13018 (2)See below for Finance Revenue Codes
Of OW (Au"I"O
ENCROACHMENT PERMIT
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: 2t7/2013
LOCATION OF CONSTRUCTION: Jefferson St from Derek Alan Drive to Pomelo Street and on Avenue 50
PURPOSE OF CONSTRUCTION: Rod and
DESCRIPTION OF CONSTRUCTION:
Existing Conduit for Time Warner Cable
DIMENSION OF INSTALLATION OR REMOVAL: Rod and Rope Approx. 3,000' of Existing Conduit for
APPROXIMATE TIME WHEN WORK WILL BEGIN:. 2/12/2015 TIME OF COMPLETIC
ESTIMATED CONSTRUCTION COST: $4,000
permanent resurfacing and/or replacing improvements)
COMMENTS
(Including removal of all obstruction, materials, and debris,
In consideration of the granting of this permit, the applicant hereby agrees to:
Street
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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) 77.7-
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 of Applicant or Agent
Cochran Communication Const - Marty Cochran 36630 Cathedral Canyon Drive, Cathedral City, CA 92234 (760) 250-2142
Name -of Applicant - Business Address Telephone No
Cochran Communication Const.
Name of Contractor and Job Foreman
478543
Contractor's License Number
36630 Cathedral Canyon Drive, Cathedral City, CA 92234 (760) 328-6778
Business Address Telephone No.
placing
865
City Business License No
Kinsale Insurance Company 0100009339-0
Applicant's Insurance Company Policy Number
FEES Subdivision Improvement Permit - Class I
Minor Improvement Permit- Class I
Finance Revenue Code
Inspection Fee E_1 ,
0.00
Permit Fee E_1
$100.60
As: -Built Deposit E-A
$0.00
Cash Deposit -Surety Bond, E=B
$0.00
if required
TOTAL
$1100.00
Public Improvements: 3% of estimated construction costs
Private Improvements: 3% of estimated construction costs
PERMIT NUMBER: 13018.
DATE -ISSUED: -/2• �3
EXPIRA AT 2•%Z /3
BY:
WORK INSPECT BY*: y Yy�irzvz
PERMIT COMPLETION DATE*: 6�. / 3
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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