2592NOTE: + • - .
;.
-With proper validation ,
ca this form constitutes an -
', ..',encroachmenrpermit
Zk
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 MINORIMPROVEMENTS and APPROVED SUBDIVISIONS
~:Subdivision Improvement Permit — Class III ,t
DATE: Marah .19, 1997 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION VestvinA Untativa Tract 28457/28458
,.� (Street•address or Description of Location) _
r" PURPOSE OF -CONSTRUCTION ftMMter-Only ,Sketch*(attach construction plans if appropriate)
'DESCRIPTION.OF CONSTRUCTION
!` to g> OW4ter only,, for Mao S#;44 g. t *,
DIMENSION OF INSTALLATION OR'REMOVAL -SIR ATTAM CONDITIONS
..
SIZE OF EXCAVATION, IF NEEDED'
APPROXIMATE TIME WHEN,WORK WILL BEGIN ;
_ �APPROXIMATE•TIME OF COMPLETION r
ESTIMATED CONSTRUCTIONCOST $
7(Including removal of all,obstruction, materials, and debris, backfilling, com-
paction. and placing permanent resurfacing and/or replacing improvements) �.
t, 'Iri -consideration of the granting of this permit, the applicant hereby agrees to: r`
. *.
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.
,r Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of he City of
P^ La Quinta and to' pay for any additional replacement necessary as the resuVrof this or -k.
"_.
Signature of Applicant or Agent
` ZZ 'Oua, ine.. ;„` 1 pioVexttiraa, R&UChn. Mirage r CA . (S19) 777-7766
Name of Applicant (please print) Business Address. Telephone No.'
Ragir Snellaaborgeir 6 Asisoa. 1 1+20rautfta,.,0AAeh0 Mirages CA, (619) 777 y7b6
.Name of Contractor and Job Foreman ' Business Address Telephone No: +
488234 1$58
Contractor's License No. City Business License No.
United' C4p:ltak OU 1251391
Applicant's Insurance Company ......,,Pyolicy Number
FEES: Subdivision Improvement Permit —Class III
Public imlirovements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs MAR 19 -1997
Minor.lmprovement Permit — Class IV: See attached schedule
TY OF LA (MINTA
Inspection Fee $ II PERMIT VALIDATION
Permit Fee 100.00
Penalty
Cash Deposit -Surety Bond,
if required
TOTAL: $ 100.00
Receipt No.
Received by Date
Recorded by
'PERMIT NO.
9§92
DATE APPROVED 3/19/97
`EXPIRATION DATE 5/30/97
11 3
DATE ISSUED/1”' 7
Administrative Authority
Telephone: (619) 777-7075
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 SUBDI'JISIONS
Subdivision Improvement Permit — Class I I I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION J��'E- T£�1TAr,JE .T12Aes i2$t�S"1/2$`iS�
(Street'address or Description of Location)
PURPOSE OF CONSTRUCTION p appropriate)
Sketch (attach construction lans.if
fts7g Ir~ t 2R Lt r1' 1 o St/5� i
DE CRIPTION OF CONSTRUCTION n
orJL(. Foy "Ass 'G2.�nI►.►� . � - Alr-r_ t �u1(b(Tj0Aj 5
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL'BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED'CONSTRUCTION COST $ 25�ip '—
(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:
Indemnity, -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 Quints and to pay for any additional replacement necessary as the result of this work. '
f
I Signature of Applicant or Agent
iEZOwE WC. `FLz
4eis� 1,�C�nP�ldatk2 �lol� 7 1�- 7 7(„fo
Name of Applicant (please print) Business Address Telephone No.
-7(0!�
Name of Contractor and Job Foreman . Business Address- Telephone No.
Contractor's License No. _ -_ City Business License No.
UijI �Qr L. CL•-' t2'�: 14!>0
Applicant's Insurance Company Cv6K LAAI5ILITy+ Policy Number
i
FEES: Subdivision Improvement Permit — Class I II
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
i Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by Date `
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED J r, 1 �
EXPIRATION DATE �'— 5L
-p
DATE ISSUED �y 9 cl -7
By
Administrative Authority
TELEPHONE: 1619) 717-1076
SPECIAL CONDITIONS --PERMIT NO. 2592
--- SNELLENBERGER & ASSOC ---
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".
No fill shall be placed which will cover or obscure asphalt concrete, petroleum product- spillage,
or other non-native materials.
2. Permittee shall furnish the name(s) and phone numbers) of the individual(s) responsible for
maintaining dust control after hours, weekends, holidays, etc.
3. All streets shall be kept clean of all trackage or spillage from vehicles using this site. The roads
shall -be completely cleaned at the end of each work day, if necessary, and more frequently if
required.
4. Construction operations 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:OO'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 is prohibited on Sundays and, all holidays observed by the City of La Quinta. Work is
allowed on Saturdays only if special arrangements, including payment of overtime inspection fee,
have been made two (2) working days prior to the desired Saturday.
5. Permittee is responsible for repair of any pavement damage or other damage to access roads and
other public facilities.
7. Should additional work or modifications be required in order to meet established City Standards
or in order to fit 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.
8. It is the permittee's responsibility to comply with the California Regional Water Quality Control
Board's National Pollutant Discharge Elimination System (NPDES).
9. Any on-site haul road shall be effectively destroyed at the conclusion of the work.to prevent use
by unauthorized vehicles.
Special Conditions - Permit No. 2592
Page 1 of 2
SPECIAL CONDITIONS - PERMIT NO. 2592 continued
SNELLENBERGER & ASSOC.
10. Permittee/contractor shall install stop signs to stop construction traffic prior to entering any street
from the construction site.
11. Street closures shall not be permitted at any time. A minimum of one lane on paved surface shall
be maintained at all times with flagmen at -all times per CALTRANS standards or the WATCH
(work area traffic control handbook). A traffic control plan shall be submitted to the Engineering
Dept. for review prior to any lane closures.
12. All excavations at or near the travel way shall be backfilled at the end of each work day for the
protection of the traveling public. No trenches shall be allowed to remain open overnight.
13. This permit is' specifically for prewatering only. No grading, trenching, excavating or construction
of any type shall be performed.
Special Conditions - Permit No. 2592
Page 2 of 2