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3049NOTE: 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 9/23/99 Subdivision Improvement Permit— Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION CALLE ESTADO, BETWEEN AVE. BERNMAS & DESERT CLUB (Street address or Description of Location) PURPOSE OF CONSTRUCTION STREET'CLOSURE FOR MATUR'T RRFT MARYETF1.ACE STREET FAIR DESCRIPTION OF CONSTRUCTION CLOSE CALLE ESTADO FROM nV.QPRT mITR TO EElMID)AS, ON FRI.DAY EVENINGS 9;_1A. PM DIMENSION OF INSTALLATION OR REMOVAL NONE SIZE OF EXCAVATION, IF NEEDED NONE Sketch (attach construction plans if appropriate) APPROXIMATE TIME WHEN WORK WILL BEGIN 5PM--10PM 1011-1115� 12/3 1999;.2/4. 3/3. 3/31. 2000 APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ N/A (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: SEE ATTACKED CONDITIONS SEE TRAFFIC CONTPOL PLANS Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all 4 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 granSed pursuant to this application. Notify the Administrative Authority at least twenty-four (24) hours in advance of the ti a when work will be started. Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and �egulat ons of the City of La Quinta and to pay for any additional replacement necessary as the result of tth7"f ork. Signature of Applicant or Agent _1.4 Qxdl'NTA CHAN,BER OF COMMERCE 51351 AVE. BE AS, L.Q., CA (760)564-3199 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business/Address Telephone No. Contractor's License No. City Business License No. ORRTTFTCATE ON FT1.E Applicant's Insurance Company 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 Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by Date 3049 PERMIT VALIDATION PERMIT NO. 00 DATE APPROVED 2122199 EXPIRATION DATE 4/1100 DATE ISSUED tit} r r� By.1)�X) le.'�x',�•... i Administrative Authority Recorded by I Telephone: (619) 777-7075 SPECIAL CONDITIONS --PERMIT NO.3o49 ' --= La Quinta Chamber ".of Commerce --- 1. Streets shall. be kept clean. They shall be completely cleaned at the end of each street fair and more frequently if required.' 2. Permittee shall assume responsibility for. repair of any -pavement damage to any public or private street and for any damage to other City streets or facilities as a "result of work performed under this permit. 3. Advance warning signs arid.traffic control shall be installed and maintained in accordance with Cal Trans Standards or the Work Area Traffic Control Handbook (WATCH Manual). It shall be, the permittee's responsibility to detour andbarricade this site.... Refer to traffic' control plans provided by the City of La Quinta, Drawings A, 1, 2, and 3. 4. Should additional -.work,. materials, or modifications of the work be required in order to meet city , standards, safety requirements, signage requirements, .or to fit actual field ,conditions, the work shall be performed by the permittee as directed by and to the satisfaction of the City Engineer at no cost to the City of La Quinta. 5. It shall be the permittee's responsibility to maintain a clear and accessible. fire access route across , the library's driveway. This area shall be kept clear of any parked vehicles and be accessible at anytime to emergency vehicles. Special Conditions - Permit No. 3049 Page 1 of 1 �n AVENIDA MONTEZUMA DRA LEGEND BARRICADE W/SIGN = BARRICADE (TYPE 2) 7' TYPICAL CALLE _ E S TAD 0 C 7' TYPICAL t IN LEGEND BARRICADE W/SIGN _ BARRICADE (TYPE 2) A 1P S E ►y'' W C2 ROAD CLOSED a (FAct cJ , FAR -WC, AREA) 10-1-96 - 1 - SLOL-LLL i6 t91Wo1�1 Ag PaP-wY A1uo40eV wqulJluwpy ago _ Av pe•tea•W A 9 I 03ASSI 31VO 'ON loitraey f =1v101 00 �' 31VO NOI1V1lldX3 Z _ 03AOVddv 31VO Puo9 A—nS'jnode0 W93 A�4ewd p 'ON 1IWl13d . 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JOd UNW43VOSON3i Nouantl1SNOO S)IV M OI1811d. 11WW3d WOd NO11V311ddV V1NIM VI 10 A113 1!fuledweunpeonw w salnapcvoo w,oj t!W wol1@P P& J.00Jd 401FA �310N SPECIAL CONDITIONS --PERMIT NO.2839 --- La Quinta Chamber of Commerce --- 1. Streets shall be kept clean. They shall be completely cleaned at the end of each street fair and more frequently if required. 2. Permittee shall assume responsibility for repair of any pavement damage to any public or private street and for any damage to other City streets or facilities as a result of work performed under this permit. 3: Advance warning signs and traffic control shall be installed and maintained in accordance with Cal Trans Standards or the Work Area Traffic Control Handbook (WATCH Manual).`It shall be the permittee's responsibility to detour and barricade this site. Refer to traffic control plans provided 'by the City of La Quinta, Drawings A, 1, 2,'and 3. 4. Should additional work, materials, or modifications of the work be.required in order to meet city standards, safety requirements, signage requirements, or to fit actual field conditions, the work shall be performed by the permittee as directed by and to thesatisfaction of the City Engineer at no cost to the City of La Quints. 5. It shall be the permittee's responsibility to maintain a clear and accessible fire access route across the library's driveway. This area, shall be kept. clear of any parked vehicles and be accessible at anytime to emergency vehicles. Special Conditions - Permit No. 2839 Page 1 of 1 i d `,. ! _ i -'x" t :+t. ,�,. -'°sT. ;'��','^.{.;al DATE (MMIDD" ® n ERA IFI AT .stirs , FLIABILI� : INS�RAN. rh� ........:.:.,.r.:«..T.aky..nr.,v,....a�.r.:.•,.,..litxs'rz:&.lc6.W.°w-3 .f�a�n_�.z 4:�A¢`r'`:o. '�X\.—.. .d t-!Yn.......••.,....•i.+n•i•��',�RKx.afifw?rv.�i:....y 2�,°'ir.-'Y•-nNi�r f:,..y.;!L lEi 08 09 PRODUCER THIS CERTIFICATE IS ISSUED- AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HRH Ins Sery of So California HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR i License Number 0684503 , ,- ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 77-W Country Club .Dr. #401 l� I I c ��' !� '' COMPANIES AFFORDING COVERAGE 221 Palm Desert CA 9 i� II COMPANY 11: j �I ; I A U G1 „ A Gulf Insurance INSURED + COMPANY La Quinta Chamber Of Commerce B P. 0. BOX 255 Ey COMPANY ' La Quinta CA 92253 C COMPANY i D i v ... ....t ;. a•• ....x:.:.:v..:Y C..'.::i...::::.:. �i: .:.;.E+•, +Yt:* 4"•ys::wfi*" •:.y=:::'> .p.,. ...., ,-.. ,.e�,y .,. 1rw .. x• �,_...at= ...✓t .ii„ .x,➢ `-qy`b• ..,...F-`sAK..... tiv.::.c,' ,::<a ...Y'•.. '._+2``.. COVERAGES. ,..,..• .x. �T. .{,..-�a....� , . . �., ....... ,.. ,�, ,.... _... x.,. • �,- ,:.�. ` � ��i-fix, ;F:`: .. .-.s.s ^- t•.. .- Ace; �+.'t` v: .=.. ..:.........-...�•....._�!G..b��*.f•.irc'(.Ssa b ���rt�� y�i•�" •-: • . ..h�'f1t.C,w.vl4C:.Y....�NF.n•.:e`�X.�ic..2ibF"' tfr5.Z:5:�.•�� 'A � id'r�i:'`'':'�:'ji•ri�e:.e......-x.b.�_F.'��..xx:.::N.i:.�Ja.:��::.{`•ii'i��.h'JL:'.n�." :�::..• . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED'ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 1 CERTIFICATE MAY BE ISSUED 013 MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES'DESCRIBED HERON IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 00 TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE D TE � � POLICY EXPIRATION DATE D� LIMITSLIMITSLTR A GENERAL LIABILITY 0147050 08/22/99 08/22/00 GENERAL AGGREGATE S. 2,000.000 X COMMERCIAL GENERAL LIABILITY PRODUCTS • COMP/OP AGG $ 2,000,000 CLAIMS MADE D OCCUR PERSONAL d ADV INJURY $ 1 , 000, 000 I OWNERS d CONTRACTORS PROT EACH OCCURRENCE $ 1.000,000 FIRE DAMAGE (Airy one fire) $ 50,000 1 MED EXP (Any one person) $ 5,000 A AUTOMOBILE LIABILITY ANY AUTO: 0147050 08 / 22 / 99 08 / 22 / 00 COMBINED SINGLE LIMIT ' $ 1,000,000 ALL OWNED ALTOS SCHEDULED AUTOS BODILY INJURY (Per person) S X HIRED ALTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE $ i GARAGE LIABILITY AUTO ONLY • EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ I AGGREGATE $ UTABRELLA FORM $ OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ATU- TWORY IM y+^ EL EACH ACCIDENT $ I THE PROPRIETOR/ INCL PARTNERSIEXECUTIVE EL DISEASE • POLICY LIMIT S EL DISEASE • EA EMPLOYEE Is OFFICERS ARE: EXCL OTHER " i I of o Rqap S& 10 S�vE cxEs�s ECIA` Ms Mas�nls fee�Fl�afkQ placeTlO/1/99 tt/P4/99 1E2/3199 2I4I00 3/3/00 and 3/31100 Certificate holder is also named. as additional insured, but only with respect to liability -arising out of your ongoing operations performed for that insured. �.•yk4: `-`$.. � �� �:'-µ � '� it .'X�+h„K•'"s Rt3' '^'r,�.t �•�-r. •.x. c CERTIFICATEwHOLDE,�;,��. �.-r. '���'�--��•��.�-.��.� ,�� �' �€>Ctl ^rt 'Ci';' -i`' <s �+:.. .z j k � ,�._. .•.:a>a*•.,... I CELtA 0�t � �...�;`�.,�, sr>. :�-` <r,�� ham.. r•. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE i The City of La Qulnta & Its Staff Community Development Dept P. QUBoxinta 1504 CA 92253 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL I 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY i OF A D UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. REPRES NTATNE ...... .,x_ ..av, .^l"c'i•`- ACOf�D25=S{ � �-F 4 �K'�>xT;�!'YS•4?t t -, ��"We�GS��..�x .eYh:/.+, t.+4�':'{3cM _ rs, :•4a'? sntr";•: - K^5�..� �ry' �°^,�a::,: >� y.-vrs,.:eb � i 2©,ACORDCORPORA710N�19813 `'::