12075 (2)IOU
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ENCROACHMENT PERMIT
PUBLIC WORKS CONSTRUCTION
See below for Finance Revenue Codes
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: 11/1/2012
LOCATION OF CONSTRUCTION: Alley South of Avenida La Fonda West of Desert Club Drive
PURPOSE OF CONSTRUCTION: Replace CAN Aerial
DESCRIPTION OF CONSTRUCTION: Replace Existing CAN Aerial in Alley South of Avenida La Fonda
DIMENSION OF INSTALLATION OR REMOVAL:
APPROXIMATE TIME WHEN WORK WILL BEGIN: 11/7/2012
ESTIMATED CONSTRUCTION COST: $1,000
permanent resurfacing and/or replacing improvements)
COMMENTS
TIME OF COMPLETION: 11/8/2012
(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: NOV
IJ,V 0 C 2012 I2
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees less from and against any
and all penalties, liabilities or loss resulting from claims or court action and arising out of any accidei t, to
property happening or occuring as a proximate result of any work undertaken under the permit grant d pursuaEli%hi
FIPdANC
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 Applicant or Agent
Cochran Commuincation Const - Marty Cochran 36630 Cathedral Canyon Drive, Cathedral City, CA 92253 760-250-2147
Name of Applicant Business Address Telephone No
Cochran Commuincation Construction Inc.
Name of Contractor and Job Foreman
478543
Contractors License Number
Mt. Hawley Insurance Co.
Applicant's Insurance Company
FEES Subdivision Improvement Permit - Class I
Minor Improvement Permit - Class I
36630 Cathedral Canyon Drive, Cathedral City, CA 92253 760-328-6778
Business Address Telephone No.
Finance Revenue Code
Inspection Fee EE=1
$0.00
Permit Fee E_1
$100.00
As -Built Deposit E-A
$0.00
Cash Deposit -Surety Bond, E_B
0.00
if required
TOTAL
$100.00
865
City Business License No
MGLO176223
Policy Number
Public Improvements: 3% of estimated construction costs
Private Improvements: 3% of estimated construction costs
PERMIT NUMBER: 12075 COM- REVE
DATE ISSUED: Abv--'i 20/Z
EXPIRpk ATE: AlvV. -7 ZO/5 .
BY:
WORK INSPECTED BY*:
PERMIT COMPLETION DATE*: CM 7, 7,013
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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