2810NOTE:
With proper•validatio
,this form constitutes ani
encroachment permit'
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS', CONSTRUCTION (ENCROACHMENT)
t
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
a ✓0/98 Subdivision Improvement Permit - Class II I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Tc+fharean ISI -reek t- wea it AMP
Tract 24890 - Citrus Perimeter Wall
(Street addressor Description of Location)
PURPOSE OF.CONSTRUCTION Grade for Masonry Wall Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Grade -- Approx. 6,000 cyd.
DIMENSION OF INSTALLATION OR REMOVAL 2,500 L.F.. SEI: ATTACHED C(3NDITIONS.
SEE APPROVED PLANS.
SIZE OF EXCAVATION, IF NEEDED 68'000 eyd. .
APPROXIMATE TIME WHEN WORK WILL BEGIN 8;00am = ~
APPROXIMATE TIME OF COMPLETION 1U/14/9B
ESTIMATED CONSTRUCTION COST $ 29,000.00
(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 authorised 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.
+,Sig�of Applicant or Agent
KSL Land = Corportthiou 55-920 PGA Blvd.,. La Qulnta, CA (760) 564-7189
Name of Applicant (please print) Business Address Telephone No.
A. 'Florea P.O. Boxc 1036. La Quin.ta, CA (760) 360'-0255
Name of Contractor and Job Foreman. -Business Address Telephone.No.
61005 532.3
Contractor's License No. City Business'License No.
Zurich Insurance Company GL0683881$04
Applicant's Insurance Company 'Policy Number "
FEES: Subdivision Improvement Permit — Class I I I OCT U 100
ti..
Public improvements: 3% of estimated construction costs p i
• Private improvements: 3% of estimated construction costs
-_1jTy A�q T `rti 1�
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 870. PERMIT VALIDATION'
100. zLb
Permit Fee PERMIT NO.
Penalty
Cash Deposit -Surety Bond r
if required
TOTAL: $ 970.
Receipt No.
I Received by
Recorded by
Date
DATE APPROVED 9/30/98
EXPIRATION DATE 9/30/99
DATE ISSUED 9/30/98
By A 1 d A /104Vii_,ye-
Administrative Authority
Telephone: (619) 777-7075