2794 (3)---------------------------------
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'NOTE: .. ' � t ' � ., � +', . =gin'•• '`•t� .,`!., .''.' -' � -
With proper validation t `'
' this form constitutes an e•
i
CITY OF CA QUINTA F $
' encroachment permit APPLICATION 'FOR 'PERMIT4k3
-
PUBLIC WORKS CONSTRUCTION' (ENCROACHMENT)
" For the constructionof 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
Air
t g/S Subdivision Impro`ve'ment Permit—`Class'llls` ,
DATE: r 3 •• J;� " Minor Improvement Perrnit Class'IV. -
`' - LOCArTII]ON_ OF CONSTRUCTION
/ -t
• (Street address or Description of Location) • . r • •' _ -:, , _ .a v
PURPOSE OF C NST UCTI N - Sketch (attach construction plans If appropriate):
/^e,� Ian ritll. S f✓t/G /�t_ . i s. - ~
r'DESCRIPTION OF CONSTRUCTION )owesw G�t7�,✓4' y {. {
' r
DIMENSION OF INSTALLATION OR REMOVAL' '
SIZE OF.EXCAVATION, IF NEEDED ;. t ' • „ ,
's ,r • .
` APPROXIMATE TIME WHEN WORK WILL BEGIN
i APPROXIMATE•TIME OF COMPLETION y is a �'` •`
!e' y ESTIMATED CONSTRUCTION COST $ 3 U 2.^ 'r.. ,' t 4
(Including removal of a ll. obstruction; materials, and debris; backfilling, com_- • .s
•-paction'and placing, permanent resurfacing and/or replacing improvements)
t " # In consideration of the granting of this permit, the applicant hereby -agrees to:
.
• - � z .� j 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
t ` *: .( • :,happening or occurringIas a proximate result of any work undertaken un permit granted i -
_ pursuant.to'thia application.
L
.. f •' Notify the AdministrativerAuthority 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 applica rules and regulationaof the City .of',,
La Quinta and to pay for any additiorial'replacement necessary
?s the result this work.
. , ( signature of Applicant or Agent `IZ+
i Name of Applicant (please print) + Y Business Address s Telephone No. -
;-6rL "y;/o ,:•�.yrevroTio+.i �c',:�O�Oit "Thc.r.naC e/a 9aa7y 7(00-3`lS-S-3� 7.
Name of Contractor and Job Foreman Business Address..'. - Telephone No. '
Contractor's License No. -City Business License N
}'•Applicant's Insance Company , + Policy Number
FEES: !Subdivision Improvement Permit =Class III -
Public improvements: 3% of estimated'construction costs
Private improvements: 3% of estimated construction costs'-
-` Minor Irnprovement Permit — Class IV: See attached schedule 2 7 7A r. 1
Inspection Fee $ ' 17 • PERMIT. VALIDATION = '
Permit Fee
_ PERMIT NO. " r
• �+. c Penalty r
f
DATE APPROVED
Cash Deposit -Surety Bond'
"{
r ' if required EXPIRATION DATE
• - f ' ' . •TOTAL: DATE ISSUED _ •'
+
r.. Receipt No., . c¢.. a+ . 7 •f.. -
< . . By
Received by Date �t a' .Administrative Authority
Recorded by Telephone: (619) 777-7075 .
: SEP r09 ' 93 1.5:16 FRS SATELLJS RCS I DDrT I R , 714 251 1933 TS 17607777155 t a 01 /03
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F A.CrS•'I 1l�I:i.,I, E T.Ii:A: N S. M.I`T TA L
,� ra y <
TQ: 4' Marcus Fuller DATE: 09/09!98 , y
'r... ' .•r•.•yrs Y. ' '• + ' L ' ,� r '4
COMPANY: City of La Quints ' -' FAX; ' (760) 777-7155
.. r FROM: •Tracy Names
MESSAGE: Marcus:. f
k, Our Genera! Liability Certificate for the Citrus Course.prdjects listing the City"
as an
�.
additional insured. The original is.in the mai! and you. should receive"by Friday. Please t`=
let me know immediately,if there are any' other insurance issues, i "^
.,.
r~ Thank.you. ,
x NUMBER OF'PAGES'L'�1 TRANSMITTAL INCLUDING COVIrR S[IEET ; 3
r - !
• IF YOU DO NOT RECENE ALL OF THESE PAGES,-
PLEASE
AGES, PLEASE CALL Tracy H41136 NT (949) 251-6192
THANK YOU! i a
ty'' w • r
= e CAT KLUS RESIDENTIAL GROUP: >
5 PARK PLAZA; SUITE 400, bevm, C,u FomiA.92714 (714)-251-6100 .FAX, (714).251-8837
y r t r k a,-
SEF' 09 '98 15:15 FR CATELLUS RESIDENTIAL 714 251 1933 TO 17607777155 ?.02103
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•S:d1::.'>�r:S;';:�::C DATE (MMMONYI.
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,,.4— .,d «.s, :::a• 9 09 98
.RoovcER
Aon Risk Services, Inc. of
Southern California •
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIO TS_ UPON THE CERTIFICATE:
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
695 Town Center Drive. Ste 500
Coe to Xes s, CA 9262C
COMPANIES AFFORDING COVERAGE
coIUPANT
714-641-8355
A Evanston Ineuranca Can any
INSUREO
catellue Residential
OWrANY
8 Insurance Co. of state of PA
Croup, Inc.
COMPANY
5 Park Plaza, Suite 400
C
Irvine, CA 92614
CCMPANY
D
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�!, . :.i :.haa•r :int;« „il,l tail„ to r`•SIr.'RY'C�� `, In?5¢;r.4}.{. . 4': •^.Y':: r• ii:>.=.4YJ'i;!S w�}Pi,:iiwNl•nnMN:DtS!:.
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTEO BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REOUIREM94T, TEAM OA CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TMIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL TWE TERMS,
EXCLUSIONS AND CONDrr!ONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAI MS.
G0 TYPE OF IUSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EKPIRAYLON LIMITS.LTR DATE (MMIOOWYI DATE IMM/ODM•! I
A
0E11114"VAB1U"
X
COMMERCIAL OIN/RALLIABIury
CLAIMS MADE OCCUA
GLPIO03258
3/01/98
3/01/99
GENERA.AGGitE-0ATE
t 2000000
PRODUCTS •COMPIDPAGG
I 1000000
C 1000000
PERSONAL b ADV INJ;IRY
EACH OC_yMENCE
E 1000000
OWNER'S 6 CONTRACTOR'S PROT
FF I`E OAMACE IA.* aro Wel
0 5'0000
_
I
I MID EXP IAnV oneovranl
a 5000
( AUTOMOBILIE
LIAOILITY
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COM81NE0 SINGLE UM(T
6
ANY AUTO
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,
ALL OWNLP AUTOS
SCmEOULED AUTO$
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,eoollr IN.Ivar
tear uc4oenu
Al RFD AUTOS
NON•OwNEO AvYOS
�
PAOPEaTY DAMAGE
GAUGE UABIIJ*T
AVTO ONLY • EA ACCIDENT
e
OTHER TMAN ALITO ONLY:
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ANY AUTO
EACH ACCIOENt I
a
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A4G11l15ATt;
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EXCESS UABIUTY
I
EACH CCCVAAENCE
S 30000000
9 30000000
8
RXIUMSRELIA FORM
42982325
3/01/98
3/01199 aGGAEQAT!
E
O'IMER THAN VMORELLA FOAM
I
WORRERO COMP&NSATION ANDwC
WPLOYEM' LIABILITY
STAT'!
T A
fl EACH ACCIDENT
b
E
THE PRCPRtETORI INCL
PAATNERSIEXECUTIVE
EL DISEASE . POLICY UMR
0
OPPICEAS ARE: E><C;
EL DISEASE - EA EMPLOYEE
t
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OTHER
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OEgCBIPTION OF OP(PATIONSILOCATtONS/ m CLES•4EPECIAL RQiuIS
RE: Grading Permits for The Citrus Projects.
see Endorsement(s) Attached.
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SMOULD AN'Y OE THE ABOVE OESCPI"D POLICIES BEE CANCELLED 979FORtc T!8E
City Of' La Oluinta
EXFIRAT109 OATI THEREOF. TME ISCUIN0 COMPANY WILL 11*08MAOO- W MALL
Attn: MEIrcus huller
33 0 OCLYS WRITTEN NOTICb TO THE CERnFICATE MoLOEA NAMED TO THE LEFT•
78-495 Calle TasDpica
La Quinta, CA 92253-1509
QR,.Artr WEIa.AaBDr s+LE Iss - - ;;
,
AUTHORIZE T�JE `�+• 000427000
• !!..'..y � J; �.:!.. Vy, n..r.e.�l::ii:ni::.1Ei�:i�� LuN� N:�wXrP; *"". m`itii..
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SEP 09 1998 13:37 714 549 1647 PAGE•02
09 ''?.8 1517=F4 "a'TELUJS RES IDENT tAL 714 251 1933 TO 17507777135 P.C3iO3•
'� � fij itt5xX t. •. A, ' . ,�•. .4 r1 .• V : �~ r * • y • ,: � i � !� • Z, _ ,
Y , POLICY NUMBER: GLP1003258 C01v1��1ERCIAI, GENERAL LL�,BILITlI j
.
"THIS ENDOPSEMIENT CHANGES THE POLICY.+BL>FASE READ IT CAREFULLY
.. � ADDITIONAL INSURED - OWNERS1' LESSEES OR
ONTRACTORS
(Including "Primary,, Wording)' r' '• .x �' .. ; ,, +
This endorsement modifies insurance:provided'uider the following:
r
COMMERCIAL GENERAL LIABILITY COVERAGE PART ; 4
SCHEDULE.
141
Name of Person or Organization:
Cloy Of jL.A Quanta r J e• s ` '
`. 78-495 Calle Ta
azapico
'F Lit Quinti, Ca. 92253-1504 r ,
R1E::Gradiug Peranits for The Citrus Projects h -
no -entry appears abovc,'information required to complete [his endorsement will,'be shown in they a
x. Declarations as applicable to this endorsement:) T '
WHO IS AN. INSURED' (Section ,lI)` is'Me—; ded .to include' as an insured ;the person ar organization-
shown
rSanization �
shown in rhe_Schedule,.but only wiih*respect to- liability,.arising out of or`related to "your work" or its,`
s, 'super'vis'ion -for that insured by or foe-you.The insurance Afforded` to such person,.or'orgaoi.zation is
primary. Any other i>b9UrAarce, which- such .person.. or` organizatioa'tnay have will be'•`non-
r contributory:
"$ ,moi - � , .i•� '^. t _ • ., 9:. , ,t .F4 s e
AI -Primary ... r
o-s,•T8 ;ALP 03 ' '
3?; . 714 Sag ioa?
PACE03
• _ SEP 09-19$8 13
TOTAL PAGE. 03 + A