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2217I ,WTE 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: 7-12-94 LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Move Equipment Subdivision Improvement Permit — Class I II Minor Improvement Permit Class IV DESCRIPTION OF CONSTRUCTION Paver With Pick up machine DIMENSION OF INSTALLATION OR REMOVAL11t6s' bide .90,0001bs all else legal Sketch (attach construction plans if appropriate) Haul Route: 58th, Madison, 54th Jefferson, Ave 52, Sinaloa Eisenhower, , Montezuma SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Haul Date: 7-13-94 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. / . te4 M D)4 A(, �" Signature of Applicant or Agent Granite Construction 38-155 Monroa St. Indio, CA 775-8327 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business License No. 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 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 2217 PERMIT VALIDATION PERMIT NO. 2217 DATE APPROVED 7-12-94 EXPIRATION DATE 7-13-94 DATE SU —12-94 gy Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 11 r. aso= IJOr17nJUUM pruwlue A%C:miivw&AoJdwt 1n1AIJd .. 1%100 ptltw}l$t 10 %C tauw,oAoAwl 0114nd Iti ttelO "" 31wJtd>IVIIW�OJdWI YOItIAIOvN� s11�}: JogwnN Nlpd Autdwoo owfintul I'JU !IOd1 •oN >nuu�1 axnf�g Ilat!p 'ON 104211"1 1,1Menuo; *ON ouo4dge1 1t/Jppy ntvnn- � � A vowlJed Qat out JoWenueO ao ow" rop wo4tl�t�l r�1PP1► 1m9 nulAd "told) Ivoilddr to *W#N 7 7 'ot8 1f 11t" 041 h A+Ma�t What over4oft ",*l "d 03 M •ulmo on &e All* W N�tOn01 1AJw tut WIN OlOses I*ft 110 Out Uwted app is tu04litiuee OWN ohh+h •in 'Oautuipuc U#3 mocotmoo 111 4104 Amain 70a11M A It04 %AM WI At kol Oip M M%MAW 4* aM M rfil JAe1•AAY1lw4 P" t0 J&~AW w1UL&V#tAWW OIA A11WAI VM11111 004 6140 et tvera,Ad M9101 Haued 00 MUM u01nw0uA NOTA wt l0 Wilm" 11wu4aere f 01 OYµttt MO M 6&Vm% tt "A664 Je "mm" 01 teewtf ro 0401 .1w"WS01 Ave l4 tAe btn111n dun goo= wfm A Outtom mml owflI & wo 10 willp"I '"amwQ 11� Put Ain MI'Vk 9111 UAJIJ tten+uey tawrillaewdw 'wlylo 't1Yek eO34Ja4aA1 tb •MN9 w 6AM eut Ouelto •yfwwoul .61 NaeJ13t JbW ><ve�11dd4N 141 'Itwjod Itl1j1 1e 6unua* #W1 ;o v04tJlpt Vft ul InuetwAsiewt- ours t;du Jellm IupttJntaa :uweWsd supold pw usum ywas 'bu!flti�vt4 'ttl0ap out '11�Anew o 'valmA40 110 $0 11*46mv em1pnou11 0 `fit `�d�� ! 150 NOIt�AIl1SN00 Qlt1I1Mt1$i (•� NOUJIdW00 40 !Pill VIVNIX01dadvi . rw 00(" -,Pyn -, - r*wy J �s ifs ling! Jdaetldt N tueld uvtuwituoe Wfuel Igtetls N10311 111M XWOM 143" vVill 81V"jX0jI"w 0303IN dt'N011VAVZXB 114011*Md1SN00 40 380dOW - - - raviewl be menew.ap M walmle as"%) NOI10numoo d0 N01tmwi Al 11110 UULIQ luew1A0Jdwl AVIW �"'�31r►0 "&I* - IIWJsd IUIWaAQJdwl uo411Alpgng 2001J wi - ..• 4N0121A10iins osAO»ddV a+/ ILLNIMAOMM UONIw talm vem"Vuae uI nutwaa0J0un txJOAA 69041 81111 Jowe out tutew JnaAA •OJW^1 •2101 a1llled •t1I1*AUpt1 '11utWSAt4 •%Aw.1Al,o '410+9 ellAsid Jo altona la uep3nnsueo •611 Jed ( N3WHOYOVON3) Ncluo VISN00 smom Ot18nd' 11W»3d WIN N011V01140 dlNino vi do A= UU1110 iYMi11AlOJOY� ut n%mwUal uu91 must uol><1pp1A MOM %Alm 1210M _ .. -v 7 d YVd 8Z I i �ilZ �6-Z i- IP.f i