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2291NOT:! -- — 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 1-17-95 LOCATION OF CONSTRUCTION 54-024 Ave Bermudas (Street address or Description of Location) Subdivision Improvement Permit —Class I II Minor Improvement Permit Class IV PURPOSE OF CONSTRUCTION InAtall sewer. lateral Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION Remove & replace 2 panels of sidewalk DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 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: See attached conditions P 0 ✓Ay1 � ?y 1995 �n P/ 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�frjesult of this work. ignature of Ap'blicant or -'Agent Jim Miller Jr. Inc 73-633 Pacheta Thousand Palms, CA 343-3276 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman 681864 Contractor's License No. Business Address Telephone No. 3602 City Business License No. Anneco Group CCP 119004 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class II I Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ 80 Permit Fee 10 Penalty Cash Deposit -Surety Bond if required TOTAL: $ - 90 Receipt No. Received by Date 2291 PERMIT VALIDATION PERMIT NO. 2291 DATE APPROVED 1-17-95 EXPIRATION DATE 1-30-95 DATE ISS ED —17-95 By Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 SPECIAL CONDITIONS --PERMIT NO. 2291 --- JIM MILLER INC. --- 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 1st to April 30: Monday -Friday 7:00 a.m. to 5:30p. m. Saturday 8:00 a.m. to 5:00p. m. May 1st 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. undays. 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. 2291 Page 1 of 2 SPECIAL. CONDITIONS ---PERMIT NO. 2291 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 backfill and subgrade soil shall . be compacted to 90 % relative dry density, all backfill soil within the top 2' of finish pavement surface shall be compacted to 95 % relative dry density, all base material shall be compacted to 95% relative dry density. 12. All excavations at or near the travel way shall be backfilled and paved at the end of every work day as directed by and to .the satisfaction of the City Engineer for the protection of the traveling public. 13. All landscaping, irrigation, decorative rock, decorative concrete, lighting etc. shall be replaced to its -original condition. 14. Access and egress to all local properties shall be maintained at all times.- 15. imes: 15. Sidewalk shall be replaced per the Standard Specification for Public Works Construction. Concrete class shall be 520-&2500. Special Conditions - Permit No. 2291 Page 2 of 2 I, NOTE: With proper validation this form constitutes an encroachment permit CITY OF . LA OUINTA APPLICATION FOR PERMIT -PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the construction of "Ic or private curbs. driveways. pavements, sidewalks. parking lots, sewers, water maim and other like public works Improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS r - cur GATE: - / /' -2 Subdivision Improvement Permit — Clan III Minor Improvement Permit Chan IV LOCATION OF CONSTRUCTION — ?— /) A//j� (Street addnu or Oesai wn of l odationl PURPOSE OF CONSTRUCTION !/ Sketch (attach construction plans if appropriate) OESCRI�TION OF CONSTRUCTION12 92 JA C5 DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST S (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 agnea to: Indemnify, defend end ran the CItY, ib authorized agars. off-mn, rapraarMUM and employees, harries horn ww cup UM my end all Pedes, liab IVIS or lou raWting from dairns or court action and wi" out of any accident. los or damepa m persons a propvty happening or occurring a e preaimete newt Of arty rM undertaken under the pen Wt granted pursuant to this applienlen, Notlfy the Administratin Authority at lem twenty -tour 1241 hours in advance of the time when work Brill be started C"nWy wddt all 800klb4 Cry Ordln wm6 the terrrn end cottdltiam of the permh and all a00keE4 rules and re of of Ota City of Oulno and to pay for anv addki*w npleow m necmery a Ota rewlt of this world v SWW61re of Applicant or AVUa `73-4-33p� C /t �7 l� c� k13 — .3,` Name of APpllpnt (please print) Business Addrae S Telephone N0. Nanta of Contractor and Job Fare"" Business Address Telephone No. Contractor's License No. City Business License No. Applicant's Insurance Company GEV, L lAelLITy Polley umber FEES: Subdivision Improveff*M Permit _Clan 111 Public: improvements: 3% of estimated construction cosi) Private improvement 3% Of estimated construction t Mirror Improvement Permit — Clan IV: See attached schedule Inspection Fee S �� Permit Fee �� I Penalty Cash Oeposit•SuretY Bond if required TOTAL: Z 61d Receipt No. Received by —.Date— Recorded by PERMIT VALIDATION PERMIT NO. 1386 DATE APPROVED EXPIRATION DATE DATE ISSUED — V9 BY � Administrative Authority TELEPHONE: (619) 5647140 . 76