2355NOTE:
With proper validation
x
this forrnrconstitutes 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: 6-16-95 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION The Citrus Course
Tract 24890
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Install Temporary chain Sketch (attach construction plans if appropriate)
link fence for security
DESCRIPTION OF CONSTRUCTION Chain Link fence W/ green
screen on Temporary posts and no footings See attached cinditinas
DIMENSION OF INSTALLATION OR REMOVAL 2150 L.F. on
Jefferson from existing Wall to and of property
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 6-16-95
APPROXIMATE TIME OF COMPLETION 6--20-95
ESTIMATED CONSTRUCTION COSTS; 10,000
(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 theesu It of this work.
r
Jk-�c%-----
Signature of Applicant or Agent
J. M. Peters Co. 3501 Jamboree Road, Suite 200 Newport Beach, CA 92660 (619) 564-4475
Name of Applicant (please print) Peter Rodholm Business Address Telephone No.
Pence Master 2845 Leandro St. Anaheim., CA 92807 (714) 998-8870
Name of Contractor and Job Foreman Business Address Telephone No.
330374 --k%
3776
Contractor's License No. City Business License No.
CNA Ins. 127771713
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I 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 $
Permit Fee
45.00
Penalty
Cash Deposit -Surety Bo4d vo
d ''
if require
TOTAL: $ 45.00
Receipt No
Received by Date
PERMIT VALIDATION
PERMIT NO. 2355
DATE APPROVED 6-16-95
EXPIRATION DATE 7-15-95
DATE IS'UED 6-16-95
By
Administrative Authority
Recorded by II TELEPHONE: (619) 564-2246
SPECIAL CONDITIONS --PERMIT NO. 2355
--- J.M. PETERS CO. 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 S:OOp.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 Alertat 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. 2355
Page I of 2
SPECIAL. CONDITIONS ---PERMIT NO. 2355
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
workday 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. ' Permittee shall remove the temporary chain link fence when & as directed by and to the
satisfaction of the the City Engineer.
16. Permittee has submitted a certificate naming the City as additional insured and accepts any and
all resposibility/liability for the fence.
Special Conditions - Permit No. 2355 Page 2 of 2
NOTE:
With Proper validation
this form constitutes an
encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENTI
t�
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water "wine
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: r C
LOCATION OF CONSTRUCTION
(Site" addna or Onmpwn of Locroonl
PURPOSE OF CONSTRUCTION �7 Me
OF
SIZE OF EXCAVATION, IF NEEDED -- �-
APPROXIMATE TIME WHEN WORK WILL BEGIN C --1 — Q
.—
Subdivision Improvement Permit — Clan 111
Minor Improvement Permit Clan IV
Sketch (attach construction plans if appropriap)
�FL� f1 T%rc f f �D aA/U i 771,9V S
APPROXIMATE TIME OF COMPLETION l —/4 — 949.
ESTIMATED CONSTRUCTION COST S LM .inn cp
(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:
Intlarnmh. Mend aha cavo me City, it, authorized seen, office". rt9eaarhtettw and amplOveea• ham4m from and aeeirut Wry and
all
panWuea. for ocia n loft rWoxwq from loofa ny court action and arwne put of Wry aeeidam. Icia or datnaea to oaraona or pf"n,
happenuhe a ooeurnnV as • poahmste rerun of any wwort untartaaen under the pemtft Vented ourwant to this sp ilication.
Notify Ire Administrative Aul%Mty at Iwt twvenW -four 1241 hours M advance of the rima wwhsn wworfi hill be statue.
Coma" wnhh all epoieaye Ctty Ordinaneas, the tam" and eonditiona of the permit and Nleppticebta rola ane fe9ula'uoru of the Gey d
V QUlnO and to pay for any eddhlonal rsptaeanrm neonary as tM vault of fhb war
Signature of Applicant or Agene
3s'°1t70
x I/l S -,a Q�RZ✓� eoa n l Sl h l lr*✓ 7
Name of Applicant (Please print)r,aBusiness Address Telephone No. '
r r,t.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business Liorw No.
x �y�- Ia777/7t3
Applimnt'sInsurance Company 01CU. LIABIL-ITY Policy Number
FEES: Subeivhshon Improvement Permit —Clan 111
Public improvements: 3% Of estimated construction posts
Private improvements: 3% of estimated construction costs 1 v Fj
Minor Improvement Permit — Clan IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Data
Recorded by
PERMIT VALIDATION
PERMIT NO. ;7
DATE APPROVED
EXPIRATION DATE 7 9S
DATE ISSUED
By /
Administrative Authority
TELEPHONE: (619)777-70755eoftW
Cod 9 Z4&0
-7s-
'-138-70
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-----------------
® A ®
ISSUE DATE (MM/DD/YY)
e
06/09/95
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
D.L.D. Insurance Brokers
2424 S.E. Bristol St.
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
Suite 360
COMPANIES AFFORDING COVERAGE
Newport Beach, CA 92660
COMPANY
LETTER A United National Ins. Co.
RR
INSURED
COMP
AN LETTER B Industrial Indemnity
J.M. Peters Company Inc., EtAI
COMPANY
LETTER C
4100 MacArthur Blvd., Ste. 200
Newport Beach, CA 92660
COMPANY D
LETTER
COMPANY E
LETTER
MENEM
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTI'VITHSTA":DING ANY REQUIREMENT, TERM OR CONDITION OF ANY-CONTRACT OR OTHER DOCUMENT WiTH'RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE(MM/DD/YY)
LIMITS
A
GENERAL
LIABILITY
BODILY INJURY OCC. $
X
COMPREHENSIVE FORM
SMP53527
08/12/94
08/12/95
BODILY INJURY AGG. $
X
PREMISES/OPERATIONS
PROPERTY DAMAGE OCC. $
EXPLOSION BNCDOLLAPSE HAZARD
X
PROPERTY DAMAGE AGG. $
X
BI & PD COMBINED OCC. $ 11000.000
PRODUCTS/COMPLETED OPER.
X
BI & PD COMBINED AGG. $
CONTRACTUAL
g
INDEPENDENT CONTRACTORS
PERSONAL INJURY AGG. $ 1000000
i+;
.......................................................................
.......................................................................................
M
BROAD FOR PROPERTY DAMAGE
X
PERSONAL INJURY
AUTOMOBILE
LIABILITY
ANY AUTO
BODILY INJURY
(Per person) $
ALL OWNED AUTOS (Priv. Pass.)
ALL OWNED AUTOS (1,r11,
Pdv. Pass.
BODILY INJURY $
(Per aoddenl)
HIRED AUTOS
NON-OWNED AUTOS
PROPERTY DAMAGE $
BODILY INJURY&
GARAGE LIABILITY
PROPERTY DAMAGE $
COMBINED
EXCESS LIABILITY
EACH OCCURRENCE $
AGGREGATE $
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
.......................................................................................
B
WORKER'S COMPENSATION
STATUTORY LIMITS
EACH ACCIDENT $ 1,000,000
CB9048094
08/12/94
08/12/95
AND
DISEASE—POLICY LIMIT $ 1,000,000
EMPLOYERS' LIABILITY
DISEASE--EACH EMPLOYEE $ 11000,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
Certificate holder is additional insured but only.as respects liabilities Re: Citrus Tract 24890
arising out of operations of the named insured.
e e
s
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of La Quinta
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, mxlgo mBx 7xxxo
71llVXlfiR ar al9tAl�achtR�tcSilBlF�c 11101.
AUTHORIZED ATIVE
000040
SID •r
S•a a•e••S• ® s
4
V
78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 - (619) 777-7000
FAX (619) 777-7101
Engineering Plan Check Deposit
Project: Date: lE
Map/Plans Submitted for Checking # Sheets/Lots Estimated Cost
r
j
v /
Other Items Submitted
City administrative charge (25%, not to exceed 82,000 per tract): $
Total Deposit Required: 8 7i,S0 O
Account No: ❑ Project origination prior to 6/30/90 .101-000-443-375
Project origination after 6/30/90 101-000-251-00< ,
251
Owner:
1
Owner:
Address:
I
J� 0OIZ-r fxiw-,t�,, 9 Zv��o Phone: ��lv`(-
Engineer:
Address:
Phone:
Prepared by: 1'Wf.0 Avr&- L��
C:\WP\F0RMS\F001.WP REV -2 1/95
MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253 �(�
T4tT.4 4aumrw
MEMORANDUM
TO: Permit File 2355
FROM: Hector Guzman, Engineering Technician
DATE: June 16, 1995
SUBJECT: J. M. Peters Co. Fence Deposit (Tract 24890)
The developer has provided the City with a cash deposit of $2,500 for the installation of the
temporary chain link fence on Jefferson St. The check was in the amount of $2545.00. The
additional $45.00 was the permit fee, which is non-refundable. The $2500 was deposited into
a plancheck deposit account. When the developer requests release of the deposit and has
complied with all city requirements a check request will be made from account No. 101-000-
251-000/251-082.
hg
J.M. PETERS COMPANY, INC.-
3501
NC.3501 JAMBOREE ROAD, SUITE 200
NEWPORT. BEACH, CA 92660
CHECK DATE
6/12/.95
PAY TO THE ORDER OF
CITY OF LA QUINTA
2640
CoreStates Bank of Delaware NA -08583
in Cooperation With :
First Interstate Bank of California
62-22!311
i•••1 i •i I d II:: •II L.....IIf .i;, ... enU
...�4 �^� 1... 1• II•dn III1I1� � :dI ..'i ,� III i i i i.i1 1IU111 III1111 + Ii ► '
• I
11'008 58 311' 1:0 3 1 100 2 2 5i: ' 00 20111 1099ii■
AMOUNT
*********2545.00