10070See below for Finance Revenue Codes
-T,d14.
ENCROACHMENT PERMIT
OF cF oti 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.
DATE: 11/9/2010
Subdivision Improvement Permit - Class III
Minor Improvement Permit - Class IV
LOCATION OF CONSTRUCTION: Adams Street at Avenue 47, Highway 111, and Blackhawk Way
PURPOSE OF CONSTRUCTION: Cochran Communication; Install 2-2" Conduits for CAN
DESCRIPTION OF CONSTRUCTION: Trench and Bore to Install 2-2" Conduits
DIMENSION OF INSTALLATION OR REMOVAL: N/A
APPROXIMATE TIME WHEN WORK WILL BEGIN: 11/15/2010 TIME OF COMPLETION: 12/15/2010
ESTIMATED CONSTRUCTION COST: $20,000
permanent resurfacing and/or replacing improvements)
COMMENTS Relates to CIP 2006-06 Adams Bridge
(Including removal of all obstruction, materials, and debris, backfilling, compaction and placing
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
Jason Cochran - Cochran Communication Const
36630 Cathedral Canyon, Cathedral City, CA 92234
760-250-2108
Name of Applicant
Business. Address
Telephone No
Cochran Communication Construction
36630 Cathedral Canyon, Cathedral City, CA 92234
760-328-6778
Name of Contractor and Job Foreman
Business Address
Telephone No.
478543
00865
Contractor's License Number
City Business License No
Mt Hawley Insurance
MGLO158865
Applicant's Insurance Company
Policy Number
FEES Subdivision Improvement Permit - Class I
Public Improvements: 3% of estimated construction costs
Minor Improvement Permit - Class I
Private Improvements: 3% of estimated construction costs
Finance Revenue Code
Inspection Fee E_1
$0.00
Permit Fee EE=1
$0.00
As -Built Deposit E-A
Cash Deposit -Surety Bond, E_B
$0.00
$0.00
if required
TOTAL
$0.00
PERMIT NUMBER: 10070
DATE ISSUED: /Z• /&y %0
EXPIRA_=N DATE11.1&-If
BY: OS–,> �r1
WORK INSPECTED BY*: 4i,-
PERMIT COMPLETION DATE*: /Z .
If the work is covered by a Subdivision lmpro4mef4Agreement, Subdivider
shall request final acceptance of improvements from the City Council.