1342I[:p7777,7"',-�;,..,,,
--_'---__--- "_------_----------------- _—'^---_ --------------- --------------i__----_
NOTE:
4 2,
With'properwalidation• , • o
this.form constitutes an
encroachment permit • � CITY OF LA QUINTA
APPLICATIION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT);
,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 I I I
DATE: January 22, 1992 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Hwy 111 and Washi iRton '
(Street address or Description of Location)
tlans if a
Install 2 4 4" construction p appropriate)
PURPOSE OF CONSTRUCTION Sketch (attach construction
P
DES.CRI TION OF CCONS RUCTION e onto existing ng water Ma O$STR,t c-17o�1 OI` TzAFr-Ic-
main �o provida a4equate water flow for fire F_ (T'OE'D
pro ect on anIrrigation. R ,f..
DIMENSION OF INSTALLATION OR REMOVAL IJ20 1 -f
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 9:00 1/28/92
APPROXIMATE TIME OF COMPLETION -
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or. replacing improvements)
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 occurring 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.
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 replace ment,necessary as the result of this work.
Signature of App ica-n or Age
-Coachella Valley Water District F.O. Box 1058 Coachella; CA 398-2 1*ERt. 321
Name of Applicant (please print) Business Address Telephone No.
Lloyd Segroves, . w�'` Sauna -" * Same
•Name of Contractor and Job Foreman Business Addr'ess' Telephone No.
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class Ill
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ -0-
$ -0_
Received by Date
Recorded by
1342
PERMIT VALIDATION
PERMIT NO. 1342
DATE APPROVED 1/22/92 Q
EXPIRATION DATE L % % �Z
DATE ISSUED 1/22J92
_
L
By::Z"
Administrative Authority
TELEPHONE: (619) 564-2246
IX
NOTE:
With proper validation
this form constitutes an
encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
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
lSubdivision Improvement Permit — Class III
DATE: �— ��— Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION A'V ton
r
(Street address or Description of Location)
PURPOSEF CONSTRUCTION �s-4 �� — `/ «fou S (�u '�� Sketch (attach construction plans if appropriate)
g t_e ('Cl
DESCRJPTION OF CONSTRUCTION Z�� (OLr 10x 'S • o
DIMENSION'OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED U
APPROXIMATE TIME WHEN WORK WILL BEGIN — -r/
APPROXIMATE TIME OF COMPLETION ,bO a —
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
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 occurring 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.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Ouinta and to pay for any additional replacement necessary as the result of this work. 9
Signature of plicant or ent
Coe i,V,1
Name of Applicant (please print)
�'Telephone No.
. L./ cep L,)L l�, ,
Business Address
Name of Contractor and Job Foreman
Contractor's License No.
Business Address
Telephone No.
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 0 11
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $—
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE:. (619) 5642246
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
.encroachment permit v
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
0 Tfl8
i For the construction of public or private curbs, driveways, pavements, sidewalks,
parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
I
i
I Januar 1992 Subdivision Improvement Permit — Class I I I
I DATE: Y 22, Minor Improvement Permit Class IV
I.
LOCATION OF CONSTRUCTION. Hwy 111 and Washington
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Install 2 — 4" construction Sketch (attach construction plans if appropriate)
Tie onto existing water
DES �RIPTIONOFCONSaRUCTION g No O$STRtLClloa,l- Olr
man to provide a equate water t1ow tor tire )� p�RfaIITTEI7
protection and irrigation.
DIMENSION OF INSTALLATION ORIREMOVAL 20'R
SES �TTAcN�D Coy-►�tT�►.�S
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 92
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
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, He or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property
happening or occurring 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.
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 App Ica or
Coachella Valley Water District P.O. Box 1058 Coachella, CA 398-2-6-51 Ext. 321
Name of Applicant (please print) Business Address Telephone No.
Lloyd Segroves Same Same
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
Public improvements: 3% of estimated construction costs i
Private improvements: 3% of estimated construction costs I
Minor Improvement Permit — Class IV: See attached schedule
Inspect ion 'Fee $ —0— PERMIT VALIDATION
Permit Fee 1342
PERMIT NO.
Penalty 1/22/92
Cash Deposit -Surety Bond DATE APPROVED
if required
EXPIRATION DATE � Z 9' 9z
TOTAL: $ —0—
DATE ISSUED 1/2Z/92
Receipt No. /
By .
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564.2246
ADDITION ----ENCROACHMENT PERMIT NO.1342 ---- CONDITIONS
R33 Survey monuments shall be protected in place or
• re-established pursuant to City standards and the State of
California Land Surveyor's Act.
R34 Work shall be coordinated with the City of La Quintals 1.
forces to preclude delay or interference with the City of La
Quintals projects.
R35 Contractor shall comply with the local noise ordinance and
construction operations and maintenance of equipment within
one half mile of human occupancy shall be performed only
during the time periods as follows:
October 1st to April 30: Monday -Friday 7:00a.m.-5:30p.m.
Saturday 8:00a.m.-5:00p.m.
May 1st to September 30: Monday_Friday 6:00a.m.-7:00p.m.
Saturday 8:00a.m.-5:00p.m.
Work shall be prohibited anytime on Sunday and Federal
holiday.
R36 Traffic control shall be as.per.Cal Trans Traffic Manual.
Field adjustments'in detouring shall be accomplished as
directed in order to adjust to actual field conditions. It
shall be the contractor's.responsibility to adequately
barricade and detour this site. A -Traffic control plan shall
be submitted for approval by,the'City Engineer.
R37 All excavation at or near the .travel way shall be backfilled
at the end of the work day, for the protection of the
traveling public.
R38 Street closures shall not.be allowed at any time.
R39 N/A
R40 N/A
R41: Ingress and egress for local properties shall'be maintained
at all times.
R42 Prior to work- starting, Underground Service Alert shall be
contacted at 1-800-422-4133 and an "inquiry number" shall be
.provided to the City Public Works Inspector.
R43 N/A
5
Additional Conditions - Encroachment Permit No. 1342
Page 2
R44 All backfill subgrade soil shall be compacted to nothing
less than 90% relative dry density, all backfill soil within
the top 2' of finish pavement surface shall be compacted to
nothing less than 95% relative dry density, all base
material shall be compacted to nothing less than 950
relative dry density.
R45 N/A +
R46 If the work is to be performed by forces other than that of
the utility company, the contracting company will be
required to apply for an additional encroachment permit
and pay the appropriate fee.
R47 Permittee shall be responsible for clean-up,and restoration
of anything damaged due to any work performed under -this
permit.
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R44 NN! t;*6?,k
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