1748NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
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
Subdivision Improvement Permit — Class II I
DATE: 5-24-93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Montezuma 6 Mendoza, Hidalgo W/O Bermudas, Sinaloa W/O Be
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION conduit for future Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION trench acroaa atrppt Ref GTE permit no. 1725
to place conduit for future use See attached condition pg
See attach j TD 11-j8-93:250.0013
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 5-26-93
APPROXIMATE TIME OF COMPLETION 6-30-93
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 replacement necessary as the result of this work.
,r—. _J
Signature of Applicant or Agent
HnnA P.O. Roy 7126 (3rAnA TprranA. CA 97324 (909) 274-0577
Name of Applicant (please print) Business Address Telephone No.
Dave Wensel
Name of Contractor and Job Foreman Business Address Telephone No.
580721
Contractor's License No.
Johnson Higgins
1182
City Business License No.
GL 7702316
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs
Prigte improvements: 3% of estimated construction costs
I
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
$ 240
10
TOTAL: $
250
Receipt No.
Received by Date
x
PERMIT VALIDATION
PERMIT NO. 1748
DATE APPROVED
5-24-93
EXPIRATION DATE 12-.30 R_-�
DATE ISSUED
By?y�Y1
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
I i.P
SPECIAL CONDITIONS --PERMIT NO. 1748
--- Hood Communications Inc. ---
In addition to the standard permit conditions, the following shall apply:
1. All work shall be performed in accordance with the plans submitted by GTE.
2. This permit is only for work within the City of La Quinta and it's R/W.
.Permittee/contractor shall acquire a permit from any other abutting agency and/or
.jurisdiction, ie, Caltrans, CVWD etc.
3. Permittee shall be responsible for providing continuous dust and erosion control.
4. Streets shall be kept clean. They shall be completely cleaned at the end of each
working day and more frequently if required.
5. Contractor shall comply with the local noise ordinance. Operation and
maintenance of equipment within one half mile of human occupancy shall be
performed only during the -following time periods:
October 1st to April 30: Monday -Friday 7:00 a.m. to 5:30 p.m.
Saturday 8:00 a.m. to 5:00 p.m.
May.lst to September 30: Monday -Friday 6:00 a.m. to 7:00 p.m.
Saturday 8:00 a.m. to 5:00 p.m.
Work shall be prohibited on legal holidays including Sundays.
6. Permittee shall assume responsibility for repair of any pavement breakdown at the
haul road access to any public or private street and for any damage to other City
streets or facilities.
7. Advance warning signs and traffic control shall be installed and maintained in
accordance with Cal Trans Standards. It shall be the permittee's responsibility
to detour and barricade this site.
8. Permittee shall notify the City Engineering Dept. at 564-2246 at least 24 hours
in advance of starting construction.
9. Street closures shall not be permitted. A minimum of one travel lane on paved
surface shall be maintained with flagmen at all times.
10. If the work is to be performed by forces other than that of the utility company
the contracting company shall apply for an additional encroachment permit and pay
the appropriate fee.
11. Permanent pavement replacement section shall be 1" greater than existing, but not
less than 3" A.C. over 4.5" A.B. which ever is greater.
i2._ All landscaping.irrigat ion decorative rock etc. shall be replaced to its original
condition.
13. Prior to excavating, the permittee shall contact Underground Service Alert at
1(800) 422-4133.
14. All work shall be coordinated with the City's contractor and others working
within the area as directed by and to the satisfaction of the City Engineer.
i
15. Should additional work, materials, or modifications of the work be required in
order to meet city standards, safety requirements, signage requirements, or to
fit actual field conditions, the work shall be performed by the permittee as
directed by and to the satisfaction of the City Engineer at no cost to the City
of La Quinta.
Special Conditions - Permit No. 1748 Page 1 of 1