2279-1
NOTE
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 I I I
DATE: 12-21-94 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
Santa Rosa Cove
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sealing of Entry
DESCRIPTION OF CONSTRUCTION Asphalt S urry
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 8'00 am
Sketch (attach construction plans if appropriate)
See attached conditions
APPROXIMATE TIME OF COMPLETION 2: 00 pm
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:
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Indemnify,defend and save the City, its authorized agents, officers, representatives and employees, harmless from and: gainst 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 applicAation. 1 _
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be stari ted.
It
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of w
La Quinta and to pay for any additional replacement necessary as the s t of this work.I —)Ol
ignature of Applicant or Agent
Asphalt M.D.'s P.O. Box 98 Thousand Palms, CA 92276 342-0013
Name of Applicant (please print) Business Address Telephone No.
Gary Butler
Name of Contractor and Job Foreman Business Address Telephone No.
626842
Contractor's License No.
City Business License No.
Pacific National BCP 2175986-05
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
20
10
30
Received by Date
2279
PERMI.Tl VALIDATION
PERMIT NO. — P7 q4
DATE APPROVED 12-21-94
EXPIRATION DATE 12-31-94
DATE IS E 12-21-94
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
4
78-495 CALLE TAMPICO — ,LA QUINTA, CALIFORNIA 92253 - (619) 777-7000
FAX (619) 777-7101
January 18, 1995.
Asphalt M.D.'s
P.O. Box 98
Thousand Palms, CA 92276
Attn: GaryButler
Re: Encroachment Permit No. 2279
Dear Mr. Butler:
The City of La Quinta hereby grants Asphalt M.D.'s a time extension on Encroachment Permit No. 2279,
for the sealing of the street entrance at Santa Rosa Cove. The revised expiration date is January 31, 1995.
All original conditions remain in full force and effect.
If you have any questions regarding this matter, please contact me at (619) 777-7075.
Very truly yours,
Hector Guzman
Engineering Technician
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cc: John Freeland, Senior Engineer
Danny Johnson, Maintenance Manager
—Encroachment Permit -File No. 2279
MAILING ADDRESS P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253
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APPLICATION FOR PERMIT
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SPECIAL CONDITIONS --PERMIT NO. 2279
--- ASPHALT M.D.'s --- .
In addition to the standard permit conditions, the following shall apply:
1. All. work shall be 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 i st to April 30: Monday -Friday 7:00 a: m. to 5:300.m.
Saturday 8:00 a.m. to 5:00p. m.
May 1 st to September 30: Monday -Friday 6:00 a. m. to 7:00p. m.
Saturday .8:00 a. m. to 5:00p. M.
Work shall be prohibited on legal holidays including Sundays.
5. Permittee/contractor shall assume responsibility for repair of any pavement damage to any public
or private street and for any damage to other City streets or facilities as a result of work
performed under this permit.
6. Advance warning signs and traffic control shall be installed and maintained in accordance with
Cal Trans Standards or the Work Area Traffic Control Handbook (WATCH Manual). 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.
Special Conditions.- Permit No. 2279 Page 1 of 2
SPECIAL CONDITIONS ---PERMIT NO. 2279
continued .,
10. 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:
11 All landscaping, irrigation; decorative rock, decorative concrete, lighting etc. shall be replaced
to its original condition.
12. Access and egress to all local properties shall be maintained at all times.
13. Traffic signals shall be controlled by the city only. The signal at Ave 50 and Eisenhower Dr.
shall be controlled as directed by and to the satisfaction of the City Engineer.
Special Conditions - Permit No. 2279 Page 2 of 2