2811%''With proper validation
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
Subdivision Improvement Permit — Class II I
DATE:
September 30, 1998 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION PGA West, Tract 28410-2, Lots 17, 18, 21, 22, 23, 41 & 48.
(Street address or Description of Location)
Revive sewer and water laterals.
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONST, UCTION Install new latera s and
abandon existing latorals. SEE ATTACHED CONDITIONS.
DIMENSION OF INSTALLATION OR REMOVAL bee Plana. SEF APPROt PLANS,
SIZE OF EXCAVATION, IF NEEDED See plans.
APPROXIMATE TIME WHEN WORK WILL BEGIN lu / 9b
APPROXIMATE TIME OF COMPLETION 10/14/96
ESTIMATED CONSTRUCTION COST $ 25,1110.
(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
a
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 advanceiof the time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the per it 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.
Trane West housing
7840
Signature of Applicant'or'Agent ~�
. 111, La Quiwlta, CA" '92253 (760) 771-3363
Name of Applicant (please print) Business -Address y Telephone No.
Jones Brothers Construction 85-989 Avenue 52, Coachella, CA (760) 347-2291
Name of Contractor and Job Foreman Business Address Telephone No.
JUM= #172092 Xbm % '#153
Contractor's License No. City Business License No.
Tudor Insurance Co. #CL00001459
Applicant's Insurance Company 1 # Policy Number
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ ]7.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
Receipt No.
850
I
Received by Date
Recorded by
FIND
`.�.orCOW
j11 j PERMIT VALIDATION
d �
PERMIT NO. 2idll
DATE APPROVED 10/1/98
EXPIRATION DATE 10/1/99
DATE ISSUED 10/1/98
By
Administrative Authority
Telephone: (619) 777-7075