2104�t
NOTE:
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:_ 3/17/94
LOCATION OF CONSTRUCTION
.r
Subdivision Improvement Permit— Class III
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 35 Tons Grove CrAne ( Haul Route: On Washington St
15'H. 111W, 80'L. Bonus Weight 172,950 lba from Hwy 111 to northern City Limits
DIMENSION OF INSTALLATION OR REMOVAL
Haul Date & Time: 3/18/94 1:90AM
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 38-155 Monroe alreeet, Indio 775-8327
Name of Applicant (please print) Business Address Telephone No.
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.
200.00
$ 200.00
Received by Date
20
PERMIT VALID,
PERMIT NO. 2104
DATE APPROVED 3/17/94
EXPIRATION DATE 3/18$94
DATE ISS ED If, P17/94
ey
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
A
MA -17a94 THU 9:12 PM
nrorE:
With pr9Pfrr validation
this form oonstaytaa an
onaroaehmant fsuntrt
CI1Y OF LA QUINTA
APPLICATION f4R PERMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P. 2
For the =n1vu4%ion of public or private sura, drivtmys. Isavemenn, sidewalks, parking IOU, WAV", wauw maln6
and other ills* pyptid works imptavenunts In connemon wilt MINOR IMPROVEMENTS and APpROVEO SJ13ptV1810N6
GATE: 7`'' Subdivision Imprdwnant permit , C4ss 1!1
Minor (mprovamoht permit Ciw IV
LOCATION OF CONSTRUCTION
ISWn itlOftrM M depamPuon et Lazu"l r
PURPOSI OR CONSTRUCTION
li DE fIPTjON O STA �O
''
17
DIM ION OF INSTALLATION OR REMOVAL,
SIZE OF EXCAVATION, IF NEEDED
��+(attach corutrUalon pjaru it appropriaal
AmPtOX11AATE TIME WHEN WORK WILL. BEGIN
A"NOXIMATE TIME OF COMPLETION`
ESTIMATED CONSTRUCTION COST 8
(including (*"WWII of all oaguu won, MStlwial6, and debris, backfiilirig, cater
plKOdrl 44 Outing permanent resurfacing andbr replatdng tnlprovymenuj
Io 1e"0entidn at the "Runs of khls pleMit, the app(imat hertby jgffftJ to:
Ibili meetr, dstrw are levo me Cltye its fumemos Rpm, onkm, roftlpetsum sna actlplpvew hamlaat 06M Mti "am Arm afw all
MnererM, riapilitias M 144 rMltirq frwn rJartrt, qr io�rn 6Uwe ane %Aura owt of Inv s c4ant, loan of Oarm" 16 atM&W WptooaMv
M
heppM,A� Of *murr" a flra;ntata ftwn of `try :MPR unowmaA wow tree fruit Innive purta"m to MIS appUm%"
f44Klfr 1116 AtsMA0111trM Ausltonry a! Mm n o"tY-rOHr 1241 hftn N a&tlarror M trig ulna whsrr wpsk MAI b6 gmea ,
Caaav w+tn all 6trwres to City ISrdLt►6natr, thv e6 me aro consitron6 at the P+ttnrt ue ul Ai plksms twin ants rsQuls wa of dte Coq or
4 Ctrltin and to fia11 fa 6nM additJonel nprar�6rnm er.n� M "Wit of erre vera.
Witte of
4aftta of
:ontrscuies
and Sod f orarnan
8usimu Addrau
C.itY IlUsinea! Limnm Na.
,pplicant's Insuranm Camoany - Pa(ICY Number
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Extended Page 2.1
EEat: Suaa�ws�on imoraven+ont Pun+it � Cbss i 11 ,
Public irnOrot+oments: 3% of estimated construction Costs
Privau irnprovsm lia: a% of egumew oonsuvalan costs
Minor Imorovamant Permit — Cism IV! SIN stteehad teheduie
Upeetion Ree _
irmil fes
Uh Deposit -Surety BON
required
TOTAL: t
�'pit No.
Date
0
PIRMIT VALIDATION
PEAMIT N0,
DATE APPRuVEo
EXPIRATION DATE
DATE INWID
IV
AdmiMsc vile Authority
TELMnw ia, IRfn.
AAR
-17-94 THU 9:11 PM P. 1
GRRnrnE
consmucTion
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TO: -DATE: ;;a
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/17
FROM: FAXED EX:
PAGE 1 OF
IF YOU EXPERIENCE ANY DIFFICULTIES FROM FACSIMILE (619) 342-75040' PLEASE
CONTACT SENDER AT (619) 775—P
77.s
✓/crs�
Palm SwiniD Stanch
R.O. abx 0011
a!m DeWrL G► 09f6W11
DnoW 619/360.4500
FAX 619 /36x4970
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NOTE:4 '
'With proper validation
'this form constitutes an
encroachment permit 'CITY OF LA QUINTA
APPLrCATrON FOR PERMIT
PUSLIC WORKS CONSTRUCTION (ENCROACHMENT)
w—
For the oonstructlon of public or private ourba, driveways, pavements, eidewelka, parking loge, eewere, water
and other Ilke public works Improvements in connect Son with .MINOR IMPROVEMENTS and APPROVED SUBDIVISmain•
IONS
DATE:- 3/17/94
LOCATION OF CONSTRUCTION
SubtllVl.Ion improvement Permit - Claaa 111
Minor Improvement Permit Class IV
(Street addroas or OOaoriPtlon of Loeetlen)
PURPOSE OF CONSTRUCTION
Sketch (attach Construction plane if appropriate)
DESCRIPTION OF CONSTRUCTION
25tH_ Iitw_ A 8otz --- w aitc 7 as0 iba Hau'Z Route.: On Wamhia8tota $t
t. Rrom Hw3r 111 to ttorthesrn City Limits
DIMENSION OF INSTALLATION OR REMOVAL
Haul Data. 6 Timet 3/18/94 3t30AM
-'-- — . I `� - Ir' NEEDED
APPROXIMATE TIME WHEN WORK WILL BEOIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST*
(Including removal of all obstruction, materials, and debris, bookfillln g, Com-
PactiOn and Placing Parmwnant rasurfoeing end/or rap lacing Irnprovemen taI
In conslderatlon of the granting of this Permit- the appllGant hereby agree• to:
IndsmnlfY,.defend cod Gave :h• City, It.
P111..,suthorlaad '
Pltl.., Ilwbllltla. o
loss r sultlno from .alma or oQento, oiHoetO, repra.en"xllve* and emPloVaee, hermleas from and aewln.t any and if
haPpahine or Occurring a. a Proximate result Of enV nt.
work unde Rak n under the Permit tn
mlt ate loss or drt
emaea to Peraons Or propey
N etlly
the Adminlstrative Auth erltY •t hest twsntY-four th
(24) hour. In adya noo of the ti me whenwekrou.nwll lO 6 rlfifr�q of why is vDplI wtlon.
Comply with ell applicable City Ordinances, the terms and ocndltlons of the Permit and all aPPllcable rules end repuleti0 n• of the CITV of
a,a Quints end to Pay for env additional reoleaoment nece..ary os rho result of thio work'.
Slonature of Applicant or Agent
Name of Applicant (pleeee print) -
27
Buslnvse Adtlreae Telephone No.
Name of Contractor end Job Foreman
Business Address
Ort Telephone No.
Ft 1a
Coneraotor's Lioanae No. �Fi2•
Oa Filesus
City lriess Llcenae No.
Appllcant's Insurance Company Ora F11a
Policy Number
PEES: Subtillwalon jr, provoment Per it Class 111
Public Improvements: 396 of estimated construction oosts L.rti O
Private Improvements: 396 of eetirnateo Construction Costa
PD
D
Minor Improvement Permit - Claaa IV: Sea attached •chsdu la
Inspection Fee rs 21 Q MAR 1 7 1994
Permit Fee_ PERMIT Y81 -IR [ON
2oe_o
Penalty PERMIT NO, 2104
Cash Deposit -Surety Bond OATEAPPROVED _ 9/r 7/oL
If required1i
-
TRANSMISSION REPORT
THIS DOCUMENT (REDUCED SAMPLE ABOVE)
WAS SENT
** COUNT
# 1
*** SEND ***
NO
REMOTE STATION I.D.
START TIME
DURATION
#PAGES
COMMENT
1
3-17-94 2:48PM
1'07"
1
TOTAL 0:01'07" 1
XEROX TELECOPIER 7020