2808N(ATE:..i`%
With proper validation
this form constitutes an
encroachment permit
I
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 MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: September 23, 1998
LOCATION OF CONSTRUCTION 50th and Eisenhower
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Install interim (temporary) Sketch (attach construction plans if appropriate)
lane stripin8 on Eisenhower Drive.
DESCRIPTION OF CONSTRUCTION Modify and install left
turn laockat and other traffic control. - see elan. SEE ATTACHED CONDITIONS.
DIMENSION OF INSTALLATION OR REMOVAL See Alan. SEE TRAFFIC STRIPING PLAN.
SIZE OF EXCAVATION, IF NEEDED None
APPROXIMATE TIME WHEN WORK WILL BEGIN 9/24/98
-APPROXIMATE TIME OF COMPLETION 9/24/98
ESTIMATED CONSTRUCTION COST $ 1.100 -
(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 propee rty
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.
/",/, r
re of Applicant or Agent
KSL Land II CorAoratiou 55 -920 -PGA West (760) 564-7184
Name of Applicant (please print) Business Address Telephone No.
James Rya Construction P.O. Box 13810, Balm Desert, CA (760)56085000
Name of Contractor and Job Foreman Business Address Telephone No.
516895 796
Contractor's License No. City Business License No.
Zurich Insurance Co. GL0683881504
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III ID
Public improvements: 3% of estimatedconstruction cost` "s
Private improvements: 3% of estimated construction costs '1C
Minor Improvement Permit — Class IV: See attached sc dul.e r
Inspection Fee $
Permit Fee
100.
Penalty
ash Deposit -Surety Bond
if required
TOTAL: $ 100.
Receipt No.
Received by Date
Recorded by
j4 i �.� • PERMITt VALIDATION
PERMIT NO. 2808
DATE APPROVED 9/23/98
EXPIRATION DATE 9/23/99
DATE ISSUED 9/231998,,
Administrative Authority
Telephone: (619) 777-7075