0874Arima'+-":r.Y,y73IIi ✓'.a:K:.,/•�+",♦,'y� ...� }�7 'i'�!y'' ' �'@�. :d'.- . ry...: �' �'E+:-.!r^Y'• '"'�;. ; L.' ..:.�.ti� ,yr , .� . — .�.5 w, , k'
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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)
W4 549-71803-I r'
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: Octnher_ 1,9 1990 _ Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Miles Ave. w/o Adams, TR 23268
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
service to tract
DESCRIPTION OF CONST RUCTIONP ace 4-4" 00 riff—M1< t
:ie,rncG M; 1ps . concrete nad and 1-4 - cond .on
Sketch (attach construction plans if appropriate)
see attached drawing
.DIMENSION OF INSTALLATION OR REMOVAL WO 549-71803=I
SIZ&OF EXCAVATION,•IF NEEDED
r
APPROXIMATE TIME WHEN WORK WILL BEGIN 12/1/90
APPROXIMATE TIME OF COMPLETION 2/1/91
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:
�lridemnify, 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
GTE California 83-793 Dr..Carreon Blvd., Indio, CA 92201 342/0535
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. ;f City Business License No.
, F
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I y -
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs }�T
`Minor Improvement Permit — Class IV: See attached schedule N2 ' " 0874
Inspection Fee $ -0 II PERMIT VALIDATION
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ -0-
Receipt No.
Received by Date
Recorded by
PERMIT NO. 0.8 7.4
DATE APPROVED . 10/19/90
EXPIRATION DATE 3/31190
DATE ISSUED 10/19/9-0 4
By
Administrative Authority
TELEPHONE: (619) 564-2246•
. �<3�s,E'�e. °Ft^�'�i!"V3a<xn+s:ti..+ w wr 1+.- «..+i+.L�.�... r... r. w►tti '...r rs a.. r .r r � w. w .0 e+ .m .r' �. �r s.. r:... w Yo r:. �. w. r w.. �.... +.."... � "r .� a....
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
-APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
WO 549-71803-I
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: Octoher. 19 � 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Miles Ave. w/o Adams, TR 23268
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 5ervice to tract
DESCRIPTION OF CONSTRUCTIONplace 4-4" COInCtUttt
across Miles. concrete pad and 1-0 cond on
the NIS of Miles see attached drawing
DIMENSION OF INSTALLATION OR REMOVAL
Sketch (attach construction plans if appropriate)
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 12/1/90
APPROXIMATE TIME OF COMPLETION 2/1/91
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:
see attached drawing
WO 549-71803-1
Jndemnify,•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 -`r
GTE California 83-793 Dr. Carreon Blvd., Indio, CA 92201 342/0535
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 II 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 $ '0— II
Permit Fee
Penalty
Cash Deposit -Surety Bond
- if required
TOTAL: $_ ' 0'
Receipt No. '
Received by Date
N!2 , Og74
PERMIT VALIDATION
PERMIT NO. 0874
DATE APPROVED 10/19/90
EXPIRATION DATE 3/31/90
DATE ISSUE /1.0/19/90
By Jam' 7
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
Yl ¢,«'
F'EFihIIT 'NO'd 'i_;874
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tNOT ICE OF WORk OFiDESTART:
WORK' ON PERMIT. NO 0814 , 'WASE JUST
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AT ADDRESS: M T LES ..WIO ADAMS:
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APR 04 1991-
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���I� �OR�
PERM I T: iV0 o i 874
-,WORK -ORDER." 549 -7,1'80
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:WORK',--'ON :PERM I T' NO. Oe74'
HAS ` LEEN COMPLETED` 0/0 1 / 91 i
Af ADDRESS:- MILES-.-- W/ O ADAMS
PERMITTEE REF'RE`;ENTAT I VE �;_ GTE :CAL I FO�iN I A T
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The following'General and Special Provisions are attached to and made apart of,Permit No. 0 U 7
ti GENERAL PROVISIONS
The following shall always apply: -., •s `
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"mustbe secured by the permittee prior to starting work.
, +.
TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated tracklaying construction equipment shall not be permitted to operate on any
ef a
ci :4K p
paved surface unlessfittedwithsmooth-faced street pads. All mechanical outriggers shall befittedwithrubber street shoestoprotect
the paving during excavations. Rubber -tired equipment'only shall be used in backfill operations in paved, areas. If the existing .
pavement is scarred. spatted, 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. r
--
PROTECTION OF TRAFFIC: All excavations and work areas shalbbe properly lighted and barricaded as deemed necessary by the City Y
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.
1
T 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 toremove or cut existing drainage structures,' City of La Quinta shall be notified prior to commencement of this work.
t
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.. `
a
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 '
•eimmediately 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''
a
The follwing shall apply ONLY when indicated:' 1
•
#
t
R NOTIFICATION' Permittee shall notify the City at 564-2246 at least 48 hours in advance of starting construction.
r,
`� 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 .
C+
R3 'UILITY CLEARANCE: (Substructures) Priortomaking any excavation within the City of La Quinta right of way authorized
permit. the permittee shall contact all concerned utility companies relative to the location of existing substructures.
`mob
Damage to existing substructures resulting from operations conducted under this permit shall be the sole responsibility
`i of the permittee.
R4-�,TILITY CLEARANCE: (Surface 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
r
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
•y1•
1/4 inch to one foot (1'). ,
y ` ,
R7 GRADES & STAKES: City of La Quinta shall establish grades and stakes for the proposed concrete curb and gutter
*'
construction. ,
4.RS
RADE CHECKING: City of La Quinta shall check grades upon receipt of plan and profile and/or grades as established by
L -'`a licensed engineer. '
'
R9 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( feet) she It 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 J
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 l l CULVERTS: A inch diameter(—) culvert shall be installed with the invert approximately 1-1 /2
inches below and inline with the existing flow line. Culvert installation shall conform to the attached drawing. -
�R�GHT CLEARANCE: Sight clearance of 600 feet in either direction shall be assured and maintained.
RT3 SOIL STERILIZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall complywith the
anufacturer's specifications..
R14 OORDINATE WORK: The proposed work shall be`subordinated to any operation which the State of California or
City of La Quinta mayconduct 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.
~
R15 RVEY MONUMENTS: Prior to`excavation or beginning of construction, all survey monuments which exist on the
�l—L-�-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 ,
S. Yt
be notified upon completion.of replacement of all survey monuments for proper project clearance.
R16 SI r MONUMENTS: Prior to excavation or beginning of cons m, all survey monuments shall be tied out by City
of L. ,Auinta and suitable payment or guarantee of payment si.a,..,d 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.
y R18 PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations, any damage to
I / pavement straight edge shall be corrected.
LIMITOF EXCAVATIONS: Excavations shall be limitedto 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 PACKFILLMATERIAL:Backfillshallbefreeofbrush,rootsorotherorganicsubstancedetrimentaltoitsuseforpurposes
of producing an adequately consolidated backfill. Any material which the City of La Quints 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 usingvibrotamper or equivalent equipment. Alternate methods maybe substituted, but in any
se a relative compaction of 95 percent shall be attained within the structural section of the roadway.
q
CKFILLPLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench
forefloodingora maximum offive-foot (5') lifts where trenches are of excessive depths. Care is to be exercised that the
ckfill 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 C P MPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line.
ne(1)copyofeachtestshallbeforwardedtotheCityEngineerforapprovalandfiledpriortomakingpermanentrepairs.
Compaction tests shall be made as outlined in Section 6.3.01 of the Standard Specifications, Division of Highways, State
�'t( 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
wafter a maximum of 3.000 lineal feet of trench has been excavated and backfill operations completed, but in no case shall
tyke placement of the temporary p-idrrlaili exceeu d iiia %a) day iimit.
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 5 days after completion of
temporary road repair._ tib! L 46 6
R27 PAVEMENT REPAIR: F.A.S.:Uponcompletibnofbackfill and colnpaction.atemporarypatchconsistingoftwoinches(2")
of cold mix paving (SC -800) shall be placed immediately. A permanent patch of three inches (3'1 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 Quints 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 Quints 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 inthefollowing 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 Guinta 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.
I. Pruning shall, in all instances, be at the shoulder of the crotch to insure even, fast healing in all cuts of two inches
(2'1 and above in size. Sealant shall be applied to all cut sections as directed by the City Public Works Inspector.
j
_. �.tik �vt Vii. �+l,,YIY.. 7-'r .d". �:� _ • _
.14
ADDITION= --- ENCROACHMENT-PERMIT'N0.0874--=-CONDITIONS,'
R3✓3' 4
.Survey' monuments shall , be protected in place or 44-Z",
re=established pursuant to City standards 'and the':State ;of
�' California'. Land Surveyor's Act.
s " R34• .
'Work 'shall be. coordinated with the 'City of La Quinta.' s t
,, forces to preclude' delay or. interference with the City of La '-
Quinta Is. proj ects.. `
R35
Contractor Contractor shall comply, with the local noise ordinance and.,.
construction operations and maintenanceof 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 7:0Oa m.-5:30p.m.,`
Saturday 8:00a.m.-5:00p.m. ..
May 1st to September 30: Monday -Friday 6: OOa.tri. -7: OOp.m. ,',;,
Saturday. •8:00a.m.-5:OOp.m.. t
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
i `All excavation at or near. the travel way shall be' backfilled-
'•at the end of the work day, for the protection of the
tr_aveling-public.
• i; °R3 8
Street closures shall not be allowed • at' any time. '
5 _R39 •
A minimum of one travel lane shall be maintained at all + "
_
times 'with flagmen -during working hours.
All .work �to be performed within the existing .paved section'
shall be temporary .paved' and maintained by the. Permitted,..,-,
permanent pavement shall be.placed no later than 15 days !`
after _completion •of the temporary road'repair. .;
A R41 "•
Ingress and! egress • for local' properties shall. be maintained'
at all times.
R42
Prior .to work starting; Underground Service Alert shall be
contacted at 'l-800-422-,4133 'and an•"inquiry number" shall be
provided to -the City Public +.Works Inspector.
R43'
Pavement shall be sawcut prior to removal.
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t - i� LOCATION LF_U�i.�%'Ni,-_rIlGa;t EXCHANGE
ISSUE DATE APPROVALS
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OWG. NO. -,RELATED DWGS. WORK ORDER
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With proper validation t
this form constitutes an
encroachment permit. CITY' OF.' LFA; DUINTA
APPLICATION FOR PERMIT
PUBLIG`VORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public~or private, curbs, driveways, pavements, sidewalks, parking lots,: sewers, water main%
and other like public works improvements in'.connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS" '
...REFERENCE GTE;W:O:#549-71803-I F -
Subdivision Improvement Permit - Class III
GATE: October 15, 1990 , • Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Miles Ave' W/O Adams, St-
(Street address or Oeseription of Location) r
PURPOSE OF CONSTRUCTION'S Servi ce to . Tract" '23268' Sketch (attach construction plans if appropriate) ,
DESCRIPTION OF CONSTRUCTION place 4=4" ,conduit "across..`jP`-W.0.#549'_71803-I. SEE ATTACHED' -DRAWING
Miles Ave -concrete pad -and - con on the o � � '-. W• 0. #549'-71803-1.
es. -,,See attached wg.,For a itiona -in orma•tion contact C.Gomez at 342-0535
DIMENSION QF, tNST. ��qqT QQttyy ppAA�REMOVAL 'F" ' • ' "
SEE ATTAC�ED bRAWING
SIZE.OF EXCAVATION, IF NEEDED .SEE ATTACHED DRAWING
APPROXIMATE TIME WHEN -WORK WILL BEGIN,: Y '
° 1-2-1-90
APPROXIMATE TIME OF COMPLETION 2-1-91.
ESTIMATED CONSTRUCTION COST $ ,
(Including removal of all obstruction, materials, and debris, backfilling, com• <
paction and placing permanent resurfacing and/or replacing improvements) _
ln'consideration of ,the granting of this permit, the applicant' hereby agrees to: c.
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`vvnrk undertaken under the permit granted pursuant to this application.
Notify theAdministrativeAuthority at least twenty-four (24) hours in advance of the time when work will be'started.
Comply with all appliceble.City Ordinances, the terms and'conditions of the permii and all applicable rules and regulations of the City of
La Quinta and -to pay.for any additional replacement necessary as the result of is work.
+' Signature of Applicant or Agent _ ,
GTE CALIFORNIA 83-793 DrJCarre'on Blvd,-Indio,'Ca 92201 61 -0535
Name of Applicant (please print)' r Business' Address Telephone No.
Name of;Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. r ' City Business License No.
A
Applicant's Insurance Company Policy Number
z
FEES: Subdivision Improvement Permit — Class I11.r
Private improvements: 3% of.estimated construction costs•
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee *S•"
Permit Fee
t
Penalty ,
Cash Deposit -Surety Bond ,
'it required
TOTAL: $
Receipt No.
Received by ~ Date.
Recorded by
PERMIT VALIDATION n
PERMIT NO.'
DATE APPROVED
EXPIRATION DATE
DATE ISSUED r
By '
Administrative Authority
TELEPHONE: (6191.564-2246 ,