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13010 (2)LaWSee below for Finance Revenue Codes y • /' U _ z f ' ... JENCROACHMENT PERMIT OFT° 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: 1/28/2013 LOCATION OF CONSTRUCTION: TM 31202; Rancho Santana; Monroe Street South of Avenue 52 PURPOSE OF CONSTRUCTION: Median Landscape Improvements on Monroe Street DESCRIPTION OF CONSTRUCTION: See Plan Set #08126 DIMENSION OF INSTALLATION OR REMOVAL: N/A APPROXIMATE TIME WHEN WORK WILL BEGIN: 2/4/2013 ESTIMATED CONSTRUCTION COST: $30,000 permanent resurfacing and/or replacing improvements) COMMENTS TIME OF COMPLETION: 3/5/2013 FINANCE (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 applicabl I and regulations of the City of La Quinta and to pay for any additional replacement necessary as the result of this work. i Signature of A p licant or Agent Desert Cheyenne, Inc. - John R. Pedalino 78401 HWY 111 Suite X, La Quinta, CA 92253 760-777-9920 Name of Applicant Business Address Telephone No ' Conserve LandCare, Inc. Name of Contractor and Job Foreman 958748 Contractor's License Number Hartford Casualty Company Applicant's Insurance Company FEES Subdivision Improvement Permit - Class 1 Minor Improvement Permit - Class 74-040 Hwy 111 Ste. L-200, Palm Desert, CA 92260 760-343-1433 Business Address Telephone No. Finance Revenue Code Inspection Fee EE' 900.00 Permit Fee E_1 $100.00 As -Built Deposit E-A $0.00 Cash Deposit -Surety Bond,E_13 0.00 if required TOTAL $1,000.00 108534 . City Business License No 72UENQY8539 Policy. Number. Public Improvements: 3% of estimated construction costs Private Improvements: 3% of estimated construction costs PERMIT NUMBER: 13010 DATE ISSUED: EXPIRATION DATE: ;_P b ZI BY: At l _. r WORK INSPECTEDBY : PERMIT COMPLETION DATE'':'/ If the work is covered by a Subdivision Improvement Agreement, Subdivider shall request final acceptance of improvements from the City Council. F 4