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3795NOTE: 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 December 6, 2002 Subdivision Improvement Permit— Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Jefferson, southbound shoulder. 586' north of 48th Avenue (Street address or Description of Location) PURPOSE OF CONSTRUCTION provides directional sirens for Sketch (attach construction plans if appropriate) builders and developere DESCRIPTION OF CONSTRUCTION Install wood siRn **See attached special conditions** DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN DepnC�stn of rhia "ermi t APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ (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 cf 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. Signature of Applicant or Agent Building Ind. Assoc. 77-570 Springfield Lane, Suite E Palm Desert (760)360-2476 Name of Applicant (please print) Business Address Telephone No. Best Signs 1550 Gene Autry, P€tim.Springs (760)320,3042 Name of Contractor and Job Foreman Business Address Telephone No. 524483 Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class 111 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 C if required TOTAL: $ DO FEE Receipt No. .. A .- Received by Date Recorded by } T PERMIT VALIDATION PERMIT NO. 3795 DATE APPROVED December 6. 2002 EXPIRATION DATE Open DATE -ISSUED December 6, 2002 By Administrative Authority Hector Guzman, Assistant Enginoer I'% Telephone: (760) 777-7075 ." NOTE: REP S' With proper validation 2002 this form constitutes an NOV 1 encroachment permit CITY ' OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORT PUBLIC WORKS CONSTRUCTION (ENCROACRMENT) 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 / / 3/ Q Subdivision Improvement Permit — Class I I I DATE: Minor Improvement Permit Class IV LOCAT(I'ON OF CONSTRUCTION �_l (�j �Q �� rpl o� (Street address or Description of L—oca— on) PURPOSE OF CONSTRUCTION Provide directional suns for uilders and developers Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION Install wood sign See attached conditions DIMENSION OF INSTALLATION OR REMOVAL iIZE OF EXCAVATION, IF NEEDED kPPROXIMATE TIME WHEN WORK WILL BEGIN ASAP .PPROXIMATE TIME OF COMPLETION STIMATED CONSTRUCTION COST $ ncluding removal of all obstruction, materials, and debris, backfilling, com- tction and placing permanent resurfacing and/or replacing improvements) 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 fro m and against any and all Penalties,' liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage 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 fAsult of this work. Signature of Applicant or A neg re of Applicant (please print) Business Address .01 Telephone No. 1-st Signs 1550 Gene Autry, Palm Springs, CA 320-3042 ne of Contractor and Job Foreman Business Address Telephone No. 524483 tractor's License No. City Business License No. •licant's Insurance Company Policy Number S: Subdivision Improvement Permit — Class 111 Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs iNlinor Improvement Permit—6Class IV: See attacherf srhorh,I- ".ail ��l d `N II ZooZ T A0N ROM hdUxb jyj As-s-oic No a M_' Ons-Oute, C h-4pler Directional Sign Program 77-570 Springfield Lane, Ste. E, Palm Desert, CA 92211 (760)360-2476 Phone / (760)772-3372 Fax / (760)578-2931 Cell -Lisa LaBonte November 13, 2002 City of LaQuinta - Attn: Hector Guzman Dear Hector: This is a request for a permit to install a new structure on Jefferson in the South bound shoulder 586" North of Avenue 48. Thank you very much, Lisa LaBonte SPECIAL CONDITIONS --PERMIT NO. 379.5 --- BIA/BEST SIGNS --- Streets and Parkways shall be kept clean. They shall be completely cleaned at the end each sign installation if required. 2. Pursuant to Section 14.16.110 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), 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. Pursuant to Section 14.16.250 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), 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 appropriately detour and barricade this site.. 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. Special Conditions - Permit No. 3795 Page 1 of 1