSE OF CONSTRUCTION -- c�t�.t`"P(�a.� Skolch tot=h wnsuvczlon plans if a
Ofxop+iaul
QE5CtO k... - ON FILi�'ION
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DIMENSION OF INSTALLATION OR REMOVAL
$129 OF EXCAVATION, IF NEEDED
A"FIOXIMATE TIME ftEN WORK WILL BEGIN
A"ROXIMATE TIME OF COMPLETION � (
EVIMATEC ys-)-
r- CONSTRUCTION COST t t1�—
iindudinp heal of all
Obrirta�'bore, metNials, and debris, bigtNllinq. portr
"M4n V4 plsdna permanent rtswtadnii and/or rgptau1)9 improvemMUl
In Ctlns'0er=tion of the Qrantiny of this permit, the ePpittAnt hereby $Wks too
Ian+h, dsfano oro Save V4 City, (tt vumomloo sorts/, ottkors, rtp"roww" Im ear+P19yM. ha"Im from bft 00141 bm and ail
f #t1N, Isabriitiq a " rtwetke4 friprn rao,rry pr CaUn WWI awntl �rlune Out of any soc�aaIn. tow or t6 pa�ont
*Mft�eAuy M tJa�LMne M i'rase"M M" of arnr Y*00 urdWMbon 1040? 1t+o PVMIV pnhted Dynuant io ��1,apoew,t�, � ArooKrtY
N�ify thS Atlmrer."Mtrw Au~tV m kma pA"Ry4oyt (${j hdan !a eQYWVO ad tfea tln+e thfeM WWW Will
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C4 wy trrth all svwwby CGty O►denanm- trrr farms arq C4n011*0 of the wma ahs allai►pliCadit lylp ar><i rtigyk�y of tf 1 Wtv of
to quint# and to par for wN wdltlom npto 4m n�asu
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TO: -DATE:
COMPANY NAME : -&,,, FAX NO:
FROM:— �/�lllZf FAXED BY:
PAGE' i OF ie
IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (619) 342-75041 PLEASE
CONTACT SENDER AT (619) 775—SM.
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t7,50
Palm Springs Branch
P.O. Box 9011
Palm Desert, U WZS-9011
Phone 619/36WS00
FAX 619/360-4570
- .._..ie
78-498 GALLR TAMPICO — LA 41(JINTA. CALIFORNIA 92257 - (B'1:) 777-7000
cF _ FAX (619) 777-7101
- r
FAX NUMBER: (619) 777-7101
TOTAL NUMBER OF PACgES:
(Including cover sheat)
DATE SENT':
TIME SENT:
.I.wwwwwwwwwwww.rw.nwa.a.e.+.ar.w.rr.aww.wwww.rww.frwwwwwwwrwwwwwwwwwwww.n r.►.►w w. r.wwwwrw.aww�.rwwww
ADDITIONAL COMMENTS:
MAILING ADDRESS - P.O. BOX 1604 - LA OUIN-rA. CALIFORNIA 92253
TRANSMISSION REPORT
THIS DOCUMENT (REDUCED SAMPLE ABOVE)
`WAS SENT
** COUNT
# 2
*** SEND ***
NO
REMOTE STATION I.D.
START TIME
DURATION
#PAGES
COMMENT
1
6193427504
1-31-94 10:10AM
1'41"
2
TOTAL 0 01'41" 2
XEROX TELECOPIER 7020