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0756��{���ji'FXr.'��'f°"'�"i�'V" o+' ���)� s,��,1, t'�" �',i7�►"c�. '��3`,..*��'�+1� M-•.�''��yH�8cp�,��.hl�'�.I'�4y;1�°w�:'/•�v.L"S�'���-•tif°Mii�:�+(`y�'"y�ti�j d%Li•"L�'�a'iY:F'6���'Wt'1,[ST'"rs-�'►'s�-wri,.��., � �, - ., .-"a+�Myt?,ww. ... �r��f.1.:• ;.J+..-r"ri°w �...: w�'r.i"r r'vw.wr �r �a.�i.' �-.,,w ew�4 •r.r.+...:..wY .�►.w11�.�in••r .-rs r. �..tw".�.:.• 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 III DATE: July 25. 1990 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Calle Barcelona, permit 0728, Av&nida Juarez permit 537, Avenida Carranza and Calle Sinaloa -permit 669, Calieo Circle, Blazing (Street address or Description of Location) . Trail permit 531 PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) strpat- rtmnai rs for aas romnanv DESCRIPTION OF CONSTRUCTION rehamr notholPs 4 ` DIMENSION OF INSTALLATION OR REMOVAL -2301. 64 SIZE OF EXCAVATION, IF NEEDED r APPROXIMATE TIME WHEN WORK WILL BEGIN 7726T96 APPROXIMATE TIME OF COMPLETION R 110/90 ESTIMATED CONSTRUCTION COST $ R00n00 (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. . ignature of Applicant or Agent sun it Paving Co. PO Box 9590'Palm Springs, CA 325-2112 Name of Applicant (please print) Business Address Telephone No., Dario Ouintero Name of Contractor and Job Foreman Business Address Telephone No. 415605 A 804 Contractor's License No. City Business License No. Golden Eagle Ins. Co CCPO 98027 Applicant's Insurance Company 'Policy Number FEES: Subdivision Improvement Permit — Class 111 3 days @$ 40.00 Public improvements: 3% of estimated construction costs 0051820 6054 07-25=90 10 Private improvements: 3% of estimated construction costs 10 : CA H 1 TOTAL 1 12040 Minor Improvement Permit — Class IV: See attached schedule Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ 120.00 Receipt No Received by Recorded by Date N° 0756 PERMIT VALIDATION PERMIT NO. 0756 DATE APPROVED '7/25/90 EXPIRATION DATE 12/31/9'0 DATE ISSUED / 7/25/90 Y Administrative Authority TELEPHONE: (619) 564-2246 �.- • �. ._ '^'h 0•.�. W -Fi. �r i+rr �•'...+•.+. w � Yr .0 w• p o.► s�•sr'-ar' w :r. -.r eY'�s w �q.- W aw NOTE: 0( 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 II I DATE: July 25. 1590 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Calle Barcelona, permit 0728, Av&nida Juarez permit 537, Avenida Carranza and Calle Sinaloa permit 669, Calieo Circle, Blazing (Street address or Description of Location) Trail permit 531 PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) streFt repairs for aas comnanv DESCRIPTION OF CONSTRUCTION rehamr potholes - DIMENSION OF INSTALLATION OR REMOVAL 2304 • 64 a.35t 13:5 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 7/26/90 APPROXIMATE TIME OF COMPLETION 8/10/90 ESTIMATED CONSTRUCTION COST $ R00000 (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 Sunair paving Co. PO Box 9590 Palm Springs, CA 325-2112 Name of Applicant (please print) Business Address Telephone No. Dario Quintero Name of Contractor and Job Foreman Business Address Telephone No. 415605 A 804 Contractor's License No. City Business License No. Golden Eaale Ins. Co CCPO 98021 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class 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 $ 120.00 Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. '$ 120.00 Received by Date 3 days @$ 40,00 p 00510 A H 1 D OTAL -�i S O120.00 Q 44- 0756 PERMIT VALIDATION 0756 PERMIT NO, DATE APPROVED 7/25/90 EXPIRATION DATE 12/31/90 DATE ISSUED.// 7/25/90 Byi s Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 ADDITION, --- FNCROACHMENT,PERMIT NO.0756-----CONDITI6NS, R3�3• Survey,,monumen• sYia11 •be_ protected�;iii pla•.;or.'. re -established --.pursuant to City,standards-and-.,the,.-State -,of,,' La.nd. St-. i_rvey_ or' s`; . _ �. ..r . Calif`ornia. . ,A= cts _. �• ,''. . . - . �.La R34 h• e. Cis t-y,o� f ,• Work sha11.be.::coordinated"with-t Quintal s ; ` forces. to preclude. delay 'or.., the City of � La; Quinta l s�' projects . :. • t .. R35 'Contractor shal-l'.comply.with the local noise: ordinance. and. i construction.operations..-and maintenance of equipment within,. P .,• one half mile . of - human, occupancy shall be a .performed -only'•, ., , = r during • the time ,-periods `as. f ollows : October 1st -to April 30: Monday�Friday.`7:O,Oa.m.-5:30p.m: ry . Saturday °;' 8:00a.m.-.5:00p.m: - yMay 1st to` September 30'...'' -Monday -Friday '6:00a.m.-.-7:00p.m. ". ' , { Saturday :-8:00a.m:-5':00p:m. ` Work.'shall, be*: prohibited anytime on Sunday -and Federal,',* '. holiday. R36 Traff.ic control"'shall• 'be',as per Cal 'Trans.. Traffic ManuaYt. -' • t Field'" adjustments in detouring. shall.be. accomplished' as. `, y, ` directed in.order.to adjust'to,..actual.field conditions._` It. shall . be. the .cont'ractor's responsibility to. adequately barricade' and,detour" this'. site. A Traffic.control :plan shall • ! -be submitted..for approval by the. City Engineer. �. - ... .r R37 .21 J ' All 'excavation at ori near..,the travel way 'shall. be -backfilled.. ' at^`the end. of the. work'.da ,," for the protection of ; the traveling- public.- :. R38 ''.- ,Street closures`" shall not be allowed -at any, time. R39 A, -minimum, of -.one .travel. lane shall .be •maintained --,at .a114 ' '`• times, with flagmen during -working, hours,- ours -RA 0, ^R40, All workh to be-'per+formdd within .the. existing_'.paved .section shall bte t temporary' paved and maintained'rby the -Permittee;,, . permanent 'pavement' shall .be •placed no' later than -l5 days ' after- completion_':of the temporary road repair.. ' R41 ,Ingress, and egress "for' local,properties shall•. be maintained. 'c at . aTl :times R42... Prior , to, work. ­'starting,, Underground' Service Alert shall be,,, - contacted at, 1-800-422-4133,:and an; 11inquiry,�number" 'shall be ' provided': tol the City .Public -'Works ' Inspector,: - R43 • 'Pavement`, shall. be sawcut- prior to -r.emoval . 41. - i •_ • rte + • . .. ! • yr` Additional Conditions' Encr.oachment'. Permi' No. 0.756• t Page_ 2 ? . r $ w, r : R44 All�.Ibackfill. subgrade.'soil' shall be. compacted^to:`notii ng' les's than- 90%`_ relative dry" dens ity; a1.1 backfill. soil within•- � the' top�,2' ; of finish pavement surf ace,;sliall.-be,`compacted-.to, ' .• -nothing 'less 'than `:95� relative dry dens ty, base' " material; shall` be compacted 'to nothing ,all fess` than `95_% .relative ,dry 'density: +,z R45 Replacement pavement ,sections:. shall:. be �3 11;`AC`•over �4" Classy aggregate, `base ^ or. , . 1"' more than;''`- existing thickness _ whichever is greater'. ti. R+ r . -r. a 1 . a ` j a `. r y,a • 4 i..t . F . • ♦F S • .. F • 41 , . ®. c , ••, . 'r � to ,- ~ .,,a .. a • .• • s s -,{ .. , The following General and Special Provisions are attached to and made a part.of Permit No. } ' p r • _ 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 ., S 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 ' }r pavement is scarred, spelled; 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 beiresurfaced 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. ° i PROTECTION OF TRAFFIC All excavations and work areas shall be properly lighted and barricaded as deemed necessary by City Engineer or La Quinta City Public Works Inspe&ors. Suitable detours and detour signs shall be placed and maintained for the duration :If 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 f concrete structures encountered during excavation -which. necessitate removal shall be replaced in kind. In the event:itbecomes o rs• , necessary to remove°or cut existing drainage structures, City of La Quinta shall be notified prior to commencementofthis 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 bebroomed 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 t -prior, to paving: Water tanker shall be used, as required, -to sprinkle the job site to keep down dust conditions and shall be used F immediately after backfill. > + r . 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 isfelt bythe permitteethat he must close a streetfor, r any length of time, permittee shall contact this office to obtain the necessary permission. ' —SPECIAL: PROVISIONS The follwing shall apply ONLY when indicated: • -� y 4 R1 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 S • 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 t ,. • posted prior to commencement of any work on this project . ZR 3) UTILITYCLEARANCE: (Substructures)_ Prior to making any excavation within the City of LaQuinta 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 thesole responsibility of the permittee. R4 ILITY CLEARANCE: structures) No work shall be done under this permit until all utilities are 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. havingan'.'R"value ofnot 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 curbshall be gradedto a slope of .1 /4 inch to one foot (11. i 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 LaQuintashall check gradesuponreceiptofplan and profileand/or grades as established by ' a licensed engineer. i R9 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter I. feet)shall be ti 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 baser Driveway construction shall conform to attached drawing. R11 CULVERTS:A inch diameter( )culvert shall be installed with the invertapproximately1-1/2 inches below and in line with the existing flow line. Culvert installation shall conform to the attached drawing. R1 IGHT CLEARANCE: Sight clearance of 600 feet in either direction shall be"assured and maintained. y R13 SOIL STERILIZER:_ The area to be surfaced shall be Treated with soil sterilizer. Rate of application shall comply with the M % manufacturer's specifications. R14 C ORDINATE WORK: The proposed work shall be subordinated to any operation which the State of California or ty 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. ' * R151'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 to the removal of any monuments. This office shall" be notified upon completion of replacement of all survey monuments for proper project clearance. Rf1_Q1 R16 VEY MONUMENTS: Prior to excavation or beginning of a ction, all survey monuments shall be tied out by City _j Quinta and suitable payment or guarantee of paymen...._I 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 pavemen! 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 shell 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. LIMIT OF EXCAVATIONS: Excavations shall be limited to 1,000 lineal feet of open trench before backfill operations must egin. 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 0aterial is actually on the work site. R20 ACKFILL MATERIAL: Backfill shall be free of brush, roots or otherorganic substance detrimentalto its use for purposes f 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 notgreaterthan 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. abackfil 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 offive-foot (5') liftswhere trenches are of excessive depths. Care isto be exercised thatthel 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 intervalsof 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 alifornia, dated January 1973. R25 TE PORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporary patch nsisting 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 he placement of the temporary pavement exceed a five (5) day limit. R26 E RMANENTT PAVEMENT REPAIR: After backfill and compaction operations have been completed, a temporary patch onsisting of two inches (2") of SC-800 shall be placed immediately. A permanent patch of inches A.C. surfacing placed on a inch class bay shall be placed no later than days after completion of temporary road repair. 1 l Ua (��/� t iS R27 PAVEMENT REPAIR: F.A.S.: Upon completion of back, ilI 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 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. 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 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 thefollowing 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 tothe 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. �i - 'a f 71,1�4n-M,�` - �"4 . __tY q, � . ,�: t" � 7, 4 q - - - - - --- - - - - ---- --------- NOTE:. -With. proper validation, thi0orm constitutes an LA�,QUINTA encroa6h CITY: OF ment permit -APPLICATI= FOR.PERMIT�` Z % PUBLIC� WORKS,' CONSTRUCTIOW, (ENCROACHMENT) j. % 4 For the. construction of IiUblic, or': private, curbs'-' driveways, 'pavern�ents;, sidewalks, parking -lots, sewers, wiiter: mains, and-oth er lik . e public Works improve ments in.conn�ction with -MINOR IMPROVEMENT . S and APPROVED-SUBDIVI-16NS.- S w 4L Subdivision Improvement Permit,-. Class,111'. DATE% 0 Minor Improvement Permit Class IV, t 6,6-37 LOCXTION,OF CONSTRUCTION - 40 (Street address or-Descripti(g of, Location V 7 77, _y PURPOSE OF CONSTRI &ION' Sketch (attach construction plans if appro0riat0i' DESCRIPTION OF-CONSTAUdTION 0 g DIMENSION OF INSTA�LATIO 0 VAL SIZE OF EXCAVATIONJF NEEDED -APPROXIMATE TIME WHEN WORK WILL'BEGIN % APPROXIMATE TIME OF COMPLETION -ESTIMATED CONSTRUCTION CIDST$ J (including removal of, al I obstr . uction,'rriaterials, and -debris, backfilling, 6om- pactior� and placi-ng'permanent! resurfacing. and/.or replacing.improvements), I n consideration ofithe granting,of this'permit, the applicant hereby agrees to: Indemnify, -defend and save thi City,Jts authorized, agents,, officers, representatives and employees, harmless from and against'any and all'. - penalties, liabilities �r loss resultingJrom claims or court - action and arising.out-of any. acci�ent, loss,or damage to pei�ons or.property" happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Notify th . e.Administrative I Authority at least twenty -fou r 1 '(24) hours in advance of-th,e.time when,work,will be started.. Comply with all- applicable City Ordinances, the terms and'condi,tions of the permit and'all applicable iules and regulations of the.City.of' La Quinta"and to pay for any additionil re�lacement, necessary as the result of this.�York. S,ignature,of Applicant or.,Agent,- Name of Applicant (please print) BL�sineis Address I- Telephone No. Na -me of Contractor,and Job Forem' an �Business Address -Telephone No: Contractor's License No. City Business License No. *(fe P 0, Applicant's lnsuran�e Company-. s Policy Nu - mber T FEES: Subdivision Improvement Permit'—,Class III, i mprovements: j% of esii��t�d construction cost Public i s� Private improvements: 3% of estimated constru ction costs Minor Improvement Peimit — Class IV: See attac�ed schedule Inspectio6 Fee $ -PERMIT VALIDATION Permit'Fee. PERMIT,NO. Penalty Cash Deposit -Surety Bond DATE APPROVED if required EXPIRATION DATE TOTAL: $ 4 DATE ISSUED' 'Aeceipt No. B y Administrati�i Authority, Received by. Date Rec�ordecl by TELEPHONE:, (619) 564-2246, 7 41.