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2611'"NOTE:""./,�.~ t 'j ' With proper validation 2 this form constitutes an `CITY OF. LA 'OUINTA encroachment permit APPLICATION ,FOR -PERMIT r, 'A PUBLIC -WORKS XONSTRUCYION (ENCROACHMENT) C ' T rh' • j ' ;' .a - `- ` _..�,f3t . • .. �0F TN89 ''�+. • - 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 Su6clivision.Improvement Permit — Class 111. . • DATE: r.' '' s' -,r. , . r--. +•', + , Minor Improvement Permit Class IV LOCATION OF, CONSTRUCTION edt 23913�1t► »•(Street address or Description of Location) x PURPOSE,OF,CONSTRUCTION ItViUdt 01tViBt '� Sketch (attach construction plans if appropriate). 1iAiati1t#►iI7E A •, M DESCRIPTION'OF,CONST,RU' ION', $tt44tO► fur tri*.'itu '��tA yy sq�N1p�y1 y�y�. �y�!t�1 g � F _ �r' + `? � `r ` � _ �` + _ '�dY/a Q #r ?F+I}W.�},fi!i� �111+r,K a, ��'�" � - ` • ' 3 •DIMENSION OF INSTALLATION OR;REMOVAL - �� • r ` _ �' `- r `, : _- 1,. •. " •�r>,�r,3Y` r i : ]' rr r ' iYi''t ! - �' - - _ i • _ ' • ".j,. - y T,v !2 _c�L �� .•`�.•,� '1 y Y �y- r"'' '. •r • r' Y' r'; u +.SIZE'OF�EXCAVATION, IF NEEDED qtr ;;APPROXIMATE TIME WHEN WORK WILL BEGIN t&•r� .,.xa Ai'r �` U •'t.S' '� "f t n''F t .. .. r •. `a���}YAPPROXIMATE TIME,OF COMPLETION '{j�• ESTIMATED;CONSTRUCTION COST -$ ' (Ihcluding removal offal) obstruction; materials Wand debris, backfiIIing'com • ;: - `,, paction and placing permanent resurfacing and/or rep lacing.improvements) . rt In consideration of tFie'granting ofahis permit;ahe` applicant hereby;agrees".to:' . .'•� Indemnify, defend i and save,t-ie City, its authorized agents, offices, representatives'and employees, harmless from and -against any and all x -penalties,..,,liabilities or•loss"resulting from claims�or courtaction"and arising out.of any.accident, loss or damage to persons_ori:property-. ; `: �'.3 � Happening oroceurring,as'a proximate result of any work undertaken under -the permit granted. pursuant to this application. • c .r Notify the'Administrative Authority `at least twenty-four (24) hours-iin'advance of the time, when work'will,belstarted" Comply �w th tall .applicable,City Ordinances, the terms and conditions of thepermit and all applicable rules -and regulations of the City of La Qui and°to ,pay for. any additional replacement necessary as'the result of this work. Signature of*AppI nt or.Agen�t�� .31'535 441uth 00a �t it 8 :1�ei�iiei Q no. 8 (9t19). 381-6!007 Name�of Applicant (please'print) Business Address' 1 +` Telephone'Not (009) 4644 _10' Name of Contractor and'Job Foreman Business Address - Telephone No. Contractor's License,No. :' y City Business License No. Applicant's Insurance'Company k..`. `Policy Number ` FEES: Subdivision Improvement Permit — Class III - r-, Public improvements: 3% of, estimated, construction costs ' JUL 21 ,199 1 ' Private improvements: 3% of estimated construction costs I1 .... Minor Improvement Permit — Class'IV: See'attached schedule Inspection Fee's $ 2- 22 PERMIT. VALIDATION �t���t�{•l 4 Permit Fee PERMIT N0. Penalty 't Cash Deposit Surety Bond DATE APPROVED 5/29/97 if 1,000. (as -bunts) required EXPIRATION DATE 5 29 98 TOTAL: $ 3.329. f DATE I/S.SU�Fn Receipt No: • gy Received by Date U Administrative Authority Recorded:by 1! It, Telephone: (619) 777-7075 UNIT PRICE 1 TRI TO =_TR2- OTY- - - 0.70 - 6.06 4.694 6,706 4,694 "� 14.896 14426 144 1 11,529 14471 k'>•H11.529 0 • 0 - � r .. i • ` r � � taw. p 0 4 A � r , � - ., a� • . Y �, . �," , 0 - O h k in+10 0-0- 0 •. 15082D 150 —REMOVAL � }' o � v 4 � ~ ` t f - � ", � "• .v .. - :.. _ �J' �, It �. •PAGE2 0 150840 .ROCK _ ,Y�, - .. "" Y 4. - UNIT PRICE 1 TRI TO =_TR2- OTY- - - 0.70 - 6.06 4.694 6,706 4,694 "� 14.896 14426 144 1 11,529 14471 k'>•H11.529 0 • 0 81,247 0 12873 0 —0-0 0 0 0 0 0 0 - O h k in+10 0-0- 0 15082D 150 —REMOVAL o 0 0 0 � 0 '. 0 -0 4 i- - 0 0 0 ` 0 150840 .ROCK 0 3.72 - 1 -'1 25 - 1 ___4,6 1 1 4,675 - 75 1 k}„.,4,875 4 0 - 0 S . 22075 150610IES 0.70 CV 1 7,857 5,500 13,714 - 11,000 44114 34680 41,114 - 34880 —17,397 t 12178 0 - 0 129,197 0 94438 0 150820 IXCAVATION"ICUs 6 FILL) ERA 0 0 0 0' 0 0 0 0 0" 4h,:0 0 0 /sas2o 0 0 0 0 0 0 0 0 'k 16-0 0 0 0 0 0 150620 SITE PREP/OVER IX 0_ 2 4800 31 4 2 30 . -4250 32 k .4900 0 0 .111 3.1771 150 275.00 - ACRE 18R-4.4010 50 6 5.100. 8 4800 6 • 4800 - 7 hk+_'.5950 0 0 344 28.9W150610 24900154s2a EROSION CONTROL - 85000 0 0 0 0 0 0 0 kh . 'a 0 t 0 0 00 0 00 0•O150620 150620 SLIDE REMOVAL 000 0 0 0 0 0 +h ,, ateO100 00 _ 000 00 0 0 0 0 0 fk`:.dt=.01 0 0 0 150820 ADDITION AL MOVE -W - 00 - 0 00 o 0 -, 0 0 b,+..t' 0 • -0 150610 152400 CONST., WATER, PREWATER 350.00 LOT 00 180 - 32 11,200 31 14850 30 14500 2631 32 1k - 0 0 0 111 - .49.350 272,411 - 24169 ,:1 44,519 72356 1.932 COST PER UNIT - - - °' ' �. , r , - _ 272,411 CUdMLLATIVE TOTA6 aaaggg�yyy . - 1 1 O - - 300.00 i -, 300 2 Soo 1 300 2 _ 600 -1600 211, --}i 600 ' '0 0 - 8 6 2.404 800 .150920 STREET SIGNS - 1 1o0 �- 2 200 1 100 2 200 - 2 . dk 200 �... 0 0 150820 10D.00 - SF - 14539 14,831 47.8 341 441 3490Q 44737 37,390 37,499 29.999 -. 0 0 184595 157270 150710 AC OVER 4'AB NTEPoO 0.80 O O U - 0 0 0 0 a- W 0 - 0- 0 1 710 - - 1071-0 - 0 0 0 - 0 0 0 0 - 0 •'0 :' 0 0- 0 0 150710 ACOVER BASE EXTEPoO 1,000 1.000 1 - 1.000 1 - 1.000 - 1 ks 1.000 0 0 5 4000 150710 STREET STRIPING 1000.00 PHASE 1 - •1 0 '• 0 0 0 0 0 0 .tr'; 0! 0 0 0 0 154710 AG ODER NAME: - -MIN , 0.25 SF 14519 0 4.635 47,893 11,923 44127 - 11,532 44737 11,666 37.499 ►-ti8.375 : 4 0 198.593 4911 0 150720 VAR. THICKNESS AC. CAP 1 0 0 0 0 0 0 �0 �-`0 0 0 1. 150900 ADJUST MANHOLES SEE SEWE 0 0 0 0 4 /° 1 0 0 1 54000 15 0720 OFFTRACT PAVING CAP 6 STRIPING 38000.04 LS 0 0 640 -31 620 30 800 320-3.200 .0 0 141 2620 150820 PAVEMENT REM O✓AL 2400 LOT _LOT 18 320. 32 32 3,200 31 3.100 30 3,000 32 0 0 141 14.100 150420 CURB AND GUTTER/R&R .i - IW.00 16 1,600 31 930 30 900 0 0 0 - 909 3270 150 220 SIDEWALK REMOVAL 30.00 LOT 16 460 32 980 0 0 0 0 0 0 0 0 0 150910 BARRICADE REMOVAL OR CONST 0700 EA 0 0 -0 - 0 0 0 0 0 0 00150920 150810 REMOVE/CONST REDWOOD HEADE 0.00 LF 0 0 0 0 0 4 0 0 0 0 0 00 0 flELOCATE WARNING SIGNS ” 4 000 0 - 0 0 0 0 150920 REFLECTORS EA 0 0 0 54678 54.483 - 55374 290.875 -- STREETS TOTAL - - 23°266 ° 2,063 - COST PER UNIT1�/ - 563.226 Ir4,c.y moi•. ,. 3.r C _. - , • -� �+, - =EY... �_+,•} _� a'� J 'F t ,s. - ^.. �' .r ,. • . v 7, - .yam " , 1 ay f. - t r P - - rZ• 4 r ••w.. 'r _ r Y- F - ' rr y - ,5 '. f �r r ` •f '4 w V\\�\�' . i A�' �- i - , • • ' _ - ._ r , _ _ - :• i`- :..:K t� ' .s1 �* .d„ , ., rt NIT , .- • e 'bi : r y 1 • �Y . . '- - �T • '}.' PAG `•.MCI .. 23935-3. _ GUTTER - - 0 0 - 0 - 867 5,419 • 540 3.375 0 0 . 0 1.107 460 &794 _ '4, • ., 2875 ' 150810 CURB AND GUTTERS' - 825 LF 0 79 191 239 1,494 112 0 0 0 0 SQ 055 , 75472 ...15081 8.25 1.30 SF 5735 7,456 11,252 18,526 13.232 17.989 - 668 12820 18668 11,110 1,848 11233 -3,2.V0 0 122 - 150810 CONCRETE SIDEWALK - .1.80.7 1.248 3,231 - 1.775 3.108 1,735 3.038 - • -- - 150810 1.75 SF .918 0 822 2550 0 0 1.025 1.203 0 0 - 150810 CONCRETE CROSS GUTTER 1.10 - 0 2 100 2 400 7 1,100 0 0 ;•r .• ' ' . 150810 . v* OFF -TRACT SIDEWALK 200.00 1069800 y _ LS 1 10,698 0 o 0 0 -0 0 0 0 117 887 0 -�. p ; 'i.w.,'U 0 0 0 t .l _ .. . t', °} _'. PROItAT 150810 150810 6' 570 O 0 0 0- 0 0 0 0 0 • ��'� 0 0 M647531 •, - 150810 REFLECTOR PADDLE .0 25 p COST PER UNIT ` TR2 TOT OTY-TR3 TRJ TOT OTY-TR4 TR4 TOT OTY-TRS TRS TOT OTY-dTTRB TOT ONTY TOTAL GRAND TOT . • �,,,, ACCT DESCRIPTION UNIT PPoCE UNIT OTY-TR1 TR1 TOT OTY-TR2 23935-3 23935-4 23935-5- 2393.5-B- 0 p 0 .. - 0 0. 0 0 0 0 0 0 - 0 0 - . 0 0 0 0- 0 0 r 0 151900 1'V.C. P. 0---T _ p p p 0 10,4100 2 13.4700 - e.813 160 sa008 - _ 15190D 6' 1500 LF - 449 6.735 • _ 1,222 18330 481 7,215 1,2940 Q U 813 13.008 . - 151900 8-V.C.P. - 0 0 , 0 813 1a008 0 0 0 _20 280 151900 1P - - 1800 0 0 0 20 - 280 0 0 -0-0 0 0 0 p 0- - " 151900 2' 0.l P. 14.00 LF 0 0 0 - 0 - 0 0 0 1 , 50 • r .. •„ - r - 1 1900 10' .. - '•�•� 0 0 0 1 50 0 0 1 0 0 0 p 0 0 / 200 ' -. • 151900 10'V.C. P. PLUG -' 1 ---m-0-0-0 r 0 0 0 0- '0 p p 0 -.• .. 15190D 2' p 0 0 0 0 p 0 _ 32 8 0 0 143 40,040 . z" ,•� ';. 151900 SAND BEDDING /8 4,480 32 8960 31 2,680 J2 8980 -1000 0 0 9 4.500 .+ • - • PRORAT 151900 - 220'00 500.00 EA - 1 -500-2 1000 2 1000 - 2 1 000 3 x750 2 2 -_2500 14 . •17.500 - 151900 JOIN EXIST SEWER 1250.00 EA 1 - 1,250 - 3 3.750 5 8.250 2 - 0 0 } . -'•'• 151900 MANHOLE EA 1 250 1 250 1 250 1 250 '2 20D 0 0 7 700 . - _ L. 151900 CL -OUT 250.00 EA 1 100 2 .. - 200 1 100 1 100 , 0 0 0 0 . 0 151900 ADJUST CO TO GRADE 100.00 0 0 0 0 0 0 - 0 0 _ 14 atso .'�. 151900 PAVEMENT REMCV 6 REPLACE 1 - y� 3 675 5 1 125 3 675 - 2 4 0 111 42300 _ 151900 ADJUST MANHOLE TO GRADE ADJUST ANHCUER .225.00 EA 1800 37 11100 310 93000 250 75000 p '. - - 151900 ERALS 300.00 LOT 16 0 0 - 0 -30 - p 188,388 - 1519G0 E. 18390 44,285 47,250 41.795- 8 1 1.336 ` TRACT SEW ER TOTAL _ •' 972 277 • COST PER UNIT - - •' - - • -. t CUMMULATNE TOTAL - � 4 .; � .. - .. s . r' ^.F•�: • � .. - - _- t "'^`-. • • r. "� r �t �. r.. i4 • _ f 'i '� `r..."TM- •Y`^ _ r r •` r • •� 'l,y '. `•.. ! � •� �. ,.43. S- •- ' �_• � � � � � � y - . •'• � _ -1 "�� .. _ _ o r � � NOTE: 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 likepublic w rks improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS LOCA ON Subdivision Improvement Permit — Class II I Minor Improvement Permit Class IV (Street address or Description of Location)_ PURPOSE OF CONSTRUC (�'tGrS l�ll�cC� ` Sketch (attach construction plans if appropriate) r � DESCRIPTI N 0 NSTRUCTION�vvI�rl A - if DIMENSION OF INSTALLATION 6R RE OVAL SIZE OF EXCAVATION, IF NEEDED .APPROXIMATE TIME WHEN WORK WILL BEGIN' APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, a e Is, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, the applicant hereby agrees to: U?) Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loin 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. Notity the Administrative Authority at least twenty-four (24) hours in advance of them n work I tiI be started. Comply with all applicable City Ordinances, the terms and conditions of the perell applicabl rni dules and regulations of the City of Le Quints and to pay for any additional replacement necessary as the result o is work. 'o gnature of Applicant or Agent S-35-5 TIt t1�"' G' gzyo8 Name of Ap li nt (pl ase / t) C d Telephone No. Na a of Contractor and Job oreman Business ddress Telephone No. i 34� 8&7 3YzZ Contractor's License No. City Business License No. �o n/M �� Wti� 0 fALIr-Z v89L Applicant's Insurance Company GEN. LIAISILITy 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 Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. $ Z zZ4 1,40 00 v (i9 -S i3u�L1/ Received by Date Recorded by PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE �v DATE ISSUED By Administrative Authority TELEPHONE: (619) 777-1075