2176NOTE.:
With proper validation
this 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
5-18-94
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Class I II
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 D 8 L Dozer with blade
15% 1416' W. Purple weight apron. 150,000.
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
ROUTE:
WASHINGTON STREET, HWY. 111
NORTH TO CITY LIMITS.
TWO PILOT CARS REQUIRED
HAUL DATE: 5-18-94 at NOON
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 agerts, 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 on File
Signature of Applicant or Agent
Granite Construction 38-155 Monroe St. 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
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.
10.
10.
Received by Date
2176
PERMIT VALIDATION
PERMIT NO. 2176
DATE APPROVED 5-18-94
EXPIRATION DATE 5-18-94
DATE ISSUED. 5A18-94
Recorded by 11 TELEPHONE: (619) 564-2246
Administrative Authoritg—
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
Subdivision Improvement Permit — Class I II
DATE: 5-18-94 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment
DESCRIPTION OF CONSTRUCTION D 8 L Dozer with blade
15'H, 14'6" W. Purple weight aprox. 150,000.
DIMENSION OF INSTALLATION OR REMOVAL
Sketch (attach construction plans if appropriate)
ROUTE:
WASHINGTON STREET, HWY. 111
NORTH TO CITY LIMITS.
TWO PILOT CARS REQUIRED
SIZE OF EXCAVATION, IF NEEDED HAUL DATE: 5-18-94 at NOON
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 on File
Signature of Applicant or Agent
Granite Construction 38-155 Monroe St. 775-8327
Name of Applicant (please print) Business Address Telephone No.
SAME
Name of Contractor and Job Foreman Business Address Telephone No.
on f ile
Contractor's License No.
on f ile
on file
City Business License No.
on f ile
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.
10.
$ 10.
Received by Date
PERMIT NO.
2176
PERMIT VALIDATION
2176
DATE APPROVED 5-18-94
EXPIRATION DATE
5-18-94
DATE IS UED 548-94
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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Nbllc Improvemenn: 3% of estimatki consttU ton COW
Privcu improvea meat 3% of trunsuad awritt?uction gain
Mtnor Irnerovemtnt Permit —Claw IV.*. Sae stU ttwd 6chmdWI9
110401ett Kos $
,rma{ Fos 10
Ail"
,N Deposit -Surety Bond
•egvitairy .
TOTAL: = t v
pt No.
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Extended_ Page 2. 1
PERMIT VALIDATION
rA11MIT N0. 7�
DATE APPROVED S (�
EXPIRATION PATI:
OAT[ ISSUSO
$y
AQR iNstnuvs AUthorit
NOTe,
Whh proper 1111datlon
thle brt. mnteltu[es •n CITY OF LA QUINTA
f04d[TfM p.rTit
APPLtCATeON POR PCRMIT
PUBLIC WORKS CONSTRUCTION (e NCROACNMCNT)
Parthe nstruatlon of Publle ar privet• urba, dNVowoYs. po Vomonts, sId—lks, Wrking lot•, m11na
ossd other Ilk. publla worlas Improvemonto in oonneeeton whh MINOR IM►ROV6MENTS and APPROVED BU601V.610.6
Bubd.VJ.I n Improvement Permit — Cloa1 111
DATA: 9-18-94 Minor Improvement Pormlt Cl... IV
LOCAT)ON OF CON6T RUCTION
(gsrwa e.e•era a,r •erlpelen es —1—
PURPOSE OF CONSTRUCTION NOv. Equipto.n! Skatah 4—ah co—ruatlon piens It opproprlete)
OEO�PI►Tll 0 C16rtP V OLLinU oT larOil/t C .oteez. 1 >IOVTEr WA68ZN6TOH BTRHET. Hwy. 111
11 SS as 4 1 N01TH TO CZTY LZDIZTB.
DIMENSION OF INSTALLATION OR AEMOVAL
TWO PZLOT OARS E.SQDI718D
OIZC OF EXCAVATION• IF NEROE0 HADL DAMN. 9-18-94 .t NOON
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATa I.M. Op COMPL•TION
E•TIMATEC CON•TRUCTION COOT B
(IneludMg r moV11 of 111 abotru"Ion, motarlols, ono dobrlo, I—ktll ling, cam-
1•eot[On erlee PlOolnB perrneMnt r"weeeing end/Or re pllaing Improvem•ntal
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ti•,nnity.•dstend • ah• f.lty, It• evfhe.l•ad • ONlwn, reP—p'—..a. n ntl eyln•t
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8iue.t:atr. n >lil.
6lgnotuI of APplltllnt or Agent
Dz.nitp con■cruccieo 99-199 nerve. 9e. 779-8327
Nemo at Appel— (PI"ro print) •usln"e Add— T01ephOne Na.
Norco O/ Centroa[er end lob Feromon Duoirsess A —.! Tolophono No.
eta til. � ea 1110
Oentroatpr'e Lleenee Ne- C.w Eue1MN Llbonso Ne.
a 111. On 111.
AFplitvrn'e IMurinu CorrspinY Pellpy Number
POHO_ SuhcIM.lon Imtsrevemon! Wrrn It —Clots 111
Publle Imp'o—r•ients: 31I of "tlmetetl o atlen Qaete
Prl Vlto Impro Vlmlr•S•I SK .f "<Imetad mn truptlpn a 2176-
s
Miner Improvement P-11 — Cle • IV: Soo eRoehod oohodulo 2 1 76 •
Inetsatbn Pee 8 ►ERMIT VAl1OAT10N
Pormlt Foe 10 • PERMIT NO. 2176
Penolty OATS APPROVEO
C"h Oopeslt-S—W Bend
It roel...dEXPIRATION OAT! 'a -16-9A
TOTAL: • 1O• OATGI�U O 3 •-94
R1aelpt
Repolvod bV Doto BY�� ` Ad men lstrotlye AushorlsY
Roeerdod by TELE►NONS: (6 1 91 6 04-2146
TRANSMISSION REPORT
THIS DOCUMENT (REDUCED SAMPLE ABOVE)
WAS SENT
*** SEND ***
COUNT
1
NO
REMOTE STATION I.D.
START TIME
DURATION
#PAGES
COMMENT
1
5-18-94 11:06AM
1'04"
1
TOTAL 0:01'04" 1
XEROX TELECOPIER 7020
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NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
<`cF�oFTRB��`S��
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 II I
DATE: 5-18-94 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 D 8 L Dozer with blade ROUTE:
15'H, 14'6" W. Purple weight aprox. 150,000. WASHINGTON STREET, HWY. 111
NORTH TO CITY LIMITS.
DIMENSION OF INSTALLATION OR REMOVAL
TWO PILOT CARS REQUIRED
SIZE OF EXCAVATION, IF NEEDED HAUL DATE: 5-18-94 at NOON
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 (241 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 on File
Signature of Applicant or Agent
% Granite Construction 38-155 Monroe St. 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
i
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule 2176
Inspection Fee $ PERMIT VALIDATION
Permit Fee -10.2176
PERMIT N0.
Penalty 5-18-94
Cash Deposit -Surety Bond DATE APPROVED
if required EXPIRATION DATE 5-18-94
TOTAL: $ 10• 5— 8-94
DATE IS UED
Receipt No.
By
Received by Date yll Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
t