0520f
+.a i`+A.....-„a--.,...,+-.e.•o"•-.rs,•- rr-�F-•A�•'►.at `,-.-.J-,"^-"^w�.-,s..ar+n..i,..... r-v.�....,...,.y....��.�...�:.� .ter 7
� .a 4.`i?r" � t •: •`'i+”. .t � 4 '•I .-,.gym ...��.
NOTE'.
With proper-validationf % Q
f.� = this form constitutes an
encroachment permit • CITY; OF LA QUINTA
x)'' .APPLICATION. FOR ,PERMIT
RUBLICWORKS; CONSTRUCT.;ION (ENCROACHMENT)
For` the,constructionl of public or, private curbs; .driveways, pavements;,sidewalks; parking lots, -sewers,' Water, inains
and.othe'r•like public, Works improvements'in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
4.
Subdivision Improvement Permit -Class I
DATE: 3/819.0 i J s -IV
Minor ImprovementPermit ermit Clas
LOCATION `OF CONSTRUCTION, JPffersfln .StrePt �' 52nd-AvOn.iugi At riro4isiria' in 141:
-locations
(Streetaddress or. Description of Location)
�_ for; the relocation '. of :'.
,..,. }�
PURPOSE OF CONSTRUCTION Sketch (attach'constructlon plans if appropriate) -
f C. V�W.i% .lr i&atlOn • Main"
7
` 4 DESCRIPTION OF CONSTRUCTION 'pi.oc� tr.Pn-h and., see' attached• CVWD • approved
backfill- AC' xetln' drawings
DIMENSIONDF INSTALLATION OR REMOVAL R x1
�x e����7"'anri rear►lana in� a ,�ra4•,� •1��a�-�^Yi5
? j.
SdZE.OF''E'XGAVATION; IF;NEEDED atirlirmo. 7 feet, deet .ditch
APPROXIMATE TIME WHEN WORK WILL BEGIN
� _ d
i APPROXIMATE TIME OF COMPLETION 71/an ' ,` - ` u l
'EST IMA_TED CONSTRUCTION COST•$
(Includi4removal;'of all obstruction, materials, and debris, backfilling,_ com �.
� ..'paction and'placing permanent resurfacing and/or replacing improvements) •. ,
Incons ideration:of•the granting of: this permit, the applicant hereby' agrees to,
spa Indemnify deferid and save the City, its authorised agents, officers; representatives and employees,'harmless Nom and•against any and ,all'
i penalties; liabilities or loss resulting from ',claims or court action and 'arising out of any accident; loss'.oc damage to. persons 'or, property; r '
r happening. or occurring -as a proximate result of•any,work undertaken under the permit'granted pursuant to this application.z;
Notify' the Administrative Authority at least twenty-four.(24)' hour'sm advance of the -time when -work will•be. started £
.. ;.`
Complywith,all applicable City, Ordinances, the terms and conditions. o_ fn the permit and all applicable rules and'regulations of the City�ofr,
t La Quin and to pay for any additional replacement necessary as dhe result of this work.
L /'Signature)of Applicant or•Agent
fir' .f Landmark ' +and. CA)inx�nay of Calif •Inc; ! Pf3. Boas 000 kE}; Qtafiita 56�-81'70
Name.of Applicant'(please print) Business Ad'dre'ss
, Jones.=Brothers .Construction ,PO Box905- Coachell'CA 92'236+,
r Name of Contractor and Job Foreman Busines's Address r %Telephone No t '
I72092A. i53
�f r'
' Contractor's: License No. City Business License No..
A tna 1
a GL .8605314fi91C�A' S� t,
Applicant's Insurance Company.Policy Number 4t ,.ee
r 4 = FEES: Subdivision Improvement Permit — Class III' s Q05,4, 2 0 7h4f0-16'9f)'kf
Public impr`ovemenf's:,3%ofiestirnated constructioncosts r '+., �;x ° '•
Private improvements: 3% of estimated construction costs
Minor Improvement Perm it=Class IV: See attached schedule N2 0520
,r•
Inspection Fee r - $ 600.00' •' PERMIT VALIDATION
i
Permit Fee 10.00PERMIT NO.. 0520
Penalty
` Cash Deposit -Surety Bond
if required .
TOTAL: $ 610..00 .
Receipt No.
Received by Date
Recorded by
DATE APPROVED 3/15/90
EXPIRATION DATE' W Q/-in/Qn "
DATE ISSUED /15/90
BY,.z��
' Administrative Authority.
TELEPHONE:`('6'191564-2246 -
v,,.;4ltLL..�1..�.'.3..� .,..a..+�W.�,�c+�"},��:i,, ki;;.r-�,.,.: <.�i .�;. •'r�,jw iia sai �..: ,�i' Y'` � ....:.+�.,'..'.-,l,rr„"'��,� +..i:. �.�,t•7o�y:;+-,.ltl:.'vy+is:J kr,t3..fK=� ^ ':fl��'�;,,.i -";,tib'. �•r-'r_
r
rAL,M�..�'l•Imi�f...�ynA:w'".^M uw w m w'ir. w. M r+:�r 4. •r wi.Y..f. wi4 Si.. rl. eo t.,. r r-`1 w► w tl'w ML �F w's N+ s�+..i. w.w -.:.ri .iw":N �f..iw+ 4>..i a..f•-F'wir«, w. e.
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
Subdivision Improvement Permit — Class III
DATE: 318/90 Minor Improvement Permit Class IV .
LOCATION OF CONSTRUCTION Jefferson Street, 52nd Avenue street crossina im (41
locations
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION for the relocation Of Sketch (attach construction plans if appropriate)
C.V.W..D irrigation mama
DESCRIPTION OF CONSTRUCTION pipe trench and see attached CVWDD approved
'backfill AC removal and replace drawings
DIMENSION OF INSTALLATION OR'REMOVALanr)rnm sn ev i n'
Af" romr�va 1 ''anri ,rrar�l ;�rA n ti OnS
SIZE OF EXCAVATION, IF NEEDED aporox. •7 feet deep ditch
APPROXIMATE TIME WHEN WORK WILL BEGIN 'A /1 010 6
APPROXIMATE TIME OF COMPLETION ./Qn
ESTIMATED CONSTRUCTION COST $ 20 - Q00
(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 At 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
Landmark Land Comonav of Calif. Inc.Box 1000. La Qui.nta 564-8170-
Name
64.--8170Name of Applicant (please print) Business Address . Telephone No.
Jones nrothers'Construction PO Box 905 Coachella, CA 92236 .34.7-2291'
Name of Contractor and.Job Foreman Business Address Telephone No. ;
172092A 153
Contractor's License.No. City Business. License No. .
Aetna GL 86C35374691CCA.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III WiEk, 10 2774 01-16-T90 i0
10 CASH i 1061. 1 610.00
Public improvements: 3% of estimated construction costs
` Private improvements: 3% of estimated construction costs
P 0520
Minor Improvement Permit =Class IV: See attached schedule
Inspection'Fee $: 600.00 PERMIT VALIDATION
Permit Fee 10.00
Penalty
Cash Deposit=Surety Bond
if required
TOTAL: $ 610.00
Receipt No:
Received by
Recorded by
Date
PERMIT NO. 0520
DATE APPROVED 3/15/90 K
EXPIRATION DATE 913190
DATE ISSUED %3/15/90
By
�� ' Adm inistrative.Authority
TELEPHONE:/.(/6'19) 564=2246
The following General and Special Provisions are attached to and made a part. of Permit No.�.
+ ^F' '*fi ;fc' CA '"fi i - GENERAL PROVISIONS ,
The following shall always apply:
ENCROACHMENT ON PRIVATE PROPERTY: :This permit authorizes work to be accomplished within City of La Quirita right of ways
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: 4 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 (2") 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'maintain6d for the duration `
of the project: -The City shall be,.notified 24 Hrs. ih,advance of any traffic detours or. delineations. z
r_
CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete pipe, steel culvert and
concrete structures encountered Id uring'excavation which• necessitate removal shall be replaced in kind. In the event.it becomes
necessary to'remove.or c"ut'existing drainage•structures, City of La Quints 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.WAYCLEANUP: Any surplusmaterial 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 afterbackfill 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.. v
DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing water on City of La Quinta roads, it shall be.
-the responsibility of the permittee (contractor) to control this water and to provide off-street barricades when necessary. -
CLOS I_NG STREET S:ANo street shall beiclosed. 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 isfelt bythe permitteethat he must close a street for
any length,of,time,*permittee shall contact this office to obtain the necessary permission..
_44; , - SPECIAL PROVISIONS
The follwing+shall apply ONLY when indicated:
qRP,CASH,
NOTIFICATION: Permittee shall notify the City at 564-2246 at least 48 hours in advance of starting construction.
'K{,; -P •
DEPOSITS OR BONrDS: A cash bond or. an approved surety bond in an amountof 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 _
3! TILITYCLEARANCE:(Substructures) Prior to making any excavation within the City of La Quinta rightof wayauthorized
U by permit„the permittee shall contact all concerned utility companies relative to the location of existing substructures.
'A r>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.
R5PAVEMENT WIDENING: Area between therproposed concrete gutter line a'nd the existing road 'pavement shall be
surfaced with: inches of A.C. paving placed on' inches of class aggregate subbase course
having an "R"viii ue,of not less than y and in conformance with City of La Quinta Road Improvement Standards
• land 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 0'►. �, t
117�- GRADES & STAKES: City of La Quinta shall establish grades and stakes for .the proposed concrete curb and gutter
construction:•
..ORADE CHECKING: City of La Quinta shall check grades upon receipt of plan and profile and/or grades as established by
Ua"li(,ensed°engineer., '
R9, -,,CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( %,feet) shall 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.,.
1310 -DRIVEWAYS, A.C::' Driveways shall be constructed, as, not to alter existing drainage pattern.. Surfacing between the
,�,-,.• property line and the 4xisting road paving shall be 2-1/2 inches of A.C. paving placed on ( ") of class
s; ,rye aggregate base. Driveway construction shall conform to attached drawing.
- . .
R11 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. -
r,
SIGHT. CLEARANCE:'Sight clearance of 600 feet in either direction -shall be assured and maintained.
R13' SOIL STERILIZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall comply with the
ma""nufacturer's',specifications. -
R14 COORDINATE WORK: She proposed'work shall be subordinated to any operation which the State of California or
City of'La'Quinia may conduct in this -area during the period of this permit. Work shall be coordinated With the State or
tf lh';y City of La.Quinta'forces't'o preclude delay or interference with State or City of La Quinta projects.
�15. SURVEY. MONUMENTS: Prior to;excavation,or beginning of construction, all survey monuments which exist on the
&enterline
of all streets'or,propertylznes when involved shall be completely tied out so they may be readily and correctly
r be replaced by a licensed'civil engineer or surveyor at the expense of the permittee. A complete set of notes showing the
" a ties to these monuments shall be furnished to the City Engineer priortothe removal of any monuments. This office shall
L be notified upon cornpletion'of replacement of all survey monuments for proper project clearance.
'i, ir.(4', .u1K�l. ..:+ �..•� :;Y�j. r"aji3*t' ..... •t , r . .
RD -31 W
R16 SURVEY MONUMENTS: Prio excavation or beginning of construction, all s4. —/ monuments shall betied 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.
18 PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations, any damage to
pavement straight edge shall be corrected.
R1 LIMIT OF EXCAVATIONS: Excavations shall be limited to 1,000 lineal feetof opentrench 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 (spongy or
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 not greaterthan
three feet (3') and vibrated using vibrotamper or equivalent equipment. Alternate methods may be substituted, but in any
case a relative compaction of 95 percent shall be attained within the structural section of the roadway.
R22 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 isto be exercised thatthe
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 isthe 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.
R26 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 repairto
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 sectionswhich can be handled safelywithout 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 500feet 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.
'
'ADDITION ---ENCROACHMEN.T. PERMIT.NO.`0: -----CONDITIONS ".
Y, R33
Survey -monuments;:. shall...be protected,' in. place:.or ..�
re-established pursuant ,to 'City standards and the. State of:.,
California•..Land• Surveyor's,.Act: `
R34
Work ,shall be coordinated-,with City, of. La Quinta's .
•
:the
forces to. preclude delay or-interference with. the City- of:'La
`
Quinta' s ects :.. s.
,pro.j
R35,-.
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 1st to-.April 30:- Monday-Friday 7:`00a.m.-5:30pm.:'
' Saturday 8:00a.m.-5:00p.m..
May; lst'to September 30: Monday-Friday 6:00a.m.-7:OOp:m..
Saturday. 8::00a.m. -5: OOp'.m..
Work shall be. prohibited anytime. on Sunday and Federal
'
holiday.
R36
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. A Traffic control plan shall
be submitted, for approval by the City Engineer'.
'R37
All excavation atl•or near.the travel way shall be backfilled-•
at. the end • of the work •day, for the protection .of .the
traveling public. L
R38
Street closures shall not bec"allowed,at any time.
R39'
A minimum of one travel lane shallbemaintained at all = ,
times with'flagmen�during working•hours., ,
R40
. All work to be,performed within the existing paved 'section
shall_be..temporary paved and maintained by the Permittee,
'
permanent pavement shall be placed'no later than 15 days
-after-completion of the temporaiy`road repair. ;
R41
Ingress„and egress for local properties shall be maintained'
'
at all• .times .
•R4'2'
Prior. to work starting, Underground Service Alert shall be
contacted.at 1-800-422-41.33 acid an."inquiry number" shall '•be
provided 'to the �Ci.ty Public. Works Inspector.'
R43°Pavement
shall be sawcut prior. to removal..
R44
All•backfill subgrade soil shall be compacted,to nothing
less than 90% relative dry density; all'.backfill soil within.
the .top 21' of. finish pavement surface-shall be compacted to
•
nothing= less than 95%, relative dry density, , all. base_.
material shall be compacted to nothing less than`95%-' ,
relative'dry.density.
R45
Replacement. pavement sections-,shall be. 4” AC over 1011 Class,
II, aggregate base. '' �'
VOUCHER INVOICE PURCHASE"' INVOICE ti
NUMBER'.. NUMBER ORDER DATE AMOUNT DISCOUNT NET AMOUNT
84609 71301,. 03/15/90 $616.00 $610:00
LANDMARK AND SUBSIDIARIES DETACH AND RETAIN THIS STATEMENT r w
LA OUINTA, CALIFORNIA" THE ATTACHED CHECK IS IN PAYMENT OF ITEMS DESCRIBED ABOVE. '
IF NOT CORRECT PLEASE NOTIFY US PROMPTLY. NO RECEIPT DESIRED.
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR 'PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)-
. - �OA'I718�re`i
For the construction of public or private curbs; driveways, pavements, sidewalks, parking lots, sewers;water mains
and other bike public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit— Class III
DATE: ra 0 ' Minor Improvement Permit Class IV
LOCATION OF ONSTRUCTION
M r % rosSi 106-5
(Street address or Descr on of Location) j t
'7 f -t'1.. ` CG Of
PUR OSE OF CONSTRUCTION , �L pel Sketch (attach construct ion'plans if appropriate)
D
DESCRIPTIQN OF CONSTRUCTION
.l ""� ("` �. l A I -
DIMENSION OF INSTALLATION OR REMOVAL t
,50`X t Q AC ce._rr. o v sc a -LA r-�� 1 c� ��f C:J�
Ll
a/� 14SP r I G c_ t,S .
SIZE OF EXCAVATION, IF NE �D
'
a
APPROXIMATE TIME WHEN WORK WILL BEGIN Q
0
APPROXIMATE TIME OF COMPLETION
00
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: r
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 ordamage o_per{ons or property
happening or occurring as a proximate result oCany work undertaken under the permit granted pursuant to s applica{ion.
Notify the Administrative -Authority at least twenty-four (24) hours in advance of the time wh n rk wi be starte /
Comply with all applicable City Ordinances, the terms and conditions of the permit and f�ppli e I s and regu tions t e ,ty
La Quinta and to pay for any additional replacement necessary as the result of this w rk. y
Signature of Applicant or Agent
Name of Applicant (please print) Business Address Telephone No. '
Name of Contractor and Job Foreman r Business Address ele-phone No.
• / ��
Contractor's License No. '• ty Business License No.
`7 -fly 7Z- 37`10 CCA
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3`Yo of estimated construction costs,
Private improvements: 3% of estimated construction costs NO ,
Minor Improvement Permit —Class IV: See attached schedule l�!
Inspection Fee S `��� u I PERMIT VALIDATION ,
Permit Fee- 110 PERMIT NO. '
Penalty r ', DATE APPROVED
Cash Deposit -Surety Bond ,
if required EXPIRATION DATE
TOTAL: $ � �i-"`" - i '
DATE ISSUED
Receipt No. ,
By
Received by . Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246