3887RECEIPT . City of La Quinta, 78-495 Calle Tampico P ox 04, La Quinta CA 92253
M` 071733
DATE 2
RECEIVED FROM
ADDRESS
DOLLARS $
FOR
A T, H
CHECK
DUE I \ I IORDER
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NOTE:
With proper validation'
t is orm constitutes an CITY OF LA OUINTA
encroachment permit I �' s
"APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT).C� ''�•��wSw�
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 III
DATE: _ . Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION ` � e? ly`�-A'",G �7 14 er(.7'e
(Street address or Description of Lobation) l
PURPOSE OF CONSTRUCTION VQ C Sketch (attach construction plans if appropriate) ,
DESC TION OF, CONSTRUCTION v c•r Q_��t�i�
-t_ r Cj�_
DIMENSION OF INSTALLATION OR.REMOVAL
Ue6
--SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
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. (241 hours in advanc of,.t time hen -work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the rmi nd al applicable rules and regulations of the City of
La Quinta�and to pay for any additional replacement necessary as the result f th• wor a
a
c. ✓fiCC�FGf�;'�' VOW-C
Sig at. r Ap icant or Agent
�.
Name of Applicant (please print) Busined ress Telephone No.
- 1-Oe F 5g
. I
Name of Contractor and Job Foreman Busine Address Telephone No.
Contractor's rLicense No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
t
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs..
Minor Improvement Permit — Class IV: See attached scheduleN 0 '
Inspection Fee $, PERMIT VALIDATION,
Permit Fee �� �
PERMIT NO.
Penalty- '
Cash Deposit -Surety Bond ' DATE APPROVED `� I ��
if required --- EXPIRATION'DATE y �D_ L
TOTAL: $ 100.
DATE ISSUED
Receipt No.
- By
Received by Date Administrative Authority
Recorded by
�,�
Telephone: (760) 777-7t�T5
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UTILITIES. '
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'. IMPERIAL IRRIGATION DISTRICT (800). 303-7756
FEE .
CATEGORY
FEE. DESCRIPTION
FEE AMOUNT
FINAL MAP APPLICATION FEE
1100'
;TRACT
MAPS
MAP CHECKING FEE
$1,000 + $10/LOT-
GIS MAP SCAN FEE
$10/LOT -
YCITY,ADMINISTRATION FEE
$1000
-SECURITY VERIFICATION.'
$150
. •
(Certificates of Deposit, Bonds, Letters of Credit)
LIEN AGREEMENT' (when eligible)
0.5% of secured value
($500 min,$5,000 max)
-- - -
FINAL MAP APPLICATION FEE
$100
PARCEL
MAPS
MAP CHECKING FEE
$500 + $250/LOT . •
-
GIS MAP SCAN.FEE -
$10/LOT.
CITY ADMINISTRATION FEE
$250
_
SECURITY: VERIFICATION' —
- $150
(Certificates of Deposit, Bonds, Letters of Credit).
LOT LINE
ADJUSTMENT
SURVEYOR'S CHECKING FEE
$50/LOT . .
1. City Council Resolution 96-27 established criteria and allowable forms of security
for subdivision improvement security.. It's recommended that prior to acquiring
security this resolution be consulted.^
T:\P WDEPT\DOCS\FORMS\F050.wpd
ENGINEERING FEE SCHEDULE
Effective 12/4/96
Page 2 of 2
FEE -
CATEGORY
FEE DESCRIPTION
FEE AMOUNT
Application Fee - $1002
MAJOR' ENCROACHMENT PERMIT
3% of 1st $1,000,000 in improvement
costs', plus
2% of 2nd $1,000,000 in improvement costs',
plus
1 % thereafter, plus
$1,000 refundable "as -built' plan deposit
MINOR ENCROACHMENT PERMIT
$1004
ENCROACHMENT
TRANSPORTATION PERMIT
$15
PERMITS
(OVERSIZE/OVERWEIGHT)
RENEW EXPIRED PERMITS
$100 + 10% of original fee for each year
the permit has been expired
WORKING. WITHOUT A PERMIT
TRIPLE the normal fee plus
48 HOUR DELAY (normal notification period)
PLAN REVISIONS
$100/Sheet/Submittal
Application Fee $100
Plan. Preparation Fee $50/intersection ,
TRAFFIC CONTROL PLANS
Traffic Control Devices':
(special events only)
Barricades $5/barricade+$0.40/day
Signs $5/sign+$1/day
Cones $1/cone+$0.30/day
Application Fee $100
BLOCK PARTY PERMITS
Non -Refundable Barricade Rental Fee - $50
Cleaning/Damage Deposit - $150 Refundable
Application Fee - $100.
EQUIPMENT RENTAL RATE
Rate Schedule - per Caltrans rate or some
other adopted standard
1. Improvement costs exceeding $5,000.
2. The fee is per application. Encroachment permits are valid for one year from date of issuance.
3. As determined by verifiable bids received by applicant, including subcontractor and material costs. The
encroachment permit fee includes costs associated with plan checking of storm drain, rough grading,
streets, and landscape improvements, Precise Plans, GIS scan and inventory, inspection, and
administration.. However, to prevent the City from incurring cost for plan check without a method of
recovering costs, the applicant will be required to submit $750 per sheet prior to start of plan check. Plan _
checking fees paid prior to permit issuance will be applied as a credit when the permit fee is calculated. If .
no permit is issued, any unspent balance will be refunded to the applicant upon written request from the
applicant. The one thousand dollars ($1,000) security deposit will be returned to permitteeupon submittal
of "As -Built" drawings.
4. Includes preparation of application, plan check, inspection of improvements and updating of GIS inventory.
5. Before issuance of an updated Encroachment Permit, expired plans are to reviewed and approved by the
City Engineer.
6. The base rental rate includes rental fee for first day.
T:\PWDEPT\D0CS\F0RMST050.wpd
ry :_ WEEKLY INSPECTION. REPORT
�`�"{�� * y� � .a o. 1t 9. ' j �.- t.•`' {, 6{.{-• t � r y � Nam'- �r
PROJECT NAME
_ t
PERMIT NO. 3 PLAN SET NO."'�INSPECTOR'
CONSTRUCTION ACTIVITY SUMMARY
YR Zl06j MO la DATES: 6 thru �_ WORK BY SPECIAL
PERMISSION
MON TUE WED THU I FRI SAT SUN NITE
TORA RA EMP RY TRAFFIC CONTROL
Conforming implementaton
Non -conforming implementation
......... .................. ......... ......... ................... .........
DUST CONTROL
..................................
Onsite Measures
Conforming implementaton
Non -conforming implementation
Trac Cl
eanup
lea nu
P
................... .................. ......... ......... ..................
Conforming implementaton
Non -conforming implementation
GRADING
Clearing & Grubbing
Earth Moving: Cut & Fill
Fine Grading
Compaction Testing/Reports
STREET IMPR NT VEME S
O
SUBGRADE
AGGREGATE BASE
AC - BASE LIFT
AC - CAP
STRIPING & SIGNS
TRAFFIC SIGNAL
Compaction Testing/Reports
Material Certifications
AC Design Mix
WATERIMPROVEMENTS V S
MAINS
SERVICES
Compaction Testing/Reports
Material Certifications
SER IMPROVEMENTS EW T VE S
MAINS
LATERALS
STRUCTURES
Compaction Testing/Reports
Material Certifications
TO IN S RM DRAINS
MAINS
STRUCTURES
SANDFILTERS
Compaction Testing/Reports
Material Certifications
DRY U TILTIES
CONDUITS
STRUCTURES
Compaction Testing/Reports
Material Certifications
FPO PRO"
LANDSCAPING SC G
MEDIAN
PERIMETER
F130 nd/n9 D '7 „a o
NOTE:
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
April 4, 2003 Subdivision Improvement Permit— Class III �
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 50-801 VoshIngton St, L4 QUtntA
1,,,a1 Quart✓~& Vill46e: ghOpptda ttUtAr - Pad #4
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Si -to P ro pt
DESCRIPTION OF CONSTRUCTION GradLaS
DIMENSION OF INSTALLATION OR REMOVAL otvuu >aq tr
d
SIZE OF EXCAVATION, IF NEEDED � � sq
APPROXIMATE TIME WHEN WORK WILL BEGIN 4111ful
Sketch (attach construction plans if appropriate)
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
4i 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.
1 '
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 thisAwork.
,. Signature of Appllcant or Agent
. Bil&A Orr 39 -301 fladpr St r #300 CA 92211 (164) 3 632
Name of Applicant (please print) Business Address Telephone No.
art $uildarc S404 Sam
Name of Contractor and Job Foreman Business Address Telephone No
693077 01345
Contractor's License No. City Business License No.
Navi$atort last Co. aA► 207696
Applicant's Insurance Company Policy Num „
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 IV: See attached schedule
1,300.00
Inspection Fee $
100.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by Date
—=� ► ^U
APR 0 8 1003
PERMIT VALIDATION
PERMIT NO. 7
4/4/03
DATE APPROVED
4/30/04
EXPIRATION DATE
DATE ISSUEDe�`"
By
,'Administrative Authority
Recorded by II Telephone: (760) 777-7075
1 f_ `•---•—•- _ - —• , — •--fir — _— .. / ,_ _ ._ `_._'_ _, _ _-: v.-- __ ,-�.� ' _
NOTE
Wlth,proper, valldatidn
this form constitutes an o
t' encroachment permit. CITY. OF LA• QUINTA + .'
<< APPLICATION FOR PERMIT
• r .` . PUBLIC .WORKS CONSTRUCTION (ENCROACHMENT) • •. ��Y Sw •• .
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 IMPRQVEMENTS.and APPROVED'SU.BD.IVISIO,NS
' Subdivision Improvement Permit — Class l ll
DATE: r AprRl k, . 2003-
Minor Improvement Permit Class IV
,LOCATION OF CONSTRUCTION 50-801 'Waohin:jton Sts ,.'L Quints
Lg. Qu lute Village Sh6pplug Cent6r Pad ' #'4
!(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Site, PreO'* '''Sketch`(attach construction plans if a •
P PPropriate)
DESCRIPTION OF•CONSTRUCTION
` DIMENSION'OF INSTALLATION OR- REMOVAL 60000 sq • r- <' _
r
SIZE OF EXCAVATION, IF NEEDED
'-APPROXIMATE TIME.WHEN WORK WILL BEGIN 4/8/03. „
APPROXIMATE:TIME•OF. COMPLETION 30 Days r
ESTIMATED CONSTRUCTION COST $ 30000`00 '
(Including removal of all obi iruction;•materials, and debris, backfilling, com-.
rpaction and placing permanent resurfacing• and/or replacing improvements)
tin consideration of the granting of this permit, the applicant hereby agrees: to: "
*` Indemnify, defend' and .save the City, its authorized agents, officers,. representatives and em- loyees,.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 when7work.will be started.
.. ,: .` •"i'..:>•��'• `
" Comply -with all applicable City Ord inances,..the'terms and 'conditions of the permit and'all applicable rules and. regulations of the City of-:-...,_
L:a Quinta and•;to pay for any additional .replacement necessary as the ressu/ltfof this iwork.
100
Sign' ture of A p icant or'Agent „
, 39-301 Badger St#300 •P� iriauCz /7632
.Name'of Applican0please'print) . Business Address Telephone No:
Orr guilders. 8aa a Stuns
Name of, Contractor and Job Foreman Business Address Telephone No:, = "
693477 01395 =; ,
Contractors License.No. City. Business License No.
l�avi utaxs'Ixse C-o. 6L,207896 -
,'Applicant's Insurance Company' Policy.Number A
FEES:.' Subdivision Improvement Permit — Class III
APR 08 2003
Public improvements: 3% of estimated construction costs .
Private, improvements: 3% of estimated construction costs . CITyt%E Ld OUlNTA
Minor Improvement -Permit — Class'IV: See attached schedule !, a� . FIAdA IC �i}EPT
'Inspection:Fee $ I,.S40100.00.00' �� , 3-+ PERMIT VALIDATION
. • ` � , • . _. ; -art �,'`:'•' ,;,,.�,,,�; „ ' �:; .. ;� � .; , :.. .
.'Permit Fee
< i a'PERMIT,NO., g '
Penalty.- + d'
Cash Deposit Surety Bond " , { ,DATE APPROVED. �/R%63 r
if required = _ EXPIRATION DATE r
' T1,11,60040
OTAL: $ '" `'' r i+p '
' ', ,a r DATE ISSUED
t
Receipt No. 1 r
Received by Date � ;Administrative Authority
' . < � .., j' b' . mow• � + _.S`' "�Mvi
' Recorded by '•; �°tTelepfi0ne: (760) 777-7075` ',-