12038 (2)See below for Finance Revenue Codes
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ENCROACHMENT PERMIT
�0F 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: 8/1/2012
LOCATION OF CONSTRUCTION: Codorniz; TM 32070; Jefferson Street and Avenue 52
PURPOSE OF CONSTRUCTION: Grade, Form, and Pour Offsite Sidewalk on Avenue 52
DESCRIPTION OF CONSTRUCTION: Plan Set No. 06131
DIMENSION OF INSTALLATION OR REMOVAL: Install 270 LF of 8' Wide x 4" Thick Meandering Sidewalk on Avenue 52
APPROXIMATE TIME WHEN WORK WILL BEGIN: 8/1/2012
ESTIMATED CONSTRUCTION COST: $15,000
permanent resurfacing and/or replacing improvements)
COMMENTS
TIME OF COMPLETION: 8/31/2012
(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 ort. r
property happening or occuring as a proximate result of any work undertaken under the permit granted pursuan appli
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work wig to60) 777-
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7097. To submit an inspection request, leave a message on the Inspection Request Hotline at (760) 7�i 7 prior to 1:30 PP_ 01
least twenty-four (24) hours prior to the anticipated inspection. y U :�
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules an re 4f @` yi,
of La Quinta and to pay for any additional replacement necessary as the result of this work. _,A%:,�Q"
RJT Homes-Codorniz, LLC - Matt Nevins
Name of Applicant
RJT Investments
Name of Contractor and Job Foreman
690645
Contractor's License Number
International Insurance Co of Hanover, LTD
Applicant's Insurance Company
FEES Subdivision Improvement Permit -.Class I
Minor Improvement Permit - Class I
P.O. Box.6089, La Quinta, CA 92248
Business Address
P.O. Box 6089, La Quinta, CA 92248
Business Address
Finance Revenue Code
Inspection Fee E_1
$450.00
Permit Fee EE=1
100.00
As -Built Deposit . E -AA
$0.00
Cash Deposit -Surety Bond, EE=6
$0.00
if required
TOTAL
$550.00
re of Applicant or Agent
(760) 564-3470/ 610-4214
Telephone No
(760)564-3470
Telephone No.
4990
City Business License No
IG011000372-00
Policy Number
Public Improvements: 3% of estimated construction costs
Private Improvements: 3% of estimated construction costs
PERMIT NUMBER 12038
DATE ISSUED: u Zv 12 -
EXPIRATION
ZEXPIRATION DA E:
BY: 1 J
WORK INSPECTEDVY*: JEL Vf�,,Uet-4
PERMIT COMPLETION DATE*: `Q• 3 (. i3
If the work is covered by a. Subdivision Improvement Agreement, Subdivider
shall request final acceptance of improvements from the City Council.
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