2817NOTE i •. r. ;�
With proper validation
this form constitutes an
encroachment 'permit
CITY OF- LA QUINTA .
-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 111
DATE: 10/6198' Minor' Improvement Permit Class• IV'
LOCATION- OF CONSTRUCTION Tract 24890-6. (Lot 27, Line BBB; Lot 36, Line ZZ. and
Trot 45, Line Yif)
(Street address or Description of Location)
PURPOSt OF CONSTRUCTION storm drain relocation.. Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION REmove and relocate . Stor[a
1.dralua from under pad location to•easeiaent'
• location.. - SEE ATTACHED, CONDITIONS.
DIMENSION OF INSTALLATION OR REMOVAL, 600 ft.
removal and relocation of. 24" atom drain .pipe.
SEE+APPROVM PLANS.`
SIZE OF EXCAVATION, IF NEEDED n/a
9
APPROXIMATE TIME:WHEN WORK WILL BEGIN 10/7 98
APPROXIMATE TIME OF COMPLETION 14 Work; days.
ESTIMATED CONSTRUCTION COST $ 45,1$1.50
(Including removal of all obstruction, materials, and debris, backfill•ing,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 1. proximate result of any work undertakers 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.
.. i
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 q.P this work.
Signature of Applicant or Age
Bracy HaMes 5 Park. Plaza., Irvine, CA 92614 (949) .251-6192.
Name of Applicant (please print) Business Address Telephone No.
Citellus Residential . Constructlen/Brian Deslim same as above
VR'M ('nnatr�rnfinn9 7Q'.Agn, Cnn,liij"a n-r- ; R®rm.�sia mina o, rA 099(11 ' (.76n) 347-1QII
Name of Contractor and Job Foreman Business Address Telephone No.
2725424 / 0588957 #5072 / #1.956
Contractor's.L'icense No.. r City Business License No.,
Evanston Insurance Co. #GLP10032.58
Applicant's Insurance, Company Policy Number.
FEES:- Subdivision .Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class 1V: See attached schedule
Inspection Fee $ 1355•45•
100.00
Permit Fee
Penalty 0
Y
-Cash Deposit -Surety Bond
if required 0
1455,45
TO TA L: $
Receipt No.
Received by Date
OCT07:1998
OF L'A
PERMIT VALIDATION '
QUINTA
PERMIT NO.
2817
DATE APPROVED 10/6/98
EXPIRATION•DATE 10/6/.99
DATE ISSUED ` 10/6/98
Administrative Authority
Recorded by
Telephone: (619) 777-7075