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NOTE:
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With proper validation,�—
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this form corstitutes an
CITY OF LA QUINTA
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encroachment permit
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APPLICATION' FOR PERMIT'
PUBLIC WORKS 'CONSTRUCTION (ENCROACHMENT),
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^ For to 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
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DATE:— Minor Improvement Permit Class IV
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LOCATION OF CONSTRUCTION
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lStraet atldross or Description of Location) - �••• J//� '•. +'-. ' ' � ,
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PURPpOSE qqI CON�vSTRUCTION Sketch (attach construction plans if appropriate)'
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DESCRIPTION OF CONSTRUCTION ��f/rSe4� G'�Adi.✓�. '
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DIMENSION OF INSTALLATION. OR REMOVAL 11T.LicGt G{'25' , . ✓✓ J .-
SIZE OF EA:('AVATION, IF NEEDED NLA= _
.APPROXIMP.TE TIME WHEN WORK WILL BEGIN : r } - 1 • )
APPROXIMP.TE TIME OF COMPLETIONL y
ESTIMATED CONSTRUCTION COST $ 5✓:h=`%Dd '
•
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or. replacing improvements)
In considerai:ion of the. granting of this permit, the applicant hereby agrees to:
,47 • 1
, Indemniy,.defend and save the City, its authorized (agents, officers, representatives and employees, harmless from and against any and all
panaltie:, liabilities or loss resulting from claims or,couri action and arising out of any. accident, loss or do Magillto persons or property '
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happening or occurring as approximate result of any work undertaken under the permit granted pursuant to this application. .
Notify tie Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started. - -.
•
Comply with all applicable City�Ordinences, the terms and conditions of the permit and all applicable rules and g lotions of the City of
La Cuing and to pay for any additional replacement necessary as the result of is work. - -
gnature of Applicant or Agent —
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Name of Apt.;icant (please print) Business Ar�ss Telephone No.
C% 90_9%Y -lav -3`i%.'• 53 of
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1 Name of Contractor and Job Foreman` r 't . ; ' Business Address r t Telephone No.
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j. Contractor's License �a V15ttii��Le- City Business License No.
App li n 's'Irsura Company Policy Number
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FEES: Subc ivision Improvement Permit = Class 111.
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
' Minr.r improvement Permit — Class IV: See attached schedule '277 4 t
Inspection Fc $ r -
PERMIT VALIDATION
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Fee
Permit
PERMIT NO.
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Penalty.
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DATE APPROVED,
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Cash Deposit:iurety Bond •'
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EXPIRATION DATE
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DATE ISSUED
Receipt No.
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Received by .. Date
Administrative Authority
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Telephone: (619) 777-7075 r
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031fl5198 ro ,03/05199
FOA PERIOD PIMA'_. 0600
IAC: gAii FRAlZCISCO,' CA - 94105
Twit OF BUSINESS
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FR CATELLUS RESIDENT,I'AL 714 251, 1933 TO '17507777155 ' P.01iO3
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Marcus Fuller - :.' DATE: - ,,, 'ter
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'Tracy Hames
MESSAGE:
C Marcus:
Our,General.,Liability Certificate "for-the'Citrus Course,projects listing the city as.ail „
additional insured.' 111 original `isin"the mail acid you should `receive by Friday. Please
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let me know .immediately:.if thele ale any other insurance Issues. • j; , ,
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Thank you.
- NUMBER OF -PAGES IN.TRANSMMAL• INCLUDING COVER SHEET 3 -'
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1F YOUZO NOT RECEIVE ALL OF THESE PAGES: ` ` ` ''� �•
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PLEASE CALL'Tracy Hames AT (949),251-6192
-THANK YOU! .,
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`CAT>?Y.LUS RESIDENTIAL GROUP , S
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S PnRx Pum. SU 400, IRVINE, CALwoRiaA 92714 (.714) 251-6100 FAX (714) 251 8837
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SEP 09 '96 15:14 FR CRTELLUS RESIDENTIRL 714 251 1933 TO 17607777155 P.02iO3
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Aon Rink Services, Inc. of
southern California
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Lw �cS;:-':,".i�w.:T:.pa ^r.. v, DATE IMMlDDryYt 'dl
THIS CERTIFICATE IS ISSUED A5 A MATTER pF INFOAAHATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER, THiS CEATIFlCATE DOES NDT AMEND, E�[TFNp OR
ALTER THE COVERAGE AFFORDED 8Y TME POLICIES BELOW.
695 TOwn Center Drive, Ste 500
COMPANIES AFFORDING COVERAGE
Costs Mona, CA 92626
COMPANY
714-641-8355
A Evanston Insurance COm an
INSUNED
Catellus Residential
COMPANY
0 insurance Cv. of state of PA
COMPANY
Group, Inc.
5 park Plaza, Suits 400
Zxvine, CA 92614
COMPAN7
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THIS !S TO CERTITY THAT THE POLICIES OF WSURANCE USTEO BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING 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 CONDITION$ OF SUCH POLICIES. LIMITS "OWN MAY HAVE BEEN REDUCED BY PAW CLAIMS.
CO TYPE OF INSURANCE I POUCY NUMBER POLICY EFFECTIVE POUCT EXPIRATION UMrr'%
LTR DATE UMM1DID TY1 DATE UMNUDO/YYI
GROWA
LIABILITY
GENERAL ^GCAMATt
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3/01/99
PnoouCTS- COMPtOPAGG
[ 2000000
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FERSONAL L ADV INJURY
GACNOCCURAENCE
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OWNER'S &CONTRACTOA'SPROT
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AUTOMOBLB LIABILMY
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COMBINED SINGLE uMIT
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ALL OWNED AUTOS
SCHEDULED AUTOS
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NON -OWNED AUTOS
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PROPERTY OAM&CE
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EXCESSUABIUTY
EACNCCCURRENCE
[ 30000000
AOGREOAT=
6 30000000
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X UMBRILLAPow
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3/01/96
3/01/99
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OTHER THAN UMBRELLA FORM
WOAIIEAS COMPOUNT10N AND
iMKOTERS' UABINTY
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THE PROPRIETOR! INCL
PARTNERS11XECUTIVE
T a STATLL 0T?4
it GACN ACCIDENT
. Q DISEASE - POUCY UIUET
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OFFICERS ARE: EXCL
El DISEASE • EA EMPLOYEE
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OEAORTFrION OF 0PERATION3/U3rATEONiMIH10""VECIAL M"S
RE: Grading Pemits for The Citrus Projects.
See Endorasm utls? Attached.
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c� ��I{�.y,y�}{ ,�y�y}��.yy L,.'7r :.qi.M nd1W'.�I.1'rM„ti. �:i�Nl�',irSr .li:'e
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SHOULD ANY OF THB ABOVE OrIt MCO FOLICEU BE CANCELLED BWOoE THE
City Of Ld Quinta
EXPIRATION OATS TNCAEOF, THE I99U1%0 COMPANY WILL lNBBArO[rT0 MAIL
Atter: KarCL18 Fuller
330 DAYS WAR -MN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LETT,
78-495 Calle Tampica
La puinta, CA 92253-1504
i1F�r[IY--lYie.i� 71r4�a`"�"'^• •�•�•i*�_n. .�;
WTNORR[ ATIVE 0000270/0
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SEP 09 1999 13:37 714 549 1647 PRGE.02
` SEP 09 '9$ 15 14 FR CATELLUS PESIGENTIAL 714 2.51 1955 TO 1760777715 P. 03 /0_3 "
- � r�Cr —IG J' 1JJV iJ•JV nwi r�aoi. .�\v :b�.r ... ....... ..v r ...
i POLICY NilM]BER: GLP1003258 . ' ' COMMERCIAL GENERAL U4JBT_ L1 'Y • `
' . THIS FNDORSEtidENT.CHANGES THE POLICY, PLEASE READ IT CA EFULLY,
ADDITIONAL INSURED OWNERS, LESSEES OR,
CONTRACTORS'FOiZM ]B)
(Including "Primary" Wording) .
This endorsement modifies insurance provided under the following:
COMNERCIAL GENERAL LIABILITY COVERAGE PART
ScHEDULE
Name of Person or Organization: Y
City of La Quinta ,
78-495 Calle Tampico
Le Quinta, Cu. 92253450 r r
RE: Grading Permits for The Citrus Projects - -
(If no entry appears above, information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement,)
a . WHO IS AN INSURED (Section U) is amended to include as an insured the person or organization
shown in tie Schedule,-- but only with, respect to liability arising out of or related to 'Your work" or its'.
supervision for that insured by or for you. _The•insurance atTorded to such person or organization i4 -
�' primary. Any other insu>rIIAce'which ` such person 'or -organisation may have will be non-
contributory. 4'
AI -Primary.
a
• • . � - TOTAL P. 03 .
4
SEP '09 1958 .3:37 714 549 1647 ?AGE. a3
f:� TOTAL PAGE: 03 :�