2670NOTE:
With p"ropei validation
this form constitutes an
j CITY OF LA QUINTA
encroachment permit
APPLICATION .FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
r 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 III
DATE: October -2,00 1997 Minor Improvement Permit Class IV
LOCATION.OFCONSTRUCTION, InterAP-Cf~iCIR of Ave. Aarmud",A and Frances Raik Lane'
(Street address or Description of Location) _
PURPOSE OF CONSTRUCTION To orovi.d.e ilr:mest:in water
service to* "Tradition" devedooment
DESCRIPTION OF CONSTRUCTION InstAl:l. 1 - 24" sr"b
out c6fina;ection 151 east of Rarmudag ca ntgrlfnw
And 3.36' south of FranaeR Fac' lane ..
DIMENSION OF INSTALLATION OR REMOVAL 81 R 81
SIZE OF EXCAVATION, IF NEEDED game as above
Sketch (attach construction plans if appropriate)
SEE ATTACHED CONDITIONS,_..».
SEE SHEET. 2 OF f5 0 THE PLANS,
TITLED,"TRADITION TRACT 28470-1 &
TRACT 28611, WATER IMPROVEMENT
PLANS," BY KEITH CO.
APPROXIMATE TIME.WHEN,WO.RK WILL BEGIN 10/97 r
APPROXIMATE TIME OF COMPLETION 10%97 .
ESTIMATED CONSTRUCTION COST $ ' '.41„000r00
(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 Ioccurring 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. .J
Signature,of Applicant or Agent
Coachella Valley Water District P.O.•Box 1058 Coachella. CA (760) 398-2651
Name of Applicant (please print) Business Address Telephone No.
96bert Ford ext: 532
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 111
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
Received by
Recorded by
$ - 0 -
Date
2-O
PERMIT VALIDATION
PERMIT NO. 2670
DATE APPROVED 10/28/97
EXPIRATION DATE 10/28/98
DATE ISSUED
By �^
Administrative Authority
Telephone: (619) 777-7075
The following General, and Special Provisions are attached to and made a part of Permit No.-
GENERAL
o:GENERAL PROVISIONS
The following shall always apply:
ENROACffi14ENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within City of La Quinta right of
way ONLY. Whenever construction extends within private property, it is the responsibility of the permittee for his contractors to
secure permission from abutting property owners. Such authorization must be secured by the permittee priorto starting work.
TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated tracklaying construction equipment -shall not be permitted .to operate on
any paved surface unless fitted with smooth -faced street pads., All mechanical outriggers shallbe fitted with rubber street shoes to
protect the paving during excavations. Rubber -tired equipment -only shall be used in backfill operations in paved areas. If the existing
pavement is scarred, spalled, or broken during the term of this contract, or if the pavement is marred,"City of La Quinta-shall request
that these portions of road be resurfaced over their entire width. Resurfacing shall consist of one coat of two inches (2") of A.C.
surfacing plus appropriate seal cost'as specified above.
PROTECTION, OF TRAFFIC: All excavations and work areas shall be properly ighted and barricaded as deemed necessary by the
Eity Engineer or La Quinta City Public Works inspectors. Suitable detours and detour signs shall be placed and maintained for the
duration of the project. The City shall be notified.24 hours in advance of any traffic detours or delineations.
CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete pipe, steel culvert and
concrete structures encountered during excavation which -necessitate removal shalt be replaced in kind. In the event it -becomes' '
necessary to remove. or, cut existing drainage structures, City of La Quinta shall be notified prior to commencement of this -work. .
Drainage structures and open drains shall be kept free of debris at all times for proper drainage.
RIGHT OF WAY CLEANUP: Any surplus material resulting from excavation and backfill operations shall be removed from the right
of way. All paved surfaces shall be broomed clean of earth and other objectionable materials immediately after backfill and compaction.
Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material -shall be removed
prior to paving. Water tanker shall be used, as required, to sprinkle the job site to keep down dust conditions and shall be used
immediately after backfill.
DE -WATER OPERATIONS:: If de -watering operations are required and pumps are forcing water on City of La Quina roads, it shall
be the responsibility of the permittee (contractor) to control this water and to provide off-street barricades when necessary.
CLOSING STREETS: No street shall be closed. A minimum of one lane of traffic shall be maintained at all times to'provide limited
access for the adjoining property, owners and emergency vehicles. In the event it is felt by the permittee that he must close a street for
any length of time, permittee shall contact this office to obtain the necessary permission.
SPECIAL PROVISIONS
The following shall apply when indicated:
RI NOTIFICATION: Permittee shall notify the City at (619)777-7075. at,least 48 hours in advance of starting construction.
R2 UTILITY CLEARANCEi (Substructures) Prior to making any excavation within the City, of La Quinta right of way
authorized by permit, the permittee shall contact all concerned utility, companies relative to the location of existing -
substructures.. Damage to existing substructures resulting from operations conducted under this permit shall be the sole
responsibility of the permittee.
R3 UTELM CLEARANCE: (Surface Structures) No work shall be done under this permit until all utilities are clear of the
proposed work site. The permittee shall notify all concerned „utility companies of the proposed work.
R4 PAVEMENT WIDENING: Area between the proposed concrete gutter line and the existing road pavement shall be surfaced
with inches of A.C. paving placed on inches of class aggregate subbase course having an "R"
value of not less than* and in conformance with City of La.Quinta Road Improvement Standards'and
Specifications, Ordinance #461. .
R5 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of
1/4 inch to one foot (P).
R6 GRADE CHECKING: City, of La Quinta shall check grades upon receipt of plan and profile, and/or grades as established by
a licensed engineer.
R7 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter (_feet) shall be
removed.' Curb and/or curb and gutter shall be�saw cut prior to removal. ,Depressed curb, matching concrete gutter and
concrete driveway approach shall be constructed in conformance with City of La Quinta -Standard 11 //207.
R8 DRIVEWAYS:- A.C. driveways shall be constructed. as not to alter, existing drainage pattern: Surfacing between the property
line and the existing road paving shall be 2 1/2 inches of A.C. paving placed on ( ) of class aggregate base.
Driveway construction shall conform to attached drawing.
R9 SIGHT CLEARANCE: Sight clearance :of 600 feet in all'directions shall be assured and maintained at all times.
RIO SOIL STERILIZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall commply with the
manufacturer's specifications:
R11 COORDINATE WORK: The proposed work shall be subordinated to any operation which the State of California or City of
La Quinta may conduct in this area daring the period of this permit. Work shall be coordinated with the State or City of La
Quinta forces to preclude delay or interference with State of City of La Quints projects.
R12 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the
centerline of all streets or property lines when involved shall be completely tied out so they may readily and correctly be
replaced by a licensed civil engineer or surveyor at the expense of the permittee. A complete set of notes showing the ties to
these monuments shall be furnished to the City Engineer prior to the removal of any monuments. This office shall be notified
upon completion or replacement of all survey monuments for proper project clearance.
R13 PAVEMENT CUTTING: Pavement will be mechanically saw cut to a straight to a straight edge prior to excavation. Method
of pavement cutting shall be approved through the office of the City Engineer. (Under no circumstances shall excavating
equipment be used to excavate prior to cutting of pavement.) Excavation material shall be placed in such a position as to best
facilitate the' general flow traffic. Prior to final paving operations, any damage to pavement straight edges shall be corrected.
R14 L 11T OF EXCAVATIONS: Excavations shall be limited to 1000 linear feet of open trench before backfill operations must
begin. All excavations shall be properly barricaded with lights overnight, on weekends and holidays for the protection of the
_ traveling public. The Public Works Inspector shall determine the suitability of excavation barricading in each case. No
excavation shall remain open for a period exceeding five (5) days. No excavation shall be made unless the construction
material is actually on the work site.
R15 BACKFELL MATERIAL: Backfill shall be free of brush, roots or other organic substance detrimental to its use for purposes
of producing an adequately consolidated backfill. Any material which the City of La Quinta deems unsuitable (spongy or
saturated material) which is encountered during excavation shall not be used for backfill, but shall be supplemented or replaced
by an approved sand or gravel.
R16 BACKFILL SAND: Backfill shall be approved transit -mix sand or equivalent and shall be placed in lifts of not greater than
three feet (3') and vibrated using vibrotamper or equivalent equipment. Alternate methods may be substituted, but in any case,
a relative compaction of 95 percent shall be attained with the structural section of the roadway.
R17 BACKFILL PLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench
before flooding or a maximum of five-foot (5') lifts where trenches are of excessive depths. Care is to be exercised that the
backfill material is not subjected to extreme swell by flooding operations. Backfill material shall be placed so that the resulting
compaction shall be not less than 90 percent or equivalent to the surrounding ground, whichever is the greater compaction.
Where ponding or flooding is used for a maximum settlement, adequate dikes will be constructed to retain the water. Where
jetting is used, the jets shall be of sufficient length to reach the bottom of each layer and the water supply shall be continuous.
R18 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made at intervals of not more than 1000
feet and a minimum of one (1) test on each road. One (1) copy of each test shall be forwarded to the City Engineer for
approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Section 6.3.01 of the
Standard Specifications, Division of Highways, State of California, dated January 1973.
R19 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line.
One (1) copy of each test shall be forwarded to the City Engineer for approval and filed prior to making permanent repairs.
Compaction tests shall be made as outlined in Section 6.3.01 of the Standard Specifications, Division of Highways, State of
California, dated January 1973.
R20 TEMPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporary patch
consisting of 2 inches of SC -800 shall. be placed on a prepared subgrade. The SC -800 temporary paving shall be placed after a
maximum of 3000 linear feet of trench has been excavated and backfill operations completed, but in no case shall the
placement of the temporary pavement exceed a five (5) day limit.
R21 PERMANENT PAVEMENT REPAIR: After backfill and compaction have been completed, a temporary patch consisting of
two inches (2") of SC -800 shall be placed immediately. A permanent patch of inches A.C. surfacing placed on a
inch class base shall be placed no later than days after completion of temporary road repair.
R22 FOG SEAL: A fog seal coat consisting of an application of asphaltic emulsion shall be applied over all patch areas as
determined by the City Engineer.
R23 STREET RESTRIPING: Where street striping is still visible on streets to be excavated, such striping shall be replaced upon
completion of permanent repairs.
R24 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quinta road right of way shall be
accomplished by a licensed, bonded and insured tree service, and handled safely without interference or hazard to the traveling
public. It shall be the responsibility of the permittee to maintain the tree in a vigorous growing condition at its new location.
Trees to be removed shall be in sections which can be handled safely without interference or hazard to highway traffic. The
entire width of the tree stump shall be removed and disposed of so that no debris remains in view of the highway. The stump
hole shall be backfilled and thoroughly compacted as specified in the following paragraph. Where is becomes necessary to
restrict traffic, the work shall be restricted to a maximum of 500 feet at any one time. Adequate signs, flagmen and or
barricades shall be provided to protect the traveling public at all times.
Large holes resulting from tree removal shall be backfilled and compacted to not less than 90 percent or equivalent to the
surrounding ground, whichever is the greater compaction as determined by the impact or field method. Compaction tests shall
comply with Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated January 1973.
t
Daily Inspection Report No. 1` Cffy Of La Qu1nta
Contractor > L4'ylyb
Supt. on Job �Co->"eCo -Sheet of
Weather Date
Temperature °F Max J8 °F Min Project zt; *-w
Work Hours 70= otoMemos Issued A •-L- " f
Photos L70
Special Conditions, Delayi, Changes '
Accidents Damage
•
Sampling, Testing r
s
Visitors to Site
Work Report (Work done, Personnel/Equipment working) i�GLTCQd�it w. .Gov /`jlcuw��
a .iLu.t.��-�9
• T i , . .�G�-�'iJC�LZa•GL[./`•l•L '�L�GO �L�.�N -Gtdi �;p� • � . ���';� ... _
.- It -
Daily Inspection Report No.
Contractor
Supt. on Job
Weather
Temperature 77— OF Max -r0 OF Min
Work Hours 729 to ' s P Memos Issued
Photos
Special Conditions, Delays, Changes
City of La Quinta
Sheet of l
Date
Project /ePsAo/7/oN
-1111 70
Accidents Damage
M
Sampling, Testing
Visitors to Site
Work Report (Work done, Personnel/Equipment working) cili1izo
L. v
By �
SPECIAL CONDITIONS --PERMIT NO. 2670
--- CVWD ---
In addition to the standard permit conditions, the following shall apply:
1. Pursuant to Section 14.16.320 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), all
work shall be performed in accordance with the.latest edition of the Standard Specifications For
Public Works Construction (SSPWC) and as directed by and to the satisfaction of the City Engineer.
2. CV WD, hereinafter referred -to as "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. Pursuant to Section 6.08.050 of.the La Quinta Municipal Code (Ordinance, 18 § 1, 19.82), throughout
the work site, the Permittee shall comply. with City regulated work hours. Operation and
maintenance of equipment within one-half mile of human occupancy shall be performed only during
the following time periods:
October l st to April 30: Monday -Friday 7:00 a.m. to 5:30 p.m.
Saturday 4:00 a.m. to'5:00 p.m.
May 1 st to September 30: Monday -Friday 6:00 a.m to 7:00 p.m.
Saturday 8:00 a.m. to 5:00 p.m.
5. Work performed within 500 feet of a signalized intersection is restricted between the hours of 9 a.m.
- 3 pm. Traffic control shall be set up after 9 a.m. and removed before 3 p.m. The Permittee shall
contact the Riverside Country Traffic Signal Maintenance Department at (909) 275-6894 if signal
operation at the intersection is to be altered in any way.
6. Pursuant to Section 14.16.110 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982),
Permittee 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.:.
7. Pursuant to Section 14.16.250 of the La Quinta Municipal Code'(Ordinance 10 § 1_ (part), 1982),
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). A traffic control
plan, if required, shall be prepared in accordance with the WATCH Manual and submitted to the City
'for review and approval one (1) week prior to starting any construction. It shall be the Permittee's
responsibility to appropriatelydetour and barricade all construction sites.
Special Conditions - Pennit No. 2670 Page 1 of 4
SPECIAL. CONDITIONS--PEFMT NO. 2670
--- CVWD ---
8. Pursuant to Section 14 16.M of the La Quinta Municipal Code (Ordinance 10§ 1 (part), 1982),
street closures shall not be permitted. A minimum of one travel lane of paved surface shall be
maintained with flagmen at all times.
9. Prior to excavating, if required, the Permittee shall contact Underground Service Alert at 1-800-422-
4133. It shall be the Permittee's responsibility to notify the Public Works Department of anticipated
excavation which impact City facilities, including but not limited to traffic signal conduits and loops,
irrigation lines, electrical conduits, and storm drain facilities.
10. 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.
11. - 'Pursuant to Section 14.16.3 70 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982),
backfill compaction within street rights-of-way shall conform with Section 306-1.3 of the latest
edition of the Standard Specifications For Public Works Construction (SSPWC), except as otherwise '
specified herein.
Native material may be used as backfill material provided that minimum compaction, achieved in
the manner prescribed herein, is achieved. Backfill shall be performed by mechanical means; no
water densified compaction via jetting or -flooding or other means. shall be allowed. It shall be the
Permittee's responsibility to provide appropriate geotechnical supervision, testing, and inspection,
onsite, at all times during backfill operations.
Backfill compaction shall be achieved by the following conditions:
A. When a firm foundation is not encountered due to soft, spongy or other unsuitable material,
such material shall be removed to the limits directed by the Geotechnical Inspector and/or the
City Inspector and the resulting excavation backfilled with pipe bedding material..
B. Backfill materials shall be brought, to or maintained at an appropriate moisture content for
compaction. The appropriate moisture content range shall be established at the onset of the
project and ensured prior to use of the materials'through progress testing on the stockpiles.
C. The first length of trench backfilled shall be backfilled in the presence of the City Inspector.
Compaction shall be tested at random depths at approximate three-foot vertical intervals as
backfill is placed to ensure the effectiveness of the compaction methods and to establish the
depth of lift that can be compacted.
D. If lifts. greater than one foot are attempted in this trial 'length- of trench, compaction tests shall
be taken within the lifts to ensure that the full depth of the lift is compacted. - Upon satisfactory
Special •Conditions - Permit No. 2670 Page 2 of 4
SPECIAL CONDITIONS --PERMIT NO. 26.70
--- CVWD --
completion of this portion of trench, the City Inspector shall establish the maximum lift
thickness to be compacted for the remainder of the project.
F. In subsequent lengths of trench, the frequency of compaction tests shall equal one per each lift
of backfill, per 300 linear feet of open trench, at randomly, selected locations within the open
length of trench:
G. The depth of the randomly selected compaction tests shall also be randomly selected except,
that where multiple tests are -.required in a given length of trench, the tests shall be no closer
than three "feet (vertically) from each other.,
H. If any compaction test fails, previously placed backfill (in the same length of open trench or
previous lengths -of trench) which is represented by the failing test (as determined by the City
Inspector), shall be tested for compliance with. compactionrequirements.
I. All costs incurred due to the conditions above shall be borne by the Permittee. Copies of all
test results shall be furnished to the City Inspector.
12. All excavations within City of La Quinta right-of-way shall be backfilled, and temporarily paved if
within the existing travel way, -at the end of every workday as directed by and to the satisfaction of
the City Engineer for the protection of the public. Lengths of open trench shall not greatly exceed
that which can not be backfilled in the same day. Excavated trenches shall not be allowedopen
overnight, however, Permittee may leave a length, of excavated trench, not to exceed twenty (20) feet
in length, open overnight at•a. point where construction will begin the next day, provided that this
length.of trench is completely covered by steel plating.
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. 'Due to the fact that contractors for the "Tradition" development (Tract 28470 and 28611) will be
constructing new water facilities from this location to inside the development, permanent pavement
CV)
WD. shall not be required by CVD. This requirement shall be borne by the contractor for
the developer, and follow completion of construction of water facilities within Avenida Bermudas .
and Francis Hack Lane. CVWD shall only be required to provide an adequate temporary a.c`.
replacement over, the work area until. such time as the contractor for the developer begins
construction of the associated water facilities.
16. Permittee shall notify, the City of La Quinta Public.Works Department a minimum. of 48 hours prior
to commencement of any construction at (760) 777-7075.
Special Conditions - Permit No; 2670
jj
• SPECIAL CONDITIONS --PERMIT NO. 2670
CVWb
',. IT, Permittee shall stabilize any soil that was disturbed, (shoulderrareas; etc.) as a result of work
performedyunder,this permit with an.approved dust control treatment. ' =
y
18. ' Pursuant toaChapter 12.56' of.the La Quints Municipal Code (Ordinance 10 § 1 (part), 1982)'the City
. ,.
has'designated certain city. streets as Truck Routes. The weight limit for restricted streets (i.e., streets
not part of the Truck Route network) is.three:(3) tons; trucks exceeding the weight limitniay use a ;
restricted street if making a delivery or.pickup on.the,subject*street; or if this permit_. specifically
grants, permission to use the street to deliver street construction materials and/or equipment.'
...
• 19.' The City. of La Quinta reserves the right to revoke, suspend or void this permit at any time.
' •20.'. This permit authorizes the installation,of a 30"00N24" tee, two (2) 30" butterfly.valves, and one
(1) 24" butterfly valve on the existing 30" water main 15 -feet east of the centerline•of Avenida
Bermudas and 3:36 feet south of the centerline of Francis=Hack Lane. water line facilities
,Remaining
' to•be constructed by separate permit.
-
J,!:
' Special Conditions - Permit No. 2670 - ti <, Page 4 of 4
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'ZOACHELLA V ALLEY WATER DISTRICT
ROBERT FORD
DEVELOPMENT SERVICES TECHNICIAN -
P.O. BOX 1058. COACHELLA, CALIF. 92236
TELEPHONE: (760) 398-2651
r• 10
NOTE:
With proper validation
this form constitutes an
encroachment permit
TRACT 28470 TRADITIONS
Com,
OFLq QUINTA
UST 2 -
CITY OF LA QUINTA PUBLjc W . .797
APPLICATION FOR PERMIT K`S
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
to (� ri-7
Subdivision Improvement Permit - Class II I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Intersection of Avenida Bermudas and Fkances Hack Lane,
0
f (Street address or Description of Location)
PURPOSE OF CONSTRUCTIOItI_ TO. provide domestic water Sketch (attach construction plans if appropriate)
service to.�,,�., ,�= i r -A Al r v. ,,* I —rA. ,._
DESCRIPTION OE pNSTRUCT Install 1-24" st ou
connection 1� east 6NN As at h s( ts)`
3.36' south of Francis Hack Lane 2 57- 8 e e . -7 ter ,
DIMENSION OF INSTALLATION OR' REMOVAL 8X8 s ict , e d ntain' i
sew wa r.
SIZE OF EXCAVATION, IF NEEDED Same as above
APPROXIMATE TIME WHEN WORK WILL BEGIN October 199
Com,
APPROXIMATE TIME OF COMPLETION October 1997 ' It T
I 4i
-ESTIMATED CONSTRUCTION COST $ 41,000-00 (,
(Including removal of all obstruction, materials, and debris, backfilling, com- 0"'��... I
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.
21
Robert Ford
Signature of Applicant or Agent
Coachella Valley 6Iater District P.O. Box 1058 Coachella, California 92236 (760)398-2651 X532
Name of Applicant (please print) Business Address Telephone No.
Same as 'above
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 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 $
F�,-rmit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by Date
Recorded by
PERMIT NO.
DATE APPRO
EXPIRATION..
DATE ISSUED
PERMIT VALIDATION
By
Administrative -Authority'
TELEPHONE: (619) 564.2246