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0588A NOTE: + With proper validation this form constitutes an f' encroachment permit t �J 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 III X DATE: April it, 1990 Minor Improvement Permit Class IV TR 25500-2 PGA West Madison Street LOCATION OF CONSTRUCTION (Street address or Description of Location) water/sewer construction PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) „y DESCRIPTION OF CONSTRUCTION wa#Pr A npwtsr . { ira� al l at inn nrrtiesst#Marx Maki �c�n �t.rRPt see attached plans • .,.,,,.�lv''..'". • -. .• ." - 1, ' DIMENSION OF INSTALLATION OR REMOVALRPIJPr — 70 fPPt j araaar _- l nn fmot SIZE OF EXCAVATION-, IF NEEDED + `f APPROXIMATE TIME WHEN WORK WILL BEGIN 51/90 APPROXIMATE TIME OF COMPLETION a wPPk " ` ESTIMATED CONSTRUCTION COST $ t a•. (Including removal of all obstruction, materials, and debris, backfilling, com- + �paction and placing^permanentresurfacing 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 penelties,-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 Authorityatleast 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 a` P Signature of Applicant or enL r " National Mortgage & Land Co 42-600 Cook St.,. Ste. 200 -Palm Desert, CA 92260 Name of Applicant (please print) Business Address % ,-� Telephone No. same Name of Contractor and Job Foreman Business Address Telephone No. 288130 328 ,. Contractor's. License No. City Business License No: Aetna, General Liability 083ACM5726732;•Workmen's Comp CKO-06973CSA, Applicant's Insurance Company Policy Number r - 1 FEES: Subdivision Improvement Permit — Class III ' Public improvements: 3% of estimated construction costs 1 Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ 210.00 II Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ 210.00 ' Receipt No. 005182 10,3486 04-13-90 Received by gDe Date -4/13/90 Recorded by N° 0588 PERMIT VALIDATION PERMIT NO. n�stst' DATE APPROVED 4118/90 EXPIRATION DATE 12/31/90 DATE ISSUE -DDD 4118/90 By Administrative Authority TELEPHONE: (619) 564-2246 NOTE: " Withxproper'val idation 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 111• X DATE: April .18 ,. 199 0 . Minor Improvement Permit Class IV. TR 25500-2 PGA'Wost Madison Streets LOCATION OF CONSTRUCTION (Street address or Description of Location) water/sewer construction , PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION water & `sewer fi •i ngtA1 l af-i nnrn-gag.i ncr Madignn Street see attached plans, DIMENSION OF INSTALLATION OR REMOVALRewer — 70 feet top+ -Or -• ion fae+ ` SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 5/l/90, APPROXIMATE TIME OF COMPLETION 1 week 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 of Applicant or Agent 5 National Mortgage & Land Co 42-600:Cook St., Ste. 2d Palm Desert, CA 92260 . Name ofApplicant (please print). Business Address Telephone No... same Name of Contractor and Job Foreman Business Address Telephone No. 288130 328 Contractor's License No. City Business License No. .Aetna, General Liability 083ACM5726732;.Workmen's Comp CK006873CSA Applicant's Insurance CompanyPoli'cy.Number FEES: Subdivision' Improvement Permit — Class I II Public improvements: 3% of estimated construction, costs Private improvements: 3% of estimated construction costs T Minor Improvement Permit — Class IV: See attached schedule 210.00 Inspection Fee $ I PERMIT'VALIDATION Permit Fee Penalty. .Cash Deposit -Surety Bond if required TOTAL: $ 210.00 Receipt No. 005182 10 3486 04-13..-90 Received by est Date 4/13/90 Recorded by i PERMIT NO. n588 DATE APPROVED 4/18/90 EXPIRATION DATE 12/31/90 w DATE ISSUED By Administrative Authority TELEPHONE: (619) 564-2246 t • Theing General and Special Provisions are attached to and man of Permit No.. 3 r GENERAL PROVISIONS t r _ The following shall always apply: T A' - 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 (21 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 rightof 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 Quinta 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: R i OTIFICATION: 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) Prior to making any excavation within the City of La Quinta right of way 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. QR4TILITY CLEARANCE: (Surface structures) No work shallbe done under this permit until all utilities ere clear of the roposed 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 Quinta 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 (11. R7 GRADES & STAKES: City of La Quinta shall establish grades and stakes for the proposed concrete curb and gutter construction. + CRRADE CHECKING: City of La Quinta shall check grades upon receipt of plan and profile and/or grades as established by a lirensed engineer. R9 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( fee0shall be . a 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 fo 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 j aggregate base. Driveway construction shall conform to attached drawing. R11 CULVERTS:A inch diameter( )culvert shall beinstalledwiththe invenapproximately 1-l/2 inches below and in line with the existing flow line. Culvert installation shall conform to the attached drawing. R12 IGHT CLEARANCE: Sight clearance of 600 feet in either direction shall be assured and maintained. -A13 SOIL STERILIZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall comply with the manufacturer's specifications.. 4 f R14 COORDINATE WORK:•The proposed work shall be subordinated to any operation which the State of California.or ( �Icity 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 of interference with State or City of La Quinta projects. SURVEY 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 andcorrectly 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 tothe removal of any monuments. This office shall be notified upon completion of replacement of all survey monuments for proper project clearance. RD -31 - R16 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments shall be tied out by City a, of La Quinta and suitable payment or guarantee of payme all be made as reimbursement for all work involved. ` PAVEMENT CUTTING: Pavement will be mechanically cut Wraight edge prior to excavatir 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. R1 B 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 feetof 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 brish, rootsor other organic substance detrimental to its use for purposes 1 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 not greaterthan = three feet 13') 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. R22ACKFILL 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') liftswhere 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 isthe greater compaction. Where ponding or flooding is used for 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. R21 COMPACTION TESTS: If so required bythe inspector. compaction tests shall be made at intervals of not more than 1,00 . 0 .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 andfiled prior to making permanent repairs. Compaction tests shall be made asoutlined in Section 6.3.01 of the "Standard Specifications, Division of Highways, State of California, dated January 1973. �V R24 gOMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line. / ne (I I 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. r,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 temporarypaving shall be placed after a maximum of 3,0001ineal feet of trench has been excavated and backfill operations completed. but in no case shall •he placement of the temporary pavement exceed a five (5) day limit. ' R26 ERMANENT 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 later than days after completion of temporary road repair. /J R27 PAVEMENT REPAIR :F.A.S.: Upon compfetibnofbackfilandcompaction.atemporary patch consisting oftwo inches (2'1 of cold mix paving (SC -800) shall be placed immediately. A permanent patch of three inches (31 of A.C. surfacing shall be placed on six inches (6") concrete base as directed, but not later than fifteen It 5) 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. i 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. , R291 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 tobe excavated, such stripingshall 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 tothe 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 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. r 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 Dermit. r, 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 pronerty owners shall be contacted, in all instances, prior to trimming or topping trees. I. Pruning sh,,;i, 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. r ...,_ . _-, -, „ �-: :...�::cA•:'....-i�.ws;�,.,;., _.K,_, .,.;.,2-.<- - r hn F ,'ay,ya,�-�c..,.. i .y.::>�• - --H++�., Y.y ,�., ..:.;. - Y' ADDITION----ENCROACHMENT PERMIT;N0.0588s---CONDITIONS G ' R33 k Survey ,monum*s', .sha'11" be • protected in. place -or. E ' re-established pursuant to City standards'and the State of California Land•Surveyor's Act:-'r" R34 Work shall be coordinated with the,City,.of La-Quinta's f forces to preclude delay or,interference with•the City of La Quintal s.r projects . t 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:lst.to April 30:' .Monday=Friday 7:00a:m.-5:30p.m.V- ' Saturday ;''' 8:60a.m.-5:00p.m. ,May lst.to.Septembei.•30:; Monday:-Friday 6:,00a.m.-7:00p.m. aSaturday '8: 0a.m. -5: 00p.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 to `adjust to actual 'field conditions. It _order, shall.1be 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 at'or near,the travel.way'•,shall•-be backfilled at the end of the,work'dag, for'the protection of the -traveling public. -� R38 Street closures shall not Fbe�allowed at any time. R39 A minimum of one•travel lane.'shall_'be�maintained at'all r 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-temporary road:trep4ir. R41 Ingress'and'egress for,-local-,properties shall be maintained at all times. R42, Prior. to work ,startin4,^_Underground' Service Alert shall be ' contacted at 1-800-•422-4133 and an "inquiry number". shall be provided to the City:Public'Works Inspector. ; R43'_ Pavement shall be sawcut prior to.removal. ya ..y n ' ,• - , . ... �a�.' -�, '�,: tom♦ national moQ'tcacEY& lana company; Aim ~ J „• * .:r r j her �4'� _j'�•. ,- April "-13; 1990 r. ,•, Mr. Frank Reynolds City Engineer >' City of -La Quinta, ' •7 78-105 Calle,LEstado` y . La Qiiinta , . CA ., 92 2 53 Ij RE: ENCROACHMENT/INSPECTION FEES,•FOR -SEWER- AND 41ATER 'CONSTRUCTION?1: IN MADISON STREET - TRACT NO. 25500-2 -Dear Mr,. Reynolds: 9: ., , ' y Enclosed. is a check in the- -amount -,of $210.00 for the ~~ } encroachment/inspection fees for.the above` referenced tract._} The fee amount is . based upon ' an, hourly inspection rate } of ttr�,.$40.00/hr.. A five (5) day construction period is.a'nticipated•with•: ". one (1) hour ,per sday allocated for construction inspection'. A'' - °,x,� $10.00 ,perm'it fee- has ,also been included.. r After the plans have been signed,,: we will provide your office with +Ff 4 Ythree (3)•sets of approved plans for your use.. ' V'4'`Sincerel y , s 5IOW.AL MO AGE & LAND COMPANY '-Allan Levin :Vice; President, Engineering _N _/sl ,. t •, Enclosures {' ` cc:, David S : Snow - Sunrise Company-.., k . J Van y` � i a • + ` •: .�' , c ' , tires .,rY Y js.� - •. •` . .. •^ M 3ru -'7 ? •. 42-600 COOK STREET, SUITE 200, PALM.DESERT, CALIFORNIA 92260 • (619)568-2828 , 7C8 PGA WEST C00-0:5`1' N '4/1.2/9C 101835 101 g= ®ATE INVOICEA : WSS NET 4/11/90' CKoRC.6805 - 210.00 21C.0C 486 04-13-90 10 ` vt � i T AL i 210.00 wT TCTAL iG.CG DETACH AND RETAIN THIS STATEMENT THE ATTACHED CHECK 15 IN PAYMENT OF. ITEMS DESCRIBED BELOW IF NOT CORRECT PLEASE NOTIFY US PROMPTLY NO RECEIPT DESIRED - SECURITY PACIFIC NATIONAL BANK 0� ��� HEADQUARTERS OFFICE SUNRISE COMP ANY 333 S. HOPE ST- 16-4 I PGA 'WESTLOS ANGELES. CA 90071 1220 CHECK NO. 42-640' COM '-STaipSUITE, 200 101839 PALM DESERT CA 92260 e, e 4/12/9C g*******21C*DOLLARS AIDC*CO*CENTS210.00 i PAY TO THE ORDER OF CITY, OF LA QUINTA II' 10 183911' 1: 1 2 200001, 31:00 11118 16494u' NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit f ' APPLICATION FOR PERMIT rEB a 'PUBLIC WORKS CONSTRUCTION '(ENCROACHMENT) �- For the construction of public oi -private curbs;` driveways,- pavements,' sidewalks; -parking 16ts,' sewers, water-main`s and, other like -public works improvements in -connection with MINOR IMPROVEMENTS and'APPROVED SUBDIVISIONS -Subdivision Improvement Permit`— Class III DATE: .4-11=90 Minor Improvement Permit Class IV - - - •'- . LOCATION OF CONSTRUC710N;�'' PGA -WEST` Tract :25500' 2 - - .Madison Street t. (Street address or Description of Location) -PURPOSE OF CONSTRUCTION. Water/sewer" construction ',Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION Waver & .sewer See attached plans K installations cross n'c Madison -Street —-ft.,, ' DIMENSION OF INSTALLATION OR,REMOVAL sewer 70 -ft. • • - - ' water_ SIZE'OF EXCAVATION, IF NEEDED ' 5-1-90 APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION'S -1 week ESTIMATED CONSTRUCTION COST; $ _ Y (Including removal of all obstruction,`materials,,and debris, backfilling; cwm• pagoon and placing permanent resurfacing and/or.. replacing improvements).- - In consideration of the grantingof this permit,,, the - applicant hereby agrees to: �` x�"'`• _ Indemnify; -defend and sew the. City, its, authorized'agems, officers,, representatives and employees, harmless from and against arty 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 Administratwe Authority at,least twenty-four (24) hours in advance of the time when work will be started., Comply with all applicaMe City Ordinances, thi terms and conditions of the permit and all applicable ruies•and regulations of the City.of , i . La Quints and to pay for any 'additional replaoament necessary as the result of this work. ` • ' Signature of.Applicant or Agent ` National Mortaaae &`-Land Co.,'42-600 Cook St., Ste:4200. Palm`Desert, CA 9226C Name of Applicant (please print)' Business Address Telephone No.' SAME Name'of Contractor and Job Fo eman ti • Business Address Telephone No. 288130 32'8 n .r Contractor's -License No. City Business License No. -Aetna, General Liability 083ACM5726732-;•Workmen''s Comp. CK006873CSA 'Applicant's Insurance Company i.` - Policy Number 'FEES: Subdivision Improvement Permit-- Class II I ' Public improvements: 3% of estimated construction costs t - -Private improvements: 3% of estimated construction costs t Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ y PERMIT VALIDATION 'Permit Fee PERMITNO. Penalty:' r{ r t i A t Cash Deposit -Surety Bond,- DATE APPROVED' if required • . EXPIRATION DATE TOTAL: $ - DATE ISSUED - Receipt No: _ By Received by " Date :Administrative Authority Recorded by 1 TELEPHONE: (6191564-2246 ' .F .