10069Lauw• See below for Finance Revenue Codes,
s
ENCROACHMENT PERMIT
of�� PUBLIC WORKS CONSTRUCTION
�-or 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: 11/3/2010
LOCATION OF CONSTRUCTION: Ave 50
PURPOSE OF CONSTRUCTION: Palm Tree Removal
DESCRIPTION OF CONSTRUCTION: NIA
DIMENSION OF INSTALLATION OR REMOVAL: Remove 6-12 Washington robustia and Replace with 6-24 Box Crate Myrtle
APPROXIMATE TIME WHEN WORK WILL BEGIN: 11/4/2010 TIME OF COMPLETION: 11/5/2010
ESTIMATED CONSTRUCTION COST: $4260.00 (Including removal of all obstruction, materials, and debris, backfilling; compaction and placing
permanent resurfacing and/or replacing improvements)
COMMENTS N/A
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 oocuring as a proximate result of any work undertaken under the permit.dranted 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.
Sign tura of Applicant or Agent
Rafael Mendoza - Horizon Professional Landscape 84501 Gultron St, Coachella, CA 92236 760-333-9371
Name of Applicant Business Address Telephone No
Horizon. Professional Landscape 84501 Gultron St,•Coachella, CA 92236
Name of Contractor and Job,Foreman Business Address
760-333-9371
Telephone No.
799029 104345
Contractor's License Number City Business License No
Essex Insurance Co. CL042600815
Applicant's Insurance Company Policy Number
FEES Subdivision Improvement Permit - Class I
Minor Improvement Permit -Class I
Finance Revenue Code
Inspection Fee E_1
$0.00
Permit Fee E_1
$0.00
As -Built Deposit E-A
$0.00
'ash Deposit -Surety Bond, E_13
0.00
required
TOTAL
$0.00
Public Improvements: 3% of estimated construction costs
Private Improvements: 3%, of estimated construction costs
PERMIT NUMBER: 10069
DATE ISSUED: -' /' "31l O
EXPIRATION DA /
BY: .
WORK INSPECTED BY*:
PERMIT COMPLETION DATE*:
If the work is coveted by a Subdivision Improvement Aar u
ment
shall request final acceptance of improvements from the City Council.