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12038 (2)See below for Finance Revenue Codes 0 4 f�G1�Gv 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- i 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. 13 t