4001 (2)NOTE:
Witl5`7'j_>r_'___ F
this I
oper validjtion
, I
rm..constixutes-an4::-—
encr6ad� rnent permit
7 12003
01-11f Z111.1- U1111
CITY OF LA QUINTA
APPLICATION. FOR PERMIT
'U41C 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 III
DATE: Septeuibar 30, 2003 Minor Improvement Permit Ciass-.IV x
LOCATION OF CONSTRUCTION Tract 31681, Coral -Mountain. Between HAdison and -Monroe and
Avenue 58 and Avenue 60
(Street address or. Description of Location)
PURPOSE OF. CONSTRUCTION, Imad Cle4arinjiy S . ketch (attach construction plans if appropriate)
DESCRIPTION OF -CONSTRUCTION clearing and grubing, .*see attached special conditions*
PLaxi Check 03128 & 03039
DIMENSION OF INSTALLATION OR REMOVAL ±550 acrer.
-mobilization,
-Stage I: ' For
pr41�Water, clea-ring & gX-iibbing
SIZE*OF EXCAVATION, IF NEEDED PM10 AB05993 s re4uired.
No' rough grading until grading.
APPROXIMATE TIME WHEN WORK WILL BEGIN October -L. 2003 plaus ,are approved. A.$
APPROXIMATE TIME OF COMPLETION Harch TA 2004
ESTIMATED CONSTRUCTION COST $ 182!51 (f>!j50&V2>
(Including removal of all obstruction, materials, and debris, backfilfing, com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration ofthe granting of this permit, the applicant hereby agrees to: 5, C)s 3� 0 0 0
Indemnify, Men& 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 result of this work.
W
of Applicant Signature 90A ht (760) 408-0106
T.D. Daeart Dev�alopment P.O. Box 1716, La Quinta-, CA 92253 (760) 771-1941
Name of Applicant (please print)' Business Address Telephone No.'
-161 - T I t C--, De- . b %A-^4_
81751) A��rltlo 4L,_Zj1.4jXL,..�' Cil)-t3o I (80a;l.
r
Name of Contractor and Job Foreman Business -Address Telephone No.
'3 Pj (xA
Contractor's License No.
71D) 0 6 IPZtitWusiness'License, No.
National Union Fire Inourituce Company G1.5440206RA
.Applicant's Insurance Company Policy
licy Number
FEES: Subdivision Improvement Permit - Class I I I
."N E R Public improvements: 3% of estimated construction cost. CaT
Private improvements: 3% of estimated construction costs
Minor. Improvement Permit - Class IV: See attached schedule
4001
Inspection Fee $�
Permit Fee Lt,
Z, 5 2, -*f
Pe"ftk-y_.
Cash Deposit -Surety Bond73]Fo 37
7PERMIT
VALIDATION14001
PERMIT NO.
,3ff Z; 1 9' .11 - - DATE APPROVED September 30, 2003.
if required I: September '310 9004
EXPIRATION DATE
TOTAL:
1.0,510.00 ;:= . DATE ISSUED
1 0 6, _� 6
Receipt No. rib
By
Received by Date Admi*nis'trative Authority
Recorded by Telephbne: (760) 777-7075
CASH SECURITY —
Dust control; As -built plans ,
Other
See Encroachment Permit for PS No(Not Approved Yet) (PC No., 03128, Rough
Grading).
Developer's Signature:
CASH PAYMENT - DESCRIPTION OF OBLIGATION PROMPTING
DEPOSIT
DEPOSIT
DATE Amount Receipt # DEBIT BALANCE
1000.00 -
5,053;000.00
COMMENTS: Deposit for: As=Built= $1000.00
Rough, Grading.Bond = $5,053,000.00
*Cash deposits placed in City administered trust accounts are typically received for two basic reasons:.1) CASH SECURITY- to provide a source of
funds for the City to draw upon if the City incurs costs satisfying obligations of the developer, or 2� CASH PAYMENT- to provide a source of funding for
improvements, property, or services to be acquired, or administered, byy.the City at the developer s expense. The City will release the fund balance when
the developer's obligations that prompted the cash deposit are fully satisfied. The release function is initiated via the Request/Demand for Release of
Cash Deposit (Form F058)
F059
�' ��