Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2814
�- With, proper`v;lidation," ; this -form constitutes an CITY OF LA QUINTA encroachment, permit APPLICATION FOR PERMIT {':f�~w-.:._ •- PUBLIC WORKS CONSTRUCTION (ENCROACHMENT). f 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 I II DATE: 10/'Minor ImprovementRe'rmit Class IV'. LOCATION OF CONSTRUCTION' Washington Street from 540' south- -of La Quih,td. Evacuation Channel S t0 . •AvenuQ (street address or Description of "Location) PURPOSE OF.'CONSTRUCTION soil. Ift3stigation for Sketch (attach -dons truction plans.if appropriate) Pr61 ec 98-09.' . DESCRIPTION .OFCONSTRUCTION Set, 4rill' rig, bore.'tt� sue,e3 f led aeipth. DIM ENSION,&.1INSTALLATION OR REMOVAL 12" diAmeter SEE ATTACHED CONDITIONS # SIZE OF FXCAVATIONjF NEEDED N/A APPROXIMATE TIME WHEN WORK WILL BEGIN 9AM 10/5/98 APPROXIMATE TIME OF,COMPLETION 10/6/98 ESTIMATED CONSTRUCTION COST $ 01" (Including,'re rioval of,all obstruction, materials, and debris, backfilling, com paction and„placing' permanent resurfacing' and/or replacing improvements) In .cons idera'tion_.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 prop 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,timewhen 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. Signa�te�of BApplAant or Agent Lok,Get ththiYical Gyroup, Ift. 6121 Quail. VA1ley Cou�Vereide, CA 925©7 (909) 653-1764 Name-of:Applicant (please print) Business Address'Telephone No. 8th', .2R.iiril,ling, Inc., Brian Serl,, sP.O.. Hos; 1489, Chino,' A_ 91708, (909) 841 3456 Name. of Contractor and Job Foreman Business Address Telephone No. . 709029 J1749 Contr`actor's License No. " City Business License No. St. Pard. Fire & Marine, #RPo6654349 Appl'icant's Insurance. Company Policy -Number FEES: Subdivision 'Improvement.Permit — Class Ill Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV:. See attached schedule 2 T .Inspection Fee'c" $ �` PERMIT VALIDATION Permit -Fee' 329M 2814 PERMIT NO. Penalty Cash Deposit-Surety Bond DATE APPROVED 10/5/98 if required' EXPIRATION DATE 10/5/99 TOTAL.. $10/5/98 DATE ISSUED ' Receipt; No: Received by Date Administrative Authority Recorded by II Telephone: (619) 777-7075 0 P; :'� �.