4500NOTE:
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 I I
DATE: September 23, 2005 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Rancho Santana TM 31202, Avenue 52 and Monroe St.
(Street address oi Description of Location)
PURPOSE OF CONSTRUCTION Off -site street imRrovemen s
DESCRIPTION OF -CONSTRUCTION .
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN -
APPROXIMATE TIME OF COMPLETIW
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, ma
paction and placing permanent resurfa
In consideration of the granting of tl t
rials.- nd &�ris, backfillVg, pbm-
=/or repiking improvVents)
Sketch (attach
permit, the appkcant hereify-agrees to:
ructioh plans if appropriate)
Indemnify,. defend- and save thi lt��tgyj 'itsmauthoriszed agentsVf! icers/representative nd employees, harmless from and against any and all
in o c aim c 't t
penalties, liabilities or loss resi or our a ion d arisin t of any accident, loss or damage to persons or property
happening or occurring as a pr ixima result of any work u dert ken u er the permit granted pursuant to this application.
Notify the Administrative Autl- xity a least twenty -four (24 h u in advance of the time when work will be started.
'o s
Comply with all applicable Cit, Ordina ces, the terms and c n itions of the permit and all applicable rules and regulations of the City of
La Quinta and to pay for any dclitiona replacement necess, ry as the result of this work.
Jolin R. Pedalino 578-69 5 Signature of Applicant or Agent
Desert Ch!�%nne, Inc. 7�401 Hwy 111 Suite."G" La Quinta, CA 92253 777-9920
Name of Applicant \Ieas,.. print) Business Address Telephone No.
ruc
Granite Construd ion 380�O Monroe St. Indio, CA 92203 775-7500
Business Address Telephone No.
Name of Contractor� and Jo Foreman\
0089 3501
Contractor's License No. City Business License No.
Valley Forge Insurance Coqmpy GL 2 4921 89 16
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 17,010.00
Permit Fee 100.00
p-eF-a7r�r As Built Dep (I . 00.0 -on.)
Cash Deposit -Surety Bond
if required
TOTAL: $ 18,110.00
Receipt No.
Received by Date
4500-
PERMIT VALIDATION
4500
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Recorded by 11 Telephone: (760) 777-7075
NOTE:
Wit� 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
Subdivision Improvement Permit — Class I I I
DATE: September 23. 2005 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Rancho Santana TM 31202�- Avenue 52 and Monrop. St.
(Street address oi� Desiription of Location)
PURPOSE OF CONSTRUCTION Off -site Rtreet imnrovements S
�� Retch (attach c6mtruction plans.if appropriate)
DESCRIPTION OF.CONSTRUCTION See PSN 05154
DIMENSION OF INSTALLATION OR REMOVAL Sep PSN 05144
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN ()CrApr I- 700S
APPROXIMATE TIME OF COMPLETION March 15� gonr.
ESTIMATED CONSTRUCTION COST$
(Including removal of all f obstruction, mav�—jal
sland debris, backfi
paction and placing pi�rmanent resurfading and/or replacing impr
In cons ideratio n,of 'tre granting of thi� permit, the app'kkcant he
Indemnify, d6fend. and save the I Citj its authorized agent
penalties, -liabilities S\
or loss resditing 4rorn claims or court a
happening or occurring as a proximate result of any work u
Notify the Administrative Authlority at least twenty-four (2,e
ordinances, the terms and
Comply with all applicable City
La Quinta and to pay for any I
additional placement necess
/ I T
agrees to:
:ers / representativesdnd employees, harmless from and against any and all
iand arising odit"'of any accident, loss or damage to persons or property
_:_1
A ken under the permit granted pursuant to this application.
� 1_;�,
Jurslin advance of the time when work will be started.
itions of the permit and all applicable rules and regulations of the City of
as the result of this work.
John R. Pedalino 578-6V — Signature of Applicant or Agent
Desert Ch!�Lnne, Inc. 7§401 Hwy 111 Suite "G" La Quinta, CA 92253 777-9920
Name of Applicant"(,please print) Business Address Telephone No.
Granite Const��ion 380�O Monroe S t. Indio, CA 92203 775-7500
Name of Contractor and Job Foreman Business Address Telephone No.
0089 3501
Contractor's License No. City Business License No.
Valley Forge Insurance
Comply GL 2 4921 89 16
Applicant's Insurance Company I Policy Number
FEES: Subdivision I morovement 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 $ 17,010.00
-Permit Fee 100.00
pgeprgl-r�r As Built De I - non . onN
Cash Deposit -Surety Bond
if required
TOTAL: $ 18,110.00
Receipt No.
Received by Date
Recorded by
4500
PERMIT VALIDATION
PERMIT NO. 4500
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075
��l
NOTE:
With proper validation
this form constitutes an
encroachment permit
.CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION jENCROACHMENT)
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 Oermit — Class I I I
DATE: September 23. 2005 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Rancho Santana TM 31202z Avenue 52 and Monroe St.
(Street address oe Description of Location)
PURPOSE OF CONSTRUCTION Off -site street imprbygments -Sretch (attach ic-onstruction plans if appropriate)
DESCRIPTION OF.CONSTRUCTION SeiX.PSN 05154
DIMENSION.OFINSTA.LLATIONOR REMOVAL See PSN 05144
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN OctAor 3. 201715
0
APPROXIMATE TIME OF COMPLETION MArCh 1.�, 7066
ESTIMATED CONSTRUCTION COST$ _56,7-7M� An
(Including removal of all obstruction, materials, and dlebris, backfi)l%'ng, c6bm-
v I
paction and :placing - permanent resurfac ! ing and/or replacing impro�v Xents)
In consicleratio��6f 56 granting of thi's permit, the applipant nerley agrees to.
1�_- ,
Indemnify, defend. and save the' City! its authorized epresentativesA employees, harmless from and against any and'all
penalties, liabilities or loss resulting !from claims or court action zind arising,oufof any accident, loss or damage to persons or property
happening or occurring as a proximat'e result of any work undert;ke 'under the permit granted pursuant to this application.
Notify the Administrative Authlority at least twenty-four (24), hPurs in adv.ance of the time when work will be started.
I
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
I I
La Quinta and to pay for any bidditional, replacement necessary as the result of this work.
John R. Pedalino 578-6945 Signature of Applicant or Agent
Desert Che�enne. Inc. 7b40I Hwy III Suite "G" La Quinta,' CA 92253 777-9920
Name of Applicant " (please print) Business Address Telephone No.
Granite Const�4tj 1�0 Monroe St. Indio, CA 92203 775-7500
Name of Contractor and Jdb Foreman Business Address Telephone N6.
0089 3501
Contractor's License No. City Business License No.
Valley Forge Insurance co�y GL 2 4921 89 16
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements.' 3% of'estimated construction costs
Private impro
vements: 3%, of estimated construction costs
Minor. Improvement Permit — Class IV: See attached schedule
N 2 450.0
Inspection Fee $ 17,010.00 PERMIT VALIDATION
Permit Fee 100.00 4500
PERMIT NO.
reral-rr As Built De (1.000-no)
Cash Deposit -Surety Bond* DATE APPROVED
if required EXPIRATION DATE
TOTAL: DATE ISSUED
Receipt No.
By
Received by Date Administrative Authority
Recorded by
Telephone: (760) 777-7075
3'.
11
NOTE: t
With propq,,r validation
this form constitutes an
encroachment permit
.11
,.,,,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 I I
DATE: September 23. 2005 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Rancho Santana T-M 31202.- Avenue 52 and Monroe St.
(Street address or Description of Locatio - n)
ff-site atreet improvatmen a
PURPOSE OF CONSTRUCTION Ske ch (attac construction plans if appropriate)
SeeNTSN 05154
DESCRIPTION OF CONSTRUCTION
DIMENSION, OF INSTALLATION OR REMOVAL See PSN 05154
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION MArSh
ESTIMATED CONSTRUCTION COST$
(including removal of all obstruction, materials, and debris, backfi�wng, co,,m-
paction and -placing permanent resurfacing and/or replacing improvements)
In consideration ' '59e" granting of this permit, the appiicant here!blylagrees to:
Indemnify, defend, and save thJ City; its authorized agents: off icers,/rIepresentatives and employees, harmless from and against any and al
penalties, liabilities or loss resulting from claims or court action a
hd arising out of any accident, loss or damage to persons or property
happening or occurring as a proximate result of any work undert.ken 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 Cit� Ordinances, the terms and c8nditions 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.
I I
John R. Pedalina 578-6915 Signature of Applicant or Agent
Deoert Cheyenne, Inc. 7t0l Evy Ill Suite "Gl# La QUiuta, CA 92253 777-9920
Name of Applicant '(please print) Business Address Telephone No.
Granite Conatru�tion 38000 Monroe St. Indio, CA 92203 775-7500
Name of Contract& and Job'Foreman Business Address Telephone No.
0089 3501
Contractor's License No. City Business License No.
Valley Forge Insurance Como"y GL 2 4921 89 16
Applicant's Insurance Company Policy Number
FEES: Subdivision I mprovement 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 $ 17,010.00
,.Rermit Fee 100.00
F;*e7al_ty` As Built Dep (1,000.()0)
Cash Deposit -Surety Bond
if required
TOTAL: $ 10'..00
Receipt No.
Received by
Recorded by
Date
4500
PERMIT VALIDATION
4500
PERMIT NO
DATE APPROVED
EXPIRATION 'DATE
'DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075 "4
NOTE:
Witf�propei"valiclation
this'form constitutes an CITY, OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT).
For the construction of public or private curb�s, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement �ermit — Class I I I
DATE:-Saptamber.23. 2065 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Rancho SAntana TM 31202% Avenue 52 And mon-taft ie.
(Street address oi Description of Locatiori)
PURPOSE OF CONSTRUCTION atract improvOtwntO Sketch (attach construction plans if appropriate)
DESCRIPTION dF-CONSTRUCTION Sea
��JPSN 05154
DIMENSION OF INSTALLATION OR REMOVAL See PSN 05154
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN OCtobar 3. 2005
APPROXIMATE TIME OF COMPLETION March 15. 2006
ESTIMATED CONSTRUCT16'N COST$ 567-000-00
(Including remtoval of all obstruction, materials, and debris, backfil . ling, com-
paction and 'placing permanent resurfacing and/or replacing improvements)
X
In consiclerati��—�e granting of this permit, the applicant hereby agrees to:
Indemnify, clefend- and save the City, its authorized agents, off icers,,,representatives and employees, harmless frbm 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 Ci—ty--0rdinances, 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.
John,.R. Pedalino 578-69.15
Signature of Applicant or Agent/
D000rt Chayenne, Inc. 78401 Hwy III
Suit* "G" La Quinta,, CA 92'253
777-9920
Name of Applicant (please pri.nt)
Business Address
Telephone No.
Granite Construction 38000 Monroe St.
Indio, CA 92203 775-7500
Name of Contractor and Job Foreman
Business Address
Telephone No.
0089
3561
,Contractor's License No.
City Business License No.
Vall*y Fargo Insurance Con�Any
OL 2 4921 89
16
.Applicant's Insurance Company
Policy Number
FEES: Subdivision Improvement, Permit — Class I I I
I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction
costs
Minor. Improvement Permit — Class IV: See attached
I
schedule
4500
k. 17,010.00
Inspeciion Fee $
PERMIT VALIDATION
Permit Fee 100.00
4500
P I enalty As Built Dop (1,000.00)
PERMIT NO.
Cash Dep6sit-Surety Bond
DATE APPROVED
if required
V.
TOTAL
Receipt No.
Received by
Recorded by
$
Date A-*",
DATE ISSUED,
By -
Administrative Authority
Telephone: (760) 777-7075
k