1797NOTE:
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
I
Subdivision Improvement Permit - Class III
DATE: 7/7/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION The Orchard Golf Club
Ave 48 between Adams & Dune Palm
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Temporary fire _ hydrant
DESCRIPTION OF CONSTRUCTION 8" PVC from private
irrigation line
DIMENSION OF INSTALLATION OR REMOVAL + or — 400'
SIZE OF EXCAVATION, IF NEEDED 48" deep trench
APPROXIMATE TIME WHEN WORK WILL BEGIN 7/7/93
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION 7/9/93
ESTIMATED CONSTRUCTION COST $ 5000.00
(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:
SEE ATTACHED PLAN
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
4
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.
Signature of Applicant or Agent
.T D Desert Development 41-555�Cook St Palm Desert 773-3302
.Name of Applicant (please print) Business Address Telephone No.
Brooks & Assoc Ray Bartlett 54-711 Eisenhower La Quints 564-3535
Name of Contractor and Job Foreman Business Address Telephone No.
576846
Contractor's License No.
654
City Business License No.
Aetna Life & Casualty Golden Eagle 86CO022703825 PWC206704-00
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111
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 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
P A I DJUL 07IM
1707
PERMIT VALIDATION
PERMIT NO. 1797
DATE APPROVED 7/7/93
EXPIRATION DATE 7/16/93
DATE ISSUED 7/7/93
By tv" u�
Administrative Authority
TELEPHONE: (619) 564-2246
js
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
DATE: % 3
LOCATION OF CON TRUCTION 11-2t? OrG
(Street address or Description of Location) /
PURPOSE OF CONSTRUCTION
DIMENSION OF INSTALLL,AATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit — Class 111
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION 3
ESTIMATED CONSTRUCTION COSTS
(Including removal of all obstruction, materials, and debris, backfilling, cont.
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 saw the City, its authorized agents, officers, representatives and employees, harmless from and against env 9.-A all
Penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or propeity
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 Quints and to pay for any additional replacement necessary as the result of this work.
7,29 1 - / Signature of Applicant or Agent
� / �1 D� rn G�c T /- SS'�'r-1-rl .l ,C/c4- -7 -7 2 rd -.
Name of Applicant (please print)
Namerof Contractors and Job Foreman
J 76f?�
Contractor's License No
ess Address Telephone No.
Address / Telephone No.
/O S¢
City Business License No.
A
s
%.Q44A6Z/ C a �r a 8(Ls Coo Z Z 705 Z3- 7-0( 70 -v D
Applicant's Insurance Company Policy Number
FEES: Subolvislon 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 $
Permit Fee �D
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ % D
Receipt No.
Received by Date
Recorded by
13886
PERMIT VALIDATION
PERMIT NO. 1-177
DATE APPROVED - 7` 7 -
EXPIRATION DATE 7 ` /& — l�
DATE ISSUED 7 y�
By
Administrative Authority
TELEPHONE: (619) 564-2246
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SPECIAL CONDITIONS --PERMIT NO. 1797
In addition to the standard permit conditions, the following',shall apply:°
1. All work shall )De performed in accordance with the latest edition of the Standard.
Specifications For Public Works Construction.
2. Permittee shall be responsible for providing continuous dust and erosion control.
3. Streets shall be kept clean. They shall be completely cleaned at the end of each
working day and more frequently if required.
4. 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 1st 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.
5. 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.
6. 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.
7. Street closures shall not be permitted. A minimum of one travel lane on paved
surface shall be maintained with flagmen.at all times.
8. Prior to excavating; the permittee shall contact Underground Service Alert at
1(800) 422-4133.
9: 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.
10. All landscaping, irrigation, decorative rock etc. shall be replaced to its
original condition.
1.1. 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..
Special Conditions - Permit No. 1797 Page I of I
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