2071NATE:
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: 2/18/94
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE F.nuiet Ant
DESCRIPTION OF CONSTRUCTION rat. PR500 Grinder
68.000 lba, 101W_ A11 faap T.egal
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit— Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
Haul Route; On Washington from
Ave.48 to Ave.50, East on Ave.50
to Jefferson St. South on Jefferson
to Ave.54. East on Ave.54 to Madison,
South to Ave.58, West to Jefferson St,.
South to Cahuilla Park Way.
Haul Date: 2/21/94
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)
V*`
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
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 III
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: $ 10.00
Receipt No.
Received by Date
Recorded by
2071
PERMIT VALIDATION
PERMIT NO. 2071
DATE APPROVED 2/18/94
EXPIRATION DATE 2/21/94
DATEJSSCIED 2/18/94
By 4) od6dp
Administrative Authority
TELEPHONE: (619) 564-2246
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FEB -13-94 FRI 3;37 AM P. 1
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TO: - ..., -DATE :
C09�PANY NAME:
FAX NO:
FROM :PAXED BY: s j,
PAGE 1 OF
IF `YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (619) 342-7504, PLEASE
CONTACT SENDER AT (619) 775 -SM.
fttm Sixito branch
P.O. "N9011
w1m pwrt CA 1
v,"m 619/bumsoo
FAX 610/360,570
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hiss leawilian Improvement Permit — Ciaae III
RuO+te tmpror•rn•nta: 3% at •stimaxed canstruction coke
Pr1v4U imProvermones 3% •4 estirmUd cvnilrLC110A Caro
Minor Imprevmsnt Permit — Chea IV: Se41Ott OWd lChadula
'Aftnan Fee
s m+i f"
'A 0e136111•Surety Bond
required
TOTAL; S
slot No. ,
�EdrO by Date
Extended Page 4 2.1
PERMIT VALIDATION
PIAMIT N0.
DATE APPRVVED
EXPIRATION DATE
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APPLICATION FOR
PERMIT
PUBLIC WORKS CONSTRUCTION (HNCROACNMHNT)
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2071
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VALI.—N
PBgMIT NO. '
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TOTAL: 0- D.00
HXPIgATION OATB
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THLBPHONS; 1@101504.224@
TRANSMISSION REPORT
THIS DOCUMENT
WAS SENT
*** SEND ***
COUNT
2
(REDUCED SAMPLE ABOVE)
NO
REMOTE STATION I.D.
START TIME
DURATION
#PAGES
COMMENT
1
2-18-94 4:15PM
1'36"
2
TOTAL 0:01'36" 2
XEROX TELECOPIER 7020.
NOTE:
Wilfh 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. 2/18/94
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
PURPOSE OF CONSTRUCTION Move F. iiinment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Cat_ PR900 Grinder
68,000 lbs. 10'W, All F.1Gp T.pgal
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Haul Route: On Washington from
Ave.48 to Ave.50, East on Ave.50
to Jefferson St. South on Jefferson
to Ave.54. East on Ave.54 to Madison,
South to Ave.58, West to Jefferson St..
South to Cahuilla Park Way.
Haul Date: 2/21/94
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
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 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
10.00
$ 10.00
Date
2®71
PERMIT VALIDATION
PERMIT NO. 2071
DATE APPROVED 2/18/94
EXPIRATION DATE 2/21/94
DATE A ED 2/18/94
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
� . (."), f-, 4'