2809NOTE:—
With Aproper-val idation
this form constitutes an CITY OF LA QUINTA
encroachment permit
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
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DATE: Sentember 14. 1998
LOCATION OF CONSTRUCTION PGA West Tract 28340-3
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Rough Grading Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Rough Grade Only — 24 Lots r
t SEE ATTACKED CON''rDITIONS.
DIMENSION OF INSTALLATION OR REMOVAL See Plans
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SEE APPROVED PLANS.
SIZE OF EXCAVATION, IF NEEDED MAM 1,015 Cubic Yards
APPROXIMATE TIME WHEN WORK WILL BEGIN
` September -October 1998
APPROXIMATE TIME OF COMPLETION October 1998
ESTIMATED CONSTRUCTION COST $ 24,500•
(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 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.
Signature of Applicant or Agent
SWH Fund 24, L.B.. 7161 Indiana Ave., Riverside, CA 92504 (909) 784»0840
Name of Applicant (please print) Business Address Telephone No.
Saame, Chuck Frase
Name of Contractor and Job Foreman Business Address Telephone No.
748004 5357 a
Contractor's License No. City Business License No. t
Tudor Insurance Co. GL 00001428 p�
Applicant's Insurance Company Policy Number
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FEES: Subdivision Improvement Permit — Class I I1 18
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit= Class IV: See attached schedule
Inspection Fee $ 7350
Permit Fee 100•
Pei" n' a'rft'-y,As Built Fee 1000.
sl' Depo 'Sur`r"-eiy'Oond (2250)
f� er qui�X1Bnpoei�R
TOTAL: �$
*CFMIT DUE*
Receipt No.
Received by Date
Recorded by
**NO FEE REQUIRED.
.809 �
PERMIT VALIDATION
PERMIT NO. 2809
DATE APPROVED 9123/99
EXPIRATION DATE 9/23/99
DATE ISSUED 9/23/98
By
r v Administrative Authority
Telephone: (619) 777-7075