10059 (2)See below for Finance Revenue Codes
Tiht 4
ENCROACHMENT PERMIT
PUBLIC WORKS CONSTRUCTION
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
Minor Improvement Permit - Class IV
DATE: 9/28/2010
LOCATION OF CONSTRUCTION: Dune Palms Road Storm Drain Improvements - Dune Palms Road at "A" Street at Retention Basin
PURPOSE OF CONSTRUCTION: 5 Geotechnical Borings to Obtain Subsurface Data & Perc Rates for Storm Drain Improvements
DESCRIPTION OF CONSTRUCTION: Five 8 inch Diameter Geotechnical Boring to a Max Depth of 35 ft, Backfill with Native
DIMENSION OF INSTALLATION OR REMOVAL: 5 Holes, 8 Inches in Diameter
APPROXIMATE TIME WHEN WORK WILL BEGIN: 10/11/2010 TIME OF COMPLETION: 10/15/2010
ESTIMATED CONSTRUCTION COST: $4,000 (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing
permanent resurfacing and/or replacing improvements)
COMMENTS For CIP 2009-10 Phase 11
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 occuring 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 at (760) 777-
7097. To submit an inspection request, leave a message on the Inspection Request Hotline at (760) 777-7097 prior to 1:30 P.M. at
least twenty-four (24) hours prior to the anticipated inspection.
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
Lisa Battiato - Leighton Consulting 42575 Melanie Place Suite #A, Palm Desert, CA 92211 760-834-6520
Name of Applicant Business Address Telephone No
2R Drilling, Inc. 3968 Chino Ave, Chino, CA 91710 909-465-1765
Name of Contractor and Job Foreman Business Address Telephone No.
702029
Contractor's License Number
Lexington Insurance Compan
Applicant's Insurance Company
FEES Subdivision Improvement Permit - Class I
Minor Improvement Permit - Class I
Finance Revenue Code
Inspection Fee E_1
Permit Fee E_1
As -Built Deposit E-A
Cash Deposit -Surety Bond, EE=B
if required
0.00
0.00
0.00
0.00
TOTAL $0.00
102113
City Business License No
065463440
Policy Number
Public Improvements: 3% of estimated construction costs
Private Improvements: 3% of estimated construction costs
PERMIT NUMBER: 10059
DATE ISSUED: (0 A j o
EXPljt,ATION DATE: t co. q . I
BY: 9
WORK INSPECTED BY*:
PERMIT COMPLETION DA E
* If the work is covered by a Subdivision Improvement Agreement, Subdivider
shall request final acceptance of improvements from the City Council.