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2816NOTE....... With proper- validation. this forrri 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 otherdike public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit,- Class III DATE: ' 10/5198. Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION —Inco Homes, Desert Pride, Tract 23995-3, Milea Avenue and Adams. (Street address or Description of Location) PURPOSE OF. CONSTRUCTION Construct street ii9rovements. Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 'Under ground utilities, street'Ampiovements. SEE ATTACHED.CONDITIONS; . DIMENSION. OF INSTALLATION OR REMOVAL N/A SIZE OF EXCAVATION, IF NEEDED None APPROXIMATE. TIME WHEN WORK WILL BEGIN October • 12, 1998 APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ 123.753.42 (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 resu'rt of this work. �. Signature of Applicant or Agent lnco 110 aee 1282 Arrow Highway: U lan.d, CA (909)..'981-8989 Name of Applicant (please print) Business Address -telephone No. Cooley.Construct;ion Inc. P.O,-Boxc 1341 Victoryille; CA 92392 (760) 245-1377 Name of Contractor and Job Foreman Business Address Telephone No. ##348038 #4083 Contractor's License.No. City Business License !No. Gerlirig America Insurance #�4003477 Applicant% nsurance Company . Policy Number FEES: Subdivision Improvement. Permit —Class III Public improvements: 3% of estimated construction costs . OCT 0.71998 Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule ®RA9�NTi� . •, .60. # Inspection Fee $ @ PERMIT VALIDATION' 100:00 l Permit Fee PERMIT NO. 2816 Penalty Cash Deposit -Surety Bond 10.00.00 (Aa built) if required. 4812,.60 TOTAL: $ Receipt No. , Received by Date Recorded by DATE APPROVED 10j5/98 > . 1OW99• EXPIRATION DATE DATE (ISSUED By Administrative Authority Telephone: (619) 777-7075 - .