12052See below for Finance Revenue Codes
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ENCROACHMENT PERMIT
OF 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.
FILE C®pw Subdivision Improvement Permit - Class III
DATE: 8/24/2012
LOCATION OF CONSTRUCTION: 46520 Washington Street
PURPOSE OF CONSTRUCTION: Time Warner Project; Trenching to Install CAN Conduit
DESCRIPTION OF CONSTRUCTION: Install 200' CAN Conduit on E. Side of Washington St.
DIMENSION OF INSTALLATION OR REMOVAL: 200' 24" Cover
APPROXIMATE TIME WHEN WORK WILL BEGIN: 8%29/2012
ESTIMATED CONSTRUCTION COST: $1500.00
Minor Imp r a ent Permit -Class IV
D
CITY OF LA
TIME OF COMPLETION: 8/31/2012
(Including removal of all obstruction, materials, and debris, backfilling, compaction and placing
permanent resurfacing and/or replacing improvements)
COMMENTS
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.
Time Warner - Jason
Name of Applicant
Cochran Communication Construction Inc.
Name of Contractor and Job Foreman
x01-1 Z u</--- -- -
Signature of Applicant or Agent
41725 Cook St., Palm Desert, CA 92260
Business Address
760-250-2108
Telephone No
36620 Catherdaral Canyon Dr, Cathedral City, CA 92253 760-328-6778
Business Address Telephone No.
478543 865
Contractor's License Number City Business License No
Mt. Hawley Insurance Co. MGLO176223
Applicant's Insurance Company Policy Number
FEES Subdivision Improvement Permit - Class I
Minor Improvement Permit - Class I
Finance Revenue Code
Inspection Fee E_1
Permit Fee EE=1
As -Built Deposit E-A
Cash Deposit -Surety Bond, EE=B
if required
TOTAL
Public Improvements: 3% of estimated construction costs
Private Improvements: 3% of estimated construction costs
PERMIT NUMBER: 12052
0.00 I i DATE ISSUED:
100.00 EXPI N DATE: • Zct • 13
BY:
0.00
0.00 WORK INSPECTED BY*:
iPERMIT COMPLETION DATE*:
100.00 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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.08/24/2012 12:58 7603284139 COCHRAN COMM CONST PAGE 01
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