2375'— NOTE: t t_.,j
W ith. proper.val idation
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 II
DATE: 8-30-95 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 53-740 Eisenhower Dr.
%-street Calls Arroba
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Construct block Hall Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Construct Mall footing in
Public R/W 212" to 3' from Property line
See attached conditions
DIMENSION OF INSTALLATION OR REMOVAL Wall Footing
in R/W 212" to 3'
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 9-1-95
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ 2.800 a
(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.
Signature of Applicant or Agent
Robert b Suzanne Andreasen 53-740 Eisenhower Dr. La Quinta, CA 92253 564-2003
Name of Applicant (please print) Business Address Telephone No.
Owner/Builder
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision 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 $ 20.00 II
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
10.00
$ 30.00
Date
2375
5
PERMIT VALIDATION
PERMIT NO. 2375
DATE APPROVED -
EXPIRATION DATE
DATE IS UED
By
8-29-95
9-30-95
8 -
TELEPHONE: (619) 564-2246
. �.
1: ! � � . ,, i � t �. i
SPECIAL CONDITIONS --PERMIT NO. 2375
--- ANDREASEN
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 1 st to September 30: . Monday -Friday 6:00 a.m. to 7:00p.m.
Saturday $: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 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. 2371 Page I of 2
i
SPECIAL CONDITIONS ---PERMIT NO. 2375
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.
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Special Conditions - Permit No. 2371 Page 2_ of 2
J
X
X
CTI y OF LA CtUINTA - - -
NOTE: 3
WM proper validation AUG 2 1995
this form constitutes an.
encroachment permit CITY OF LA OUINTA��pAi��� C1r,ORK.S
APPLICATION FOR PERMIT'
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs. driveways, p.avem nu. sidewalks. parking lots, sewers, water maim
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: _ �4 Subdivision Improve hent Permit — Class 111
Minor improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Oaniption of t.oesaon) 7
PURPOSE OF CONSTRUCTION Sketch (attach construction
plans it apprapriap)
DESCRIPT NOF CON RUCTION , r
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION �' ^
ESTIMATED CONSTRUCTION COSTS
(Including removal of all obstruction, nuteruls, and debris, backfilling, cam.
Paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
IndamniN, defend and are the CITY, its authorized agues, officers, repnMmathna SSM amployab, harrnlas from and against any
end an
penalties. i4bilitla or los rawting from Caine or cowl action and arising out of ant accident. Ips or
happening or ooarrring SS • prp�eimete new" of any wort undertaken and r the palmi. dan� persons or pMepaety
gtarrtad Iturtaunt to this application.
NOUN the Admininratire Authority at hest [wentydour 4241 hours in edwe¢e of the time when "Wt aril be torted
Cpmply rash all app kWO City Ordinances, ow tams and ewnditio a of the permit and all applicable MISS end regulations of the City ot
V Oulnu and to pay ter any eldkWW replacement necessary IS the mutt of this work.
e7 — A S;gna/ Lure of Applicant or Agent
x
Contractor's License No.
Duman NQarges
Telephone No.
City Business I ice—
Applicant's Insurance Company 01CU. 1-II015ILITY Polky Number
FEES: Subacvision Improvement Permit —Class 111
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit Class IV: See acpdied schedule
Inspection Fee
Permit Fee
Penalty
Cash Oeposit•Surety Bond
if reQuired
TOTAL: s 3
Receipt No.
Received by Date
Recorded by `
1 v2FJ
PERMIT VALIDATION
PERMIT NO. 7,5
DATE APPROVEDy
EXPIRATION DATE
DATE ISSUED
BY �
Administrative Authority
TELEPHONE: (619) 5642240 .
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