13024 (2)See below for Finance Revenue Codes
T4ht 4
C/;
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: 2/19/2013
LOCATION OF CONSTRUCTION: La Quinta Arts Festival 2013; Civic Center Park
PURPOSE OF CONSTRUCTION: To Install Pole Banners, Directional Signs, 4'x8' Signs, and Other Traffic Control Signage
DESCRIPTION OF CONSTRUCTION: See Traffic Control Plan and Exhibits
DIMENSION OF INSTALLATION OR REMOVAL: See Traffic Control Plan and Exhibits
APPROXIMATE TIME WHEN WORK WILL BEGIN: 3/5/2013
TIME OF COMPLETION: 3/11/2013
ESTIMATED CONSTRUCTION COST: N/A (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.
Signature of Applicant or Agent
La Quints Arts Foundation - Kathleen Hughes 78-150 Calle Tampico #215, La Quinta, CA 92253
Name of Applicant Business Address
Tops N Barricades 44631 Jackson Street, Indio, CA 92201
Name of Contractor and Job Foreman Business Address
787664
Contractor's License Number
Nonprofits Ins. Alliance of Ca.
mppncam: s insurance Company
FEES Subdivision` Improvement Permit - Class I
Minor Improvement Permit - Class I
Finance Revenue Code
Inspection Fee EE -1
Permit Fee E-1
As -Built Deposit E-A
Cash Deposit -Surety Bond, E_B
if required
TOTAL
(760)564-1244
Telephone No
(760)347-2111
Telephone No.
103875
City Business License No
2012 -31475 -NPO
Policy Number
Public Improvements: 3% of estimated construction costs
Private Improvements: 3% of estimated construction costs
i PERMIT NUMB R: 13024
DATE ISSUED: 3 /�
0.00 i ; EXPIRATION T : S /
0.00 I BY:
0.00
0.00 WORK INSPECT BY*:
PERMIT COMPLETION DATE*:
0.00 ' 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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