0906A.
nu -
Sr
1,71
4 -
NOTE:
With proper validation k
ihis'form constitutes an
CITY-
'`permi OF 'LA�,40UINTA�.
encroachmentt
APPLICATION' FOR PERMM
4 PUBLIC WORKS CONSTRUCTION (ENCROACHMENT),
*4k -49'
_-etCfTE ;WO �jq nl f
For the construction of publi6, or private curbs; driveways pavements, sidewalks "parking lots,"sewers, water mains
and other like public works improvements in connection with M-INOR.IMPROVEMENTSand APPROVED SUBDIVISIONS
AL
I'Subdivision Improvement Permit — Class III
-Nov"er,.9'- 1990',
DATEi Minor Impro'vementPermit Class IV
ir 77
LOCATION OF CONSTRUCTION, j TR"23935 Dune Palm's W/S.S/O.mi&es and Miles'S/S.,W/O..
Dune P a 1 M'S'i"k.
(Street address or Description of Location).
'r z`IPURPOSE ds:* to crrade
- .; adjust '4 MH 11
OF.CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTIONreplace'.3'parkway lift with
street. lids .and,adjust to grade. adjust J_Lparkway
,
'fil-d —to,.qradeiw3r1r.,wi11.be.done by,c'ohtradt Perso'hnel
L:
-DIMENSION OF INSTALLATION OR R 30" dia MH_ lids
REMOVAL —
see attahc(id -d'rawin
SlRbF EXCAVATION, IF NELDED'
APPROXIMATE TIME,WHENIWORK WILL.BEGIN x,12/19/90
.'#APPROXIMATE,TIME OF,COMPLETION 131/91 -"71-- -7
4 EST I M A T*E' D`601\1 ST' A 0 CT 10 N'C'OSf
(Including 'remova'I, o'f �a'Il 8bstruction, mit"eriali,'and debris, 'ba'ckfi ing, com
paction and' placing permanent resurfacin'g 'and/orre'placinb iniprovements)
In consideration of the,..granting of this permit; the applicant hereby agrees.. to;
$
'Indemnify, -defend and save -the City, its abthorizecl.agents, 'officers, representatives and employees, harmless f rom and against.ariy and all
- ` I .., k m .. .
penalties, -liabilities o"r, resulting from,sclaims or,coLirt action and arisinglout of any accident, loss & damage to persons or property,
Joss res
happening or occurring s . , im. work ui4de'. permit granted tHis., pplic
rring as a prox , ate result of any wo rtaken under.�Ie te pursuant to a ation:
Notify the Administrative Auth*ority at least twenty-four '(24)" hours 'in a6anceof the time when work will belstarted.
Comply with all 'applicable City, Ordinances, -the terms and conclitioris of,ihe permit and all applicable rules and4egulat'lons of the City of
_r6plac'
.,La Ouinta and'to pay for any.additional- ement, necessary as the result -of this work
Signature of -Applicant or Agent'
GTE -California "Incorporated -83-�39 Dr -.0a'rreon Blvd.,Indio 342-!
-0535
Name of Applicant (please print), '.Business,Addess Telephone'No.
'Name of Contract6'r and Job Foreman Business Address Telephone No.
Contracto;r's bc6se No.;, 0 . City Busindss License -No.
Applicant's Insurance Company Policy Number..
FEES: Subclivision:lmproyemdnt Permit = Class I Il
Public improvements: 3% of estimated construction "costs
Priva e im:prove;e'nts: i% of estimated construction ruction costs
4t w
Minor Improvement Permit - Class IV: See attached schedule N,
Inspection Fee PERMIT VALIDATION 9 0,6
Permit Fee 4.: s.
PERMIT NO.
Penalty 119/90
Cash Deposit -Surety B6nd DATE APPROVED
'if required, EXPIRATION DATE 6/30/9M
TOTAL: O_
DATE ISSUED,-
Receipt No.
BY_
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
rr.• '�-�'yyr,t,,,�,•�+�. +. •-�+Wv-�..,.. a.it aya.-,Y'� b""'�.f�',:T,1!""v^•<.'�..✓•�....`�•-�....Y.:�d;."'ip-,wa'�V9Y•G+l.,y.....,Ayn:yJ..r..i�,.�r..ut�:4 }�'@:+r� :. ai��.. &., ,: .r
w..n*�.�11fMi+�Ja.��.�wo!..wrw.o�^oF.J .Yv. �''.�+� +,� .r +i .�. �w►....ww-.!. l�!. p_�... r.�e�iw .'w:: M, -K �',r�w r....�a.n�'� �n►w-w .+•-.l+.r... � ..a. ... r.....a�-.:.:r s�
4.
NQ t:
With proper validation
this form constitutes an
encroachment permit—
CIT Y OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
GTE WO.#549-41703-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
' November 9, 1990 Subdivision Improvement Permit -Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION TR 23935 Dune Palms W/S S/0 Mmes and Miles SIS W/O
Dune.Palms
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION. adjust 4 MH lids to grade Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTIONreplace 3 parkway lids with
street lids and'adjust to grade adjust 1 parkway
t
lid to grade work will be done by Conttact personnel
DIMENSION OF INSTALLATION OR, REMOVAL 30" dia MH lids
see attahced drawing
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN' 12/19/90
r
APPROXIMATE TIME OF COMPLETION 1/31/91
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:
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
GTE California Incorporated 83-739 Dr. Carreon Blvd., Indio 34,E-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 I II
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule R 0 9 "i
Inspection Fee $ --�—
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ --0-
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 0906
DATE APPROVED 11/9/90
EXPIRATION DATE 6/30/90
DATE ISSUED 11/9/90
By
Administrative Authority
TELEPHONE: (619) 564-2246
Y!x The following General -and Special Provisions are attached to and made a part of Permit No.
^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
t s " ONLY. Whenever construction extends within private property. it shall be the responsibility of the permittee for his contractors) to
secure permission from abutting property owners: Such auihorization 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 fittedwith smooth -faced street pads. AII`mechanical outriggers shall be fitted with rubber street shoes to protea
the pavingduring . excavations: Rubber -tired equipment onj shall be used in backfill operations in paved areas. If the existing
9Y,. _ P P g'
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 a pro riate seal coat as s ecjfied above:' "',+
c C 9P P p P r• ,. 4 y
PROTECTION OF TRAFFIC: All excavations and work areas shall beproperly lighted and barricaded as deemed necessary bythe 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. r
,• .,
r, „ .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 '
necessaryto remove or,.cut existing drainage' structures, City of La'Quinta shall be notified prior to commencement of thiswork.
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.
r , 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
• - t r; 'tivc 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.
t•.,,. CLOSING -STREETS: No street shall be closed. A minimum of one Ian e of traffic shall be maintained at all times to provide limited
access for theadjoining-property.ownerrsandei;ergencvvehicles.Intheevent itisfelt bYthepermittee that hemustcloseastreet for
any length of time. permittee shall contact this office to obtain the necessary permission.
t
SPECIAL! PROVISIONS '
j The follwing shall apply. ONLY when indicated: r
1 OTIFICATION: Permittee sh_ all notifyiti City at 564-2246 at least 48 hours in advance of starting construction.
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
v '11 'r roads and survey monuments. This bond shall be continuous' until cancelled by the City Engineer. This bond must be
sled prior to commencement of any work on this project . p i
''.•• "r ,
3 `UT LiTY CLEARANCE: (Substructures) Priorto akirtg any excavationwithin the City of La Quinta right of way authorized ,
t ` 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.
(:9pl
TILITY CLEARANCE: (Surface structures) No work shall be done under this permit until all utilities are clear of the
" oposed work site, The permittee shalriotify 911 concerned utility companies of the proposed work.
r a.
„R5' PAVEMENT WIDENING: Area between the proposed concrete gutter line and the existing road pavement shall be
�•;4. - surfaced with inches of A.C:rpaving placed on , inches of class aggregate subbase course
,, ..
•r. " r = having an"R"valueof not lessthan and in conformance with City of La Quinta fioadlmprovementStandards
and Specifications, Ordinance #461 as3v, `i F
t R6 ' PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of
1 /4 inch to one foot (1')� r i • , x w',t, : tr
R7' GRADES & STAKES: City of La Quinta shall establish grades and stakes for the proposed concrete curb and gutter
J .* "construction.
'
(!t;R 8 RADE CHECKING: City of La Quinta shall check grades upon receipt of plan and pFofile and/or grades as established by s
a licensed engineer.
e - ,
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
r •' f; concrete driveway approach shall be constructed in conformance, with City of La Quinta Standard #207. _
RIO DRIVEWAYS. A.C.: Driveways shall.be constructed�as not to alterexisting drainage pattern! Surfacing between the
property line and the existing'road paving shall be 2-1 /2 inches of A.C. paving placed on (_"1 of class
aggregate base. Driveway construction shall conform to attached drawing.
•. •fix ,. .:- , , .r .` P .. ,
R11 CULVERTS: A inch diameter ( 1 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. ,
t 113'.'
IGHT CLEARANCE: Sight clearance of 600'feet in either direction shall be assured and maintained.
OIL STERILIZER:.,The area to be surfaced shall be treated with soil sterilizer. Rate of application shall complywith the
y `i- anufacturat's specifications.
R14 ORDINATE WORK: The proposed work shall' be subordinated to. any operation which the State of California or
s City of La Quirita 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 A6rference with State or City of La Quinta projects.
R15•S VEY 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 maybe readily and correctly
I be replaced by a licensed civil engineer or surveyor at the expense of the permittee. A complete setof notes showing the
ties to these monuments shall be furnished to the City Engineer prior tothe removal of any monuments. Thisoffice shall
be notified upon completion of replacement of all survey'inonuments for proper project clearance.
R16 Y MONUMENTS: Prior to excavation or beginning of co on, ail survey monuments shall be tied out by City
luinta and suitable payment or guarantee of payment„a,.. a 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.
is 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 linealfeetof 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 BACKFILLMATERIAL:Backfillshallbefreeofbrush,rootsorotherorganicsubstancedetrimentaltoitsuseforpurposes
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 notgreaterthan
three feet (31andvibrated using vibrotamper or equ iva lent 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.
R22)ACKFILL PLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench
efore flooding or a maximum of five-foot (5') lifts where trenches are of excessive depths. Care is to be exercised thatthe
backfill material is not subjected to extreme swell by flooding operations. Backfill material shalt 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
---�tandard 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.
nd e(1)copyofeachtestshallbeforwarded tothe City Engineer for approval and filed prior tomaking 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 i n no case shall
ti)ie placement of the temporary p ve,rajq exceeu a fi:a i5) day limit.
26 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 classbase shall be placed no later than days after completion of
temporary road repair. �ncoR27 PAVEMENT REPAIR: F.A.S.: U/m) n ackffffl�
andel compaction, a temporary patch consisting of two inches (2")
of cold mix paving (SC -800) shall be placed immediately. A permanent patch of three inches (3") of A.C. surfacing shall
be placed on six inches (6") concrete base as directed, but not later than fifteen (15) days after completion of temporary
paving. Concrete base shall be of five -sack mix and shall conform to the City of La Quinta Road Improvement Standards
and Specifications. Ordinance #461.
R28 FOG SEAL: A fog seal coat consisting of an application of asphaltic emulsion shall be applied over all patch areas as
determined by the City Engineer.
R29 SEAL ARMOR COAT: A seal coat consisting of an application binder and screenings shall be applied on all patch areas
where such seal coats existed prior to issuance of this permit. Seal or armor coats shall be applied as specified in Section
37, Standard Specifications. State of California. Division of Highways, dated January 1973. Work of pavement repair to
be accomplished by a licensed contractor engaged in the business of pavement repair.
R30 STREET RESTRIPING: Where street striping is still visible on streets to be excavated. such striping shall be replaced upon
completion of permanent repairs.
R31 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quinta road right of way shall be accomplished
by a licensed, bonded and insured tree service, and handled safely without interference or hazard to the traveling public.
It shall be the responsibility of the permittee to maintain the tree in a vigorous growing condition at its new location.
Trees to be removed shall be removed in sectionswhich can be handled safely without interference or hazard to highway
traffic. The entire width of the tree stump shall be removed and disposed of so that no debris remains in view of the
highway. The stump hole shall be backfilled and thoroughly compacted as specified in the following paragraph. Where it
becomes necessary to restrict traffic, the work shall be restricted to a maximum of 500 feet at any one time. Adequate
signs, flagmen and/or barricades shall be provided to protect the traveling public at all times.
Large holes resulting from tree removal shall be backfilled and compactedto not less than 90 percent or equivalenttothe
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 any one 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.
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.
R33
R34
R35
R36
R37
R38
R39
R40
R41
"
ADDITION ----ENCROACHMENT PERMIT NO.0906 ---- CONDITIONS
Survey monuments shall be protected in.place or
re-established pursuant to City standards and -the State of
California Land Surveyor's Act.
Work shall be'coordinated with the.City of La Quintals
forces to'preclude delay or interference with the City.of La
Quintals projects.
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.-5:30p.m.
Saturday 8:.00a.m.-5:00p.m.
May 1st to September 30: Monday-Friday6:00a.m.-7:00p.m.
Saturday 8:00a.m.-5,:00p.m.
Work shall be prohibited anytime on Sunday and Federal
holiday.
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.
All excavation at or near the travel way shall be backfilled
at the end of the,work day, for the protection of the
traveling public.
Street closures shall not be.allowed at any time.
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 Permittee,,
permanent pavement shall'be:placed no later than'15 days
after completion of the temporary road repair.
Ingress and egress for local properties shall be maintained
at all times.
R42 Prior to work starting, Underground Service Alert shall be
contacted at 1-800-422-4133 and an "inquiry number" shall be
provided to the City Public Works Inspector.
R43 Pavement shall be sawcut prior to removal.
REFERENCE GTE W.O.#549=41703-I
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 II I
DATE: Nov 8, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Dune Palms W/S S/0 Miles and Miles Ave S/.S W/O Dune Palms
(Street address or Description of Location)
P RPO OF CONST UCTION adjust 4 M.H. lids to grade Sketch (attach construction plans if appropriate)
or�R Dev. Spee attached wq.
DESCRIPTION OF CONSTRUCTION repl ace 3 parkway 1 i ds wi th .street 1 i ds and adjust to, grade.
Adjust 1 parkway lid to grade work will be done by contract personnel.
For additional information call Cruz Gomez at 342-0535 and refer to W.O.#549-41703-I
DIMENSION OF INSTALLATION OR REMOVAL 30 dia. M.H. lids
SIZE OF EXCAVATION, IF NEEDED t(yy 3
RECE VII -0 ►�V ► M IVJ
APPROXIMATE TIME WHEN WORK WILL BEGIN 12-19-90
APPROXIMATE TIME OF COMPLETION 1-31-91 RECEIVED NOVy Irk
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 eppticable rules and regulations of the City of
La Quints and to pay for any additional replacement necessery as the .result o his work.
- , G
Signature of A4piicant or Agent
GTE CALIFORNIA,INCORORATED 83-739 DR CARREON BLVD, INDIO, CA 92201
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 III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit --Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond.
if required
TOTAL:
Receipt No.
Received by I Data
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246
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H
Mm, . calltomla
LOCATION S IS MJLES PNF 4 W15 bUME,
EXCHANGE 1p L DS C.O. laRDW
ISWE DATE APPROVALS
DWG.
NO
AREA GENERAL MANAMA.
U
WORK ORDER
FOMMIM
H
Mm, . calltomla
LOCATION S IS MJLES PNF 4 W15 bUME,
EXCHANGE 1p L DS C.O. laRDW
ISWE DATE APPROVALS
DWG.
NO
AREA GENERAL MANAMA.
RELATED IWGS.
WORK ORDER
FOMMIM