2061NOTE:
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
DATE:2/10/94
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Paver and Pick Up
Machine, 1116" W 90,000 lbs
.All Else Legal Haul Route: West on Ave 48 at
DIMENSION OF INSTALLATION OR REMOVAL AdmnsSt. to Washington St., West
on Eisenhower to Avenida Montezuma.
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Haul DAte: 2/10/94
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 38-155 Monroe St. Indio 775-8327
Name of Applicant (please print) Business Address Telephone No.
Same
Name of Contractor and Job Foreman Business Address Telephone No.
On File 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
t Minor Improvement Permit — Class IV: See attached schedule
r'
Inspection Fee $ 10.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ 10.00
Received by Date
2061
PERMIT VALIDATION
PERMIT NO. 2061
DATE APPROVED 2/10/94
EXPIRATION DATE 2/10/94
DATE ISS ED 2/10/9,4
By
Administrative Authority
Recorded by II TELEPHONE: (619) 564-2246
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r F'JF-10-94 THU 12:08 AM
NOTE:
With proew validation
04 form 40"Mltuta an
envosofttrterit aatmrt
CITY OF LA DUINTA
APPLICATION FOR PERMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P. 2
Fat the Millittuation of plt4lls or privets gybe. drlvrwtys. pavements. sldowalks. parkin lots. s#v j. wauw tossing
std Other Ilk# Owbiia works inromvermnu in connection witrt MINOR IMPROVEMENTS and APPROV&D SUBDIVISIONS
�r
�p Subdivision Imorovsrmnt Permit — Clan III
Minor improvement Perttlit Clan IV �^
LOCATION OF CONSTRUCTION
hussar adddnas N oownpuon st foortrenl
PURPOSE OP CONSTRUCTION
F. CONST
DIMENSION OF INSTALLATIAN 09 REMOVAL
Sketch�tettadt oonauv=son plans It apprWietal
G J
$126 OF EXCAVATION. If kEEDEO
ROXIMATlr-Tima WHEN WORK WILL OEGIN
APPROXIMATE TIMI OF COMPLETION
ESTIMATED CONSTRUCTION COST i�_�_�„�^�
(Including rt"Mal of ail aaetrvAtron, motariala, en0 doorii, backtlllim ppttt~ 9 /j
"=or, and placing Petmertent r~rwtadng arld/or replaung improvitmenulpe
Ifs CM6,144flUa t of the granting of 01111, permit, the appliurit hereby 19rus to:
IhOSIMOV, defend am gave me Olt,, its eutnonir{t agents, of/►eers, reae�eeAtauwe eta erMIGVM, hanntew Ironi s� eta�et &” u1"d e11
0411031114,liabilities w IM+e>tlltir+e ftatn aeu"o a loon Irnwn W*etW" out of env e0C46m. too at dumps to ft"o to at mv
Napeftine or ooaurmne a a granum a rrn of any wan und.rvson anger the aarnrs pronted ownuaht to Olt$ spolMteuadt.
NOUN the Adminmrstra Aumonty as Nast evnntv�+eyr 1241 hors rn 40 m ma or the tum# Vohs" woftt well be lunm
Canraty ants gut e=cs w Gtr Ortlu%was. th, un"e aro ponslitions of the W""R and all 401iaeols Fula and ry WWtJtM of ate City at
4 00In1111 and to Dov for my eddltb" RoLacemem nednwy sus ins rtrlMlt 01 tare "sort.
Aust# at ApplicAnt (ploass print)
Veme of Contractor andJob Foramen
Ahtlil=rls L.,canso No.
%pplicanCs Insutanol C
SIpRi-We at Applicant at
X6.4
BkWneu Address
Telephone Na
Businau Addron T is OM No.
City No. _
Policy Number
I
r
f
'EEK Suoliviman rmprovomsM Pa mit r. Ciau III
Pubile improvernena: 3% of 41timatld cchatrustion coats
PrlV410 improvermlilat 3% Of estimated conttrvatlon cosy
Mlner Improvement Permit — CIM IV; Sas attachad schedule
�jPsCtloA lyse _
ermr; Fit
iMlfy
uh Depel+t•Surety Sono
required
TOTAL: s
vist No.
:-,!Y44 by.. Qat
..bed by
Extended Page _ 2.1
Yr�
PERMIT VALIDATION
DATE APPROVED
EXPIRATION OATS
DATE ISSUND
By
Adminlatraws Authority
TELEDl. )MC,.latn- vo-,
B;10-94 THU 12:00 AM P. 1.
���rnon
can�n�
TO :� •DATE o
COMPANY NA*iE t A
A FAX N0: zxol�ll
FROM: FAXED EY:*
PAGE ]. OF
r
IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE .(619) 342-7504, PLEASE
CONTACT SENDER AT (519) 775—.
$3L7,
ez
77-5---
0
11
aim 8arim Branch
P.O. Box 9D11
itim DGUM CA 9M5-9011
Phone 619/360AW
SAX 619/3604570
I NOTE:
v
p�
M o
O C
LA QUINTA e
encroachment permit
APPLICATION
ti
FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)c^
C�yOF
3
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
OQ
N
Subdivision Improvement Permit - Class I II
DATE:2/10/94
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
a_
PURPOSE OF CONSTRUCTION Move Equipment
Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Paver and Pick Up
Machine, 11'6" W 90,000 lbs
All Else Legal
Haul Route: West on Ave 48 at
DIMENSION OF INSTALLATION OR REMOVAL
Adams -St. to Washington St., West
I
I
SIZE OF EXCAVATION, IF NEEDED
�
It
M
y
X
vn
s o
TI
4h
0 (�
3 0
11
I NOTE:
With proper validation
this form constitutes an CITY OF
1
LA QUINTA e
encroachment permit
APPLICATION
ti
FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)c^
C�yOF
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:2/10/94
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment
Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Paver and Pick Up
Machine, 11'6" W 90,000 lbs
All Else Legal
Haul Route: West on Ave 48 at
DIMENSION OF INSTALLATION OR REMOVAL
Adams -St. to Washington St., West
on Eisenhower to Avenida Montezuma.
SIZE OF EXCAVATION, IF NEEDED
Haul DAte: 2/10/94
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 38-155 Monroe St. Indio 775-8327
Name of Applicant (please print) Business Address Telephone No.
Same
Name of Contractor and Job Foreman Business Address Telephone No.
On File 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 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.
Received by
Recorded by
$ 10.00
$ 10.00
Date
2061
PERMIT VALIDATION
PERMIT NO. 2061
DATE APPROVED 2/10/94
EXPIRATION DATE 2/10/94
DATE ISS y ED 2 10
By
Administrative Authority
TELEPHONE: (619) 564.2246