0376Reference GTE W.O. 0543-31437-1
NOTE: •
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
February 23, 1909
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit.Class IV
LOCATION OF CONSTRUCTION Coachella Drivel E,/0 Avenida Fernando
(Street address or Description of Location)
PURPOSE OF CONSTRUCTIONOry1Cc t0 new house at
45-455 Coachella Drive
DESCRIPTION OF CONSTRUCTION cut or bore street as
required, to n1ace telcnhonn cable. Work will
contract forces, acc attached drmx;Tina
DIMENSION OF INSTALLATION OR REMOVAL 1.20' 1" D.
t,elevhon(�� cable
SIZE OF EXCAVATION, IF NEEDED 110' 30" min t< rnnch
APPROXIMATE TIME WHEN WORK WILL BEGIN 2/24/89
APPROXIMATE TIME OF COMPLETION 2/28/99
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
Sketch (attach construction plans if appropriate)
The Contract Company will be
required to apply for an
additional Encroachment Permit
and pay the required fen *prior
to the otart of work.
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
Food Cor-munication S. 4th Banning, CL 714--+349,112
Name of Applicant (please print) Business Address Telephone No.
Hoo& Cor,?,municLtion/T1x Baird 494 S. 4th, Banning 71.4-949-1121
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.
City Business License No.
Applicant's Insurance Company
PP ' P Y Policy�,Numbe�,r j J.�'a ��"g,v,
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.
Received by
Recorded by
$ 35.00
10.00
$ 45.00
Date
YT rd 1' 375
PERMIT VALIDATION
PERMIT NO. 376
DATE APPROVED /91/^o"
EXPIRATION DATE S/1/99
DATE ISSUED 2/23/09 p
By
Administrative Authority
TELEPHONE: (619) 564-2246
to r!,'i rn
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Reference' GTE W.O. 03-31437-I
NOTE: '
With proper validation Q•
this form constitutes an CITY OF LA' QUINTA'
encroachment permit'_
' • APPLICATION FOR PERMIT -
+PUBLIC WORKS CONSTRUCTION' (ENCROACHMENT) '•..:. Sw�
OF f[���•
For the construction of public or 'priva(te curbs, driveways, pavements, sidewalks, parking lots; sewers, water mains
and other like, public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
February 23, 1989, Subdivision Improvement Permit- Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Coachel(la'. Drive 'E/O' Avenida Fernando `
(Street address or Description of Location)
Service. to new house at p ppropriate)
PURPOSE OF CONSTRUCTION,. Sketch (attach. construction tans if a
45-455 Coachella Drive
DESCRIPTION.OF CONSTRUCTION cut or bore.. street as
r2quir -d. o' place. telephone cable.' - 'Work will The% Contract .Company will be,
contract forces' see attached drawinct required: to apply for an .
'
DIMENSION OF INSTALLATION,OR REMOVAL 12'0 1 D.'" additional Encroachment Permit
and' pay. the..req.uired fee'.prior '
telephone cable to. the.. start of work.
SIZE OF EXCAVATION, IF NEEDED _11.0' 30" min. .trench' 369•
APPROXIMATE TIME WHEN•WORK WILL BEGIN 2/24/89
APPROXIMATE TIMEOF•COMPLETION 2/L28/89__
ESTIMATED
/28/89 -
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 res this work. +
+ Signature of Applicant or Agent
Hood Communication • _494 S. 4.th..•13anni6CA. 714=849-1121
Name of Applicant (please print) Business Address' Telephone No.
Hood Communication/Rex.Baird '494 S. .4th, "Banning' 714-849-1121
Name of Contractor and Job Foreman Business -Address Telephone No.
Contractor's License No. City'Business License No.
Applicant's pp cant's Insurance Company , Polic umgo 45..00,
i ICTAL i
FEES: Subdivision Improvement Permit — Class III
• Public improvements: 3% of estimated construction costs ,
Privafe improvements: 3% of estimated construction costs j �j a
Minor Improvement Per —Class IV: See attached schedule y` 37"
Inspection Fee $' 35.00 PERMIT VALIDATION` `
Permit Fee 10 00 ., 376
PERMIT NO.
Penalty
Cash Deposit -Surety Bond DATE APPROVED
if required EXPIRATION DATE _,r./1/R9
TOTAL: $ •45.0.0
DATE ISSUED` 2/23/89 `
Receipt No.
By
Received by Date ° Administrative Authority
Recorded by TELEPHONE: (619) 564-U46
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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 I I
DATE: Minor. Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION "
DIMENSION OF INSTALLATION OR REMOVAL
.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 124) 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 Cluinta-and to pay for any additional replacement necessary as the result is work.,''
Signature of Applicant or Agent
it-/oQ �' v its 5�i s %A" ,6.4"rosy 7w-_k4,,q,
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 LII .
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs NO.
Minor Improvement Permit = Class IV'- See attached schedule,.
Inspection Fee $ -3 - PERMIT VALIDATION
Permit Fee PERMIT:NO..
Penalty /Z 3/
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
Recorded by
DATE APPROVED
EXPIRATION'DATE
DATE ISSUED -4 t
By '
Administrative Authority
TELEPHONE: (619) 564.2246
1
The following General and Special Provisions are attached to and maoe a part of Permit No. .3 69
GENERAL PROVISIONS
The following shall always apply:
ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within City of La Quinta right of way
ONLY. Whenever construction extends within private property, it shall be the responsibility of the permittee (or his contractors) to
secure permission from abutting property owners. Such authorization must be secured by -the permittee prior to starting work.
TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated tracklaying construction equipment shall not be permitted to operate on any
paved surface unless fitted with smooth -faced street pads. All mechanical outriggers shall be fitted with rubber street shoes to protect
the paving during excavations. Rubber -tired equipment only shall be used in backfill operations in paved areas. If the existing
pavement is scarred, spalled, or broken during the term of this contract, or if the pavement is marred, City of La Quinta shall request
that these portions of road be resurfaced over their entire width. Resurfacing shall consist of one coat of two inches j21 of A.C.
surfacing plus appropriate seal coat as specified above.
PROTECTION OF TRAFFIC: All excavations and work areas shall be properly lighted and barricaded as deemed necessary by the City
Engineer or La Quinta City Public Works Inspectors. Suitable detours and detour signs shall be placed and maintained for the duration
of the project. The City shall be notified 24 Hrs. in advance of any, traffic detours or delineations.
CARE OF DRAINAGE STRUCTURES: Any drainage structure' including corrugated metal pipe, concrete pipe, steel culvert and
concrete structures encountered during excavation which necessitate removal shall be replaced in kind. In the event.it becomes
necessary to remove or cut existing drainage structures, City of La Quinta shall be notified prior to commencement of this work.
Drainage structures and open drains shall be kept free of debris at all times for proper drainage.
RIGHT OF WAY CLEANUP: Any surplus material resulting from excavation and backfill operations shall be removed from the right of
way. All paved surfaces shall be broomed clean of earth and other objectionable materials immediately after backfill and compaction.
Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shall be removed
prior to paving. Water tanker shall be used, as required, to sprinkle the job site to keep down dust conditions and shall be used
immediately after backfill.
DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing water on City of La Quirita roads, it shall be
the responsibility of the permittee (contractor) to control this water and to provide off-street barricades when necessary.
CLOSING STREETS: No street shall be closed. A minimum of one lane of traffic shall be maintained at all times to provide limited
access for the adjoining property owners and emergency vehicles. In the event it is felt bythe permittee that he must close a street for
any length of time, permittee shall contact this office to obtain the necessary permission.
SPECIAL PROVISIONS
The follwing shall apply ONLY when indicated:
R1 NOTIFICATION: Permittee shall notify the City at 564-2246 at least 48 hours in advance of starting construction.
R2 CASH DEPOSITS OR BONDS: A cash bond or an approved surety bond in an amount of not less than $
shall be furnished in the name of City of La Quinta to cover all work involved in the restoration of the various La Quinta
roads and survey monuments. This bond shall be continuous until cancelled by the City Engineer. This bond must be
posted prior to commencement of, any work on this project .
R3 UTILITY CLEARANCE: (Substructures)Priortomaking any excavation within the City ofLaQuinta right ofway authorized
by permit, the permittee shall contact all concerned utility companies relative to the location of existing substructures.
Damage to existing substructures resulting from operations conducted under this permit shall be the sole responsibility
of the permittee.
R4 UTILITY CLEARANCE: (Surface structures) No work shall be done under this permit until all utilities are clear of the
proposed work site. The permittee shall notify all concerned utility companies of the proposed work.
R5 PAVEMENT WIDENING: Area between the proposed concrete gutter line and the existing road pavement shall be
surfaced with - inches of A.C. paving placed on inches of class aggregate subbase course
having an "R"value of not less than and in conformance with City of La Quints Road Improvement Standards
and Specifications, Ordinance #461.
R6 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of
1/4 inch to one foot (1').
R7 GRADES & STAKES: City of La Quinta shall establish grades and stakes for the proposed concrete curb and gutter
construction.
R8 GRADE CHECKING: City of La Quinta shall check grades upon receipt of plan and pFofile and/or grades as established by
a licensed engineer.
R9 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( fee0shall be
removed. Curb and/or curb and gutter shall be saw cut prior to removal. Depressed curb, matching concrete gutter and
concrete driveway approach shall be constructed in conformance with City of La Quinta Standard #207.
R10 DRIVEWAYS,.A.C.: Driveways shall be constructed as not,to alter existing drainage pattern. Surfacing between the
property line and the existing road paving shall be 2-1/2 inches of A.C. paving placed on ( ") of class
aggregate base. Driveway construction shall conform to attached drawing.
R 11 CULVERTS: A inch diameter ( ) culvert shall be installed with the invert approximately 1-1 /2
inches below and in line with the existing flow line. Culvert installation shall conform to the attached drawing.
,R12) SIGHT CLEARANCE: Sight clearance of 600 feet in either direction shall be assured and maintained.
R'i3 SOIL STERILIZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall comply with the
r� manufacturer's specifications.
(R14 1 COORDINATE .WORK: The proposed work shall be subordinated to any operation which the State of California or
City of La Quinta may conduct in this area during the period of this permit. Work shall be coordinated with the State or
City of La Quinta forces to preclude delay or interference with State or City of La Quinta projects.
�1
!R15SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the
centerline of all streets or property lines when involved shall be completely tied out so they may be readily and correctly
be replaced by a licensed civil engineer or.surveyor at the expense of the permittee. A complete set of notes showing the
ties to these monuments shall be furnished to the City Engineer prior to the removal of any monuments. This office shall
be notified upon completion of replacement of all survey monuments for proper project clearance.
R16 SURVEY MONUMENTS: Prior excavation or beginning of construction, all .:y monuments shall be tied out by City
of La Quinta and suitable payment or guarantee of payment shall be made as reimbursement for all work involved.
R17 - PAVEMENT CUTTING: Pavement will be mechanically cut to a straight edge prior to excavation. Method of pavement
cutting shall be approved through the office of the City Engineer. (Under no circumstances shall excavating equipment
be used to excavate prior to cutting of pavement). Excavation material shall be placed in such a position as to best
facilitate the general flow of traffic. Prior to final paving operations, any damage to pavement straight edge shall be
corrected.
R18 PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations, any damage to
pavement straight edge shall be corrected.
R19 LIMIT OF EXCAVATIONS: Excavations shall be limited to 1,000 lineal feet of open trench before backfill operations must
begin. All excavations shall be properly barricaded with lights overnight, on weekends and holidays for the protection of
the traveling public. The Public Works inspector shall determine the suitability of excavation barricading in each case. No
excavation shall remain open for a period exceeding five (5) days. No excavation shall be made unless the construction
�.� material is actually on the work site.
R20 ! BACKFILL MATERIAL: Backfill shall be free of brush, roots or other organic substance detrimental to its use for purposes
of producing an adequately consolidated backfill. Any material which the City of La Quinta deems unsuitable (spongyor
saturated material) which is encountered during excavation shall not be used for backfill, but shall be supplemented or
replaced by an approved sand or gravel.
R21 BACKFILL SAND: Backfill shall be approved transit -mix sand or equivalent and shall be placed in lifts of notgreaterthan
three feet (3') and vibrated using vibrotamper or equivalent equipment. Alternate methods maybe substituted, but in any
case a relative compaction of 95 percent shall be attained within the structural section of the roadway.
iR22 ) BACKFILL PLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench
before flooding or a maximum of five-foot (5') lifts where trenches are of excessive depths. Care is to be exercised that the
backfill material is not subjected to extreme swell by flooding operations. Backfill material shall be placed so that the
resulting compaction shall be not less than 90 percent or equivalent to the surrounding ground, whichever is the greater
compaction. Where ponding or flooding is used for a maximum settlement, adequate dikes will be constructed to retain
the water. Where jetting is used, the jets shall be of sufficient length to reach the bottom of each layer and the water
supply shall be continuous.
R23 ` COMPACTION TESTS: If so required bythe inspector, compaction tests shall be made at intervals of not more than 1,000
feet and a minimum of one (1) test on each road. One (1) copy of each test shall be forwarded to the City Engineer for
approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Section 6.3.01 of the
Standard Specifications, Division of Highways, State of California, dated January 1973.
;R24 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line.
One (1) copy of each test shall be forwarded to the City Engineer for approval and filed prior to making permanent repairs.
Compaction tests shall be made as outlined in Section 6.3.01 of the Standard Specifications, Division of Highways, State
of California, dated January 1973.
R25 TEMPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporary patch
consisting of 2 inches of SC -800 shall be placed on a prepared subgrade. The SC -800 temporary paving shall be placed
after a maximum of 3,000 lineal feet of trench has been excavated and backfill operations completed, but in no case shall
the placement of the temporary pavement exceed a five (5) day limit.
R261 PERMANENT PAVEMENT REPAIR: After backfill and compaction operations have been completed, a temporary patch
consisting of two inches (2") of SC -800 shall be placed immediately. A permanent patch of inches A.C.
surfacing placed on a inch class base shall be placed no laterthan days after completion of
temporary road repair.
R27 PAVEMENT REPAIR: F.A.S.: Upon completion of backfill and compaction, a temporary patch consisting of two inches (2")
of cold mix paving (SC -800) shall be placed immediately. A permanent patch of three inches (3") of A.C. surfacing shall
be placed on six inches (6") concrete base as directed, but not later than fifteen (15) days after completion of temporary
paving. Concrete base shall be of five -sack mix and shall conform to the City of La Quinta Road Improvement Standards
and Specifications, Ordinance ##461.
R28 FOG SEAL: A fog seal coat consisting of an application of asphaltic emulsion shall be applied over all patch areas as
determined by the City Engineer.
R29 SEAL ARMOR COAT: A seal coat consisting of an application binder and screenings shall be applied on all patch areas
where such seal coats existed prior to issuance of this permit. Seal or armor coats shall be applied as specified in -Section
37, Standard Specifications, State of California, Division of Highways, dated January 1973. Work of pavement repair to
be accomplished by a licensed contractor engaged in the business of pavement repair.
R30 STREET RESTRIPING: Where street striping is still visible on streets to be excavated, such striping shall be replaced upon
completion of permanent repairs.
R31 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quinta road right of way shall be accomplished
by a licensed, bonded and insured tree service, and handled safely without interference or hazard to the traveling public.
It shall be the responsibility of the permittee to maintain the tree in a vigorous growing condition at its new location.
Trees to be removed shall be removed in sections which can be handled safely without interference or hazard to highway
traffic. The entire width of the tree stump shall be removed and disposed of so that no debris remains in view of the
highway. The stump hole shall be backfilled and thoroughly compacted as specified in the following paragraph. Where it
becomes necessary to restrict traffic, the work shall be restricted to a maximum of 500 feet at any one time. Adequate
signs, flagmen and/or barricades shall be provided to protect the traveling public at all times.
Large holes resulting from tree removal shall be backfilled and compacted to not less than 90 percent or equivalent to the
surrounding ground, whichever is the greater compaction as determined by the impact or field method. Compaction
tests shall comply with Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated
January 1973.
R32 TREE TRIMMING:
a. Only the necessary trimming shall be accomplished to provide clearance of the facility for one calendar year.
All broken or weak sections within the trimming shall be removed.
b. Where it becomes necessary to restrict traffic, the work shall be restricted to a maximum of 500 feet at anyone time.
Adequate signs, flagmen, and/or barricades shall be provided to protect the traveling public at all times.
c. If tree trunks are partially outside of the City of La Quinta road right of way, permittee shall make his own
arrangements with adjoining property owners for consent to the trimming in addition to the authorization provided
by this permit.
d. All tree trimming on EVERGREEN TREES, PALM TREES, and other ORNAMENTAL TREES shall be accomplished to
the satisfaction of the City Public Works Inspector.
e. Abutting property owners shall be contacted, in all instances, prior to trimming or topping trees.
f. Pruning shall, in all instances, be at the shoulder of the crotch to insure even, fast healing in all cuts of two inches
(2") and above in size. Sealant shall be applied to all cut sections as directed by the City Public Works Inspector.
78-105 CALLE ESTANDDIZIONRITAC 4D"TRONS 92253. (619) 564-2246
.,ENCROACHMENT PERMIT NO. 369
Survey.monuments shall be protected in place or
re -established -pursuant to City standards and the State of ,.
California Land Surveyor's Act.
Contractor shall comply -with the local noise ordinance and
construction operations and maintenance of equipment within
one half mile of human.occupancy shall be performed only
during the time periods as follows:
October ls't to.April 30: Monday-Friday.7:00a.m.-5:30p.m.
Saturday 8:00a.m.-5:00p.m.
May lst to September 30: Monday -Friday 6:00a.m.-7:00p.m.
Saturday I 8r00a.m.-5:00p.m.
Work shall be prohibited anytime on. Sunday and Federal
holiday.
R35 Traffic control shall be as per Cal Trans Traffic Manual.
Field adjustments in detouring.shall be accomplished as
directed in order to adjust to actual field conditions. It.
shall be -.the contractor's responsibility to adequately
barricade and.detour this site.
R36 All excavation at -or near -the travel way shall be backfilled
at the end of the workaday, for the protection of the
traveling public.,,,
R37 This permit is only for work within public street right-of-
way.
R38 Ingress and egress for local properties shall be maintained
at all times
R39 Prior to work starting, Underground Service Alert shall be
contacted at 1-800-422=4133 and an "inquiry number" shall be
provided to the.City,Public Works Inspector.
R40 Replacement pavement shall- be existing asphalt thickness
plus one inch,.'but not less than 3 inches of AC pavement
shall be placed. Class 2 aggregate base shall be as per
existing or All, minimum (whichever.is greater).
R41 If the work -is to be performed'by forces other than that of
the utility -company's than that contracting company will be
required to apply for an.additional encroachment permit and
pay the appropriate fee.
MAILING ADDRESS P.O. BOX 1504 - LA `QUINTA, CALIFORNIA 92253
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,-STATE OF CALIFORNIA—BUSINESS, TRANSPORTATION AND HOUSING AGENCY ARNOLD SCHWARZENEGGER, Governor
DEPARTMENT OF TRANSPORTATION
DISTRICT 8 e
PERMITS (MS -619)
464 W. FOURTH STREET, 6T" FLOOR
SAN BERNARDINO, CA 92401 Flex your power!
PHONE (909) 383-4017 Be energy efficient!
FAX (909) 383-6370
TTY (909) 383-6300
May X-2664-7
08 -00 -6 -MC -0375 coply
08-RIV-111-32.81 /3 3.32
Developers Surety & Indemnity Company
P.O. Box 19725
Irvine, CA 92623
BOND RELEASE
Returned herewith are State Highway Encroachment Permit Payment and Performance
FBond_Nos. 86_66305& 866634S issued by your company on behalf of, 111 Venture, LLC
,& Ray Troll Development Co., principal.
Your principal has completed the permitted work warranted by your bond in an
apparently satisfactory manner. Therefore, you may consider, your liability to no longer
be in full force and effect. However, your company, as surety is still responsible for any
latent defects until such time as is provided for in California Code of Civil Procedures
Section 337.15.
If you have any questions, please call Mr. Jesus Galvan at (909) 383-4017.
Original signed by JESUS GALVANJR., P.E.
JESUS GALVAN JR., P.E.
District Encroachment Permit Engineer
San Bernardino County
Attachment
c: Ray TrollDevelopmentCo.
1 Venture`LLC:
:'Caltrans improves mobility across California"
I,
STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION
PERFORMANCE BOND OF STATE HIGHWAY ENCROACHMENT PE Page 1
T9-0001 (REV. 9/93) D FRONT
[To Accompany the Permit]
Streets and Highways Code Section 677
BOND NUMBER UMBER
PERMIT NUMBER
PRINCIPAL
66630S
08 -0006 -MC -0375
111 VENTURE, LLC
-^"-
LOCATION
CATION
DIST.
CO.
RT.
P.M.
EFFECTIVE DATE
08
RIVERSIDE
111
32.81/33.32
APRIL 6, 2001
BOND NUMBER
PREMIUM AMOUNT
866630S
$3,802.00 one year term subject to renewal
(PLEASE FILL OUT FORM COMPLETELY)
Know All Persons By These Presents:
That 111 VENTURE, LLC as PRINCIPAL, having an address for service of
74-33 HWY 111, SUITE 207, PALM DESERT, CA 9226(, and DEVELOPERS SURETY AND INDEMNITY a Surety
Company qualified and duly licensed to do business in the State of California, as SURETY, are held and firmlr-bound to the
STATE OF CALIFORNIA, as OBLIGEE, in the sum of
_..o
m c, • (T1
ONE HUNDRED FIFTY EIGHT THOUSAND FOUR HUNDRED TWELVE AND 00/100 Dollars ($ 156&QOt
lawful money of the United States of America, to be paid to the OBLIGEE, for which payment, we bind W-selves:,�our Airs,
nr' 0 O
executors, administrators, successors,:and assigns, jointly and severally, to those persons referred to in paragraph 4 below.
THAT THE CONDITION OF THIS OBLIGATION IS SUCH,
1. That whereas PRINCIPAL has made, or is about to make, application to the State of California for a permit under Article 2
of Chapter 3 of Division 1 of the Streets and Highways Code to place, change or renew an encroachment in, under or over
any portion of state highway, and Streets and Highways Code Section 677'requires a bond payable to the State of California
as a condition.therefore, this payment bond is executed and tendered in accordance therewith.
2. That this bond shall be subject to all of the terms and provisions of the afore -mentioned provisions of the Streets and Highways
Code.
3. That if the PRINCIPAL shall fail to faithfully perform the work for which the encroachment permit was issued, or fail to pay
all encroachment permit fees then the SURETY. herein shall pay for the same, otherwise this obligation is null and void.
4. No right of action shall accrue under this bond to or for the use of any person or entity other than the State of California.
5. That this bond shall be deemed continuous in form, remain in full force and effect, and run concurrently with the permit period .
and any and all renewals, or until cancellation or withdrawal of the SURETY form the bond. If no work has commenced under
the encroachment per the SURETY may cancel this bond upon thirty (30) days written notice to the ORLIGEc: Bend
cancellation notice shall be sent to the Department of Transportation District Office issuing the encroachment permit. The
notice should include the permit number and the project's location: county, route, and post mile.
(SEE REVERSE SIDE)
FM 90 1068 M —�
PERFORMANCE BOND OF STATE HIGHWAY ENCROACHMENT PERMITTEE Paget
TR -0001 (REV. 9/93) BACK
6. That the SURETY shall bear no liability on this bond in the event the encroachment permit issued to the PRINCIPAL is cancelled
or withdrawn prior to commencement of work on State property by the PRINCIPAL.
7. This bond to become effective APRIL 6 2 V
c eon 001
8. This bond is executed to comply with the provisions of Chapter 3'of Division 1 of the Streets and Highways Code and of
Chapter 2, Title 14, Part'2 of the Code of Civil Procedure, and said bond shall be subject to all of the terms and provisions
thereof.
NAME OF PRINCIPAL DATE
111 VENTURE, LLC APRIL 6, 200.1 '
BUSINESS ADDRESS OF PRINCIPAL: BUSINESS, PHONE
7433 HIGHWAY 111, SUITE 207 760-674-9001
CITY: STATE.- ZIP CODE:
PALM DESERT CALIFORNIA 192260
PRINT R TYPE NAME OF AUTHORIZED SIGNATURE AND TITLE AUT ZED D TITLE
5
NAME OF SURETY DATE:
DEVELOPERS SURETY AND INDEMNITY APRIL 6, 2001
BUSINESS ADDRESS OF SURETY: 'BUSINESS PHONE
17780 FITCH, SUITE 200 800 --782 - 1546
CITY: STATE: ZIP CODE:
IRVINE CALIFORNIA 92623
/certify (or declare) under penalty of perjury that/ have executed the foregoing bond under an unrevoked power of attorney. .
Executed on (date) APRIL 6, 2001 in (city, state) WALNUT CREEK, CA
under the laws of the State of C lifornia.
PRINT OR TYPE NAME OF. ATTORNEY-IN-FACT FOR SURETY: SIGNATUR O NEY-1 F FOR U
MICHAEL J. BROWN
FM 901068 M - --
STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION
PAYMENT BOND OF•STATE HIGHWAY ENCROACHMENT PERMITTEE
T9-0018 (REV. 9/93)
[To Accompany the Permit]
Streets and Highways Code Section 677
Page 1
FRONT
BOND NUMBER PERMIT NUMBER PRINCIPAL
866630S 08 -00 -6 -MC -0375 111 VENTURE, LLC-
LOCATION
CO. REF
T. P.M. FECTIVE DATE
LOCATION 08 RIVERSIDE 111 32.81/33.32 APRIL 6,2001-
BOND NUMBER PREMIUM AMOUNT
866630S - included with performance bond
(PLEASE FILL OUT FORM COMPLETELY)'
Know All Persons By These Presents:
- That 111 VENTURE, LLC as PRINCIPAL, having an address for service of
74-33 HWY 111, SUITE 201, PALM DESERT, CA 92260 and DEVELOPERS SURETY AND INDEMNITY a Surety
Company qualified and duly licensed to do business in the State of California, as SURETY, are held and firmly bound to the
STATE OF CALIFORNIA, as OBLIGEE, in the sum of
ONE HUNDRED FIFTY EIGHT THOUSAND FOUR HUNDRED TWELVE AND 00/100 Dollars ($. 158,412.00 ),
lawful money of the United States of America, to be paid to the OBLIGEE, for which payment, we.bind ourselves, ou C'Peirs,
4
executors, administrators, successors, and assigns, jointly and severally, to those persons referred to in paw rahelov��
(J N �11
THAT THE CONDITION OF THIS OBLIGATION IS SUCH,J� ; '', Cry
1. That whereas PRINCIPAL has made, or is about to make, application to the State of.California for a perr�iit%under'Article 2
of Chapter 3 of Division 1 of the Streets and Highways Code to place, change or renew an encroachment in, under or over
any portion of a state highway, and Streets and Highways Code Section 677 requires a bond payable to the State of California
as a condition therefore, this payment bond is executed and tendered in accordance therewith.
2.. That this bond shall be subject to all of the terms and provisions of the afore -mentioned provisions of the Streets and Highways
Code.
3. That if the PRINCIPAL or his or its subcontractors shall fail to pay any of the persons named in Civil Code Section 3181,. or
amounts due under the Unemployment Insurance Code with respect to work or labor performed by such claimant, or any
amounts required to be deducted, withheld, and paid over to the Franchise Tax Board from the wages of employees of the
PRINCIPAL and his or its subcontractors pursuant to Section 18806 of the Revenue and Taxation Code, with respect to such
work and labor, that the SURETY herein will pay for the same in an amount not exceeding the sum specified in this bond,
otherwise the above obligation shall be void. In case suit 'is brought upon his bond, the SURETY, will pay a reasonable
attorney's fee to -be fixed by the court.
4. That this bond shall insure to the benefit of any of the persons named or referred to in Civil Code SectijIP 3181 as to give a
right of action to such persons or their assigns in any suit brought upon this bond.
(SEE REVERSE SIDE)
FM 90 1069 M
PAYMENT BOND OF STATE HIGHWAY ENCROACHMENT PERMITTEE Paget
TR -0018 (REV. 9/93) BACK
i
5. This bond to become effective on APRIL 6. 2001
6. That this bond shall be deemed continuous in form, remain in full force and effect, and run concurrently with the permit period .
and any and all renewals, or until cancellation or withdrawal of the SURETY from the bond. If no work has commenced under
the encroachment permit, the SURETY may cancel this bond upon thirty (30) days written notice to the OBLIGEE. Bond
cancellation notices shall be sent to the Department of Transportation District Office issuing the encroachment permit. The
notice should include the permit number and the project's location: county, route, and postmile.
7. That the SURETY shall bear no liability on this bond in the event the encroachment permit issued to the PRINCIPAL is
cancelled or withdrawn prior to commencement on work of State property by the PRINCIPAL.
8. This bond is executed to comply,with the provisions of Chapter 3'of Division 1. of the Streets and. Highways Code and of
Chapter 2, Title 14, Part 2 of the Code of Civil Procedure, and said bond shall be subject -to all of the terms and provisions
thereof.
j 9. . No action may be brought upon this bond more than six (6) months after acceptance by the State of California of the work
performed under the encroachment permit issued to the principal.
111 VENTURE, LLC
BUSINESS ADDRESS OF PRINCIPAL:
74-33 HIGHWAY 111, SUITE 207
CITY:
PALM DESERT
NAME OF SURETY
DEVELOPERS SURETY'AND INDEMNI'
BUSINESS ADDRESS OF SURETY:
17780 FITCH, SUITE 200
CITY:
IRVINE
DATE
APRIL 6, 2001
BUSINESS PHONE
760-674-9001,
TATE: ZIP CODE: .
ALIFORNIA 92260
JTHP& ED,P6 D TITLE
STATE:
CALIFORNIA
v
DATE:
APRIL 6, 2001
BUSINESS PHONE
800-782-1546
ZIP CODE:
92623
/certify (or declare) under penalty of perjury that/ have executed the foregoing bond under an unrevoked power of attorney.
Executed on (date) APRIL 6, 2001 in (city, state) WALNUT CREEK. CA
under the Yaws of the State of California.
PRINT OR TYPE NAME OF ATTORNEY-IN-FACT FOR SURETY: SIGN RE TT RNEY-1 F FOR UR
MICHAEL J. BROWN �G
FM 90 1069 M
POWER OF ATTORNEY FOR
DEVELOPERS SURETY AND INDEMNITY COMPANY
INDEMNITY COMPANY OF CALIFORNIA
PO BOX 19725, IRVINE, CA 92623 • (949) 263-3300
KNOW ALL MEN BY THESE PRESENTS,.that except as expressly limited, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY
OF CALIFORNIA, do each severally, but not jointly, hereby make, constitute and appoint:
as the true and lawful Attorneys) -in -Fact, to make; execute, deliver and acknowledge, for and on behalf of said corporations as sureties, bonds, undertakings and contracts
of suretyship giving and granting unto said Attomey(s)-in-Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in
connection therewith as each of said corporations could do, but reserving to each of said corporations full power of substitution and revocation, and all of the acts of said
Attomey(s)-in-Fact, pursuant to these presents, are hereby ratified and confirmed.
This Power.of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Board of Directors of
DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of November I, 2000:
RESOLVED, that the Chairman of the Board, the President and any Vice President of the corporation be, and that each of them hereby is, authorized to execute Powers of
Attorney, qualifying the attorney(s) named in the Powers of Attorney to execute, on behalf of the corporations, bonds, undertakings and contracts of suretyship; and that the
Secretary or any Assistant Secretary of the corporations be, and each of them hereby is, authorized to attest the execution of any such Power of Attorney;
RESOLVED, FURTHER, that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such
Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporation when so affixed and in the future with respect to any bond,
undertaking or contract of suretyship to -which it is attached.
IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these
presents to be signed by their respective Executive Vice President and attested by their respective Secretary this 8" day of November, 2000.
. C����� ..
David H. Rhodes, Executive Vice President
By:
Walter A. Crowell, Secretary
STATE OF CALIFORNIA )
)SS.
COUNTY OF ORANGE )
•`Q�cAND /& •'
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WAN),
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On November 8, 2000, before me, Diane J. Kawata, personally appeared David H. Rhodes and Walter A. Crowell, personally known to me (or proved to me on the basis of
satisfactory evidence) to be the persons whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their authorized
capacities, and that by their signatures on the instrument the entity upon behalf of which the persons acted, executed the instrument.
WITNESS my hand and official seal.
Signature.
CERTIFICATE
DIANE J. KAWATA
COMM. #1167828
MMY R)BUC- CALIFORNA
m ORANGE COUNTY,
My CWM W. Jan B, 2002
The undersigned, as Chief Operating Officer of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY, COMPANY OF CALIFORNIA, does
hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked, and furthermore, that the provisions of the resolutions of the respective
Boards of Directors of said corporations set forth in the Power of/Attorney, are in force as of the date of this. Certificate.
This Certificate is executed in the City of Irvine, California, the �h day of
By
David G. Lane, Chief Operating Officer
ID -13 80(11/00)
Personally known to me (or proved to me on -the basis of satisfactory
evidence) to be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they executed.
the same . in his/her/their authorized capacity(ies), and that by
his/her/theirsignature(s) on -the instrument. the person(s), or the
entity upon behalf of which the persons) acted, executed the
instrument.
WITNESS my hand and official seal.
This area for Official Notarial Seal,
M. A..�Current, Notary P c
OPTIONAL
.Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of
its form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT'
❑ Individual "
❑ Corporate Officer Encroachment Permittee Performance and Payment
Bond No. 866630S
Title(s)
❑ Partners
❑ Limited
❑
General,
X Attorney -in -Fact
❑ Trustee(s)
❑ Guardian/Conservator
❑ Other
SIGNER IS REPRESENTING:
NAME OF. PERSON(S) OR ENTIFY(IES) . '
Developers Surety and Indemnity Company
Title of Type of Document
Four
Number of Pages
April 6, 2001
Date of Document
Signer(S) Other Than Named Above
ALL-PURPOSE ACKNOWLEDGEMENT