4026NOTE:"—
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
11/2S/03 Subdivision Improvement'Permit - Class III
DATE:' Minor Improvement Permit Class IV
LOCATION OF. CONSTRUCTION Avenue 60 rom Madison to Monroe
(Sireet'addiress or Description of Location)
f PURPOSE OF CONSTRUCTION special events .traffic control Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION t>-moorary trAffic'control eSee attached ispeclnl coaxdttioua
DIMENSION OF INSTALLATION OR REMOVAL 1 Mile'
SIZE OF EXCAVATION, IF NEEDED N/A
APPROXIMATE TIME. WHEN WORK WILL BEGIN 11/2'8/03 " D
APPROXIMATETIME1OFCOMPLETION 12/01/03
ESTIMATED CONSTRUCTION COST $ Udder 5�.000.00 Q�C a
(Including, removal of all obstruction, materials, and debris, backfilling"com 1 4;�C73
paction and placing permanent, resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the- applicant hereby agrees to:Ocp.'�
\'-
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and -al
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.
Signature of Applicant or Agent
Shea -Romeo, Ulrich-J. Sauerbrey*s 81-260 Aire, 62, La QUInta,, CA .92253' (760) 427-4707
Name of Applicant (please print) Business Address Telephone No. .
Topp N Barrtcades, 44»631 Jackoon Strode, Indio,. CA 92.20.1 .(760). 347.--2111 '
Name of Contractor and Job Foreman Business Address Telephone 'No.
Contractor's License No. City. Business' License, No.
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 T
Minor, Improvement Permit — Class IV: See attached'schedule, �S°!
4026.
Inspection Fee $ PERMIT VALIDATION
Permit Fee I0040 4026
PERMIT NO.
Penalty '1-1/25/03,
Cash Deposit -Surety. Bond DATE APPROVED
if required EXPIRATION DATE 44425-AA3 11/30/04 +
TOTAL: $ 100,00 il/Z6/fl3
DATE ISSUED r
+ . Receipt No.
By
-Received by• Date Administrative Authority
• Recorded by Telephone: (760) 777-7075
F
4 NOTE: .
With proper validation. #
-this form, eonstitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT' $
PUBLIC WORKS CONSTRUCTION. (ENCROACHMENT} �g
�OP Tf�9v
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
iv )rh".oe
Subdivision Improve m nt Per
—Class III
.• DATE: l ��.0
Min nt Permi Class V
LOCATION 0 CONSTRUCTION L" �V�
(Street address of Description of Locetlo Vv / SQc .i ` �;,Q � (rq r{j; c C,, o
PURPOSE OF C iTIO� Sketch (attach construction plans If.appropriete)
DESCR TION OF•CO STRU _TION,
t
OIM NSION pF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION,' IF NEEDED
APPROXIMATE TIME WHEN WORK•WILL BE N
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing' permanent resurfacing end/or replacing improveme
•In consideration of the granting of this permit, the -applicant he re a to.
Indemnity,. defend• and save the City, its. authorised agents f ers, tatl ployees, harmless from and against any and all
penalties, Ilabllitler or loss renrlting from claims or a an rig ny accident, loss or damage to persons or property '
happening or occurring as a proximate remit of n r nd ken rider permit grenfed pursuant to this. application.
Notify the Administrative Authority at lea n •f r I ou nee of.the time whari rk will be started.
Comply with all applicable City Ordinance th arm d dition f. permit a all eppllea Ie.rules d re ationsof the City of.'
. La. Quints and to pay for any additional re a nt ry es the esu t the k.
* ' Ignat re A pit t or Ag t
(25 t2
Neale of Applicant ( ase print) Business Address Telephone No,
Name of ntraet 'and Job Foremen Business Address Telephone No.
Contractor's License No. City Business License No.
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 3 .PERMIT VALIDATION
Permit Fee )1717 • '
PERMIT NO.
Penalty "
Cash DepositSurety'Bond DATE APPROVED
If required EXPIRATION DATE
TOTAL: $ — to 0. C,) DATE ISSUED
Receipt No.
By
Received by Date— Administrative Authority
Recorded by Telephone: (760) 777-7075
s W H t
a r
NO SCALE
MADISON ST. - s, _ ,- • ., , . - , _ �:
Y'sue,. .. ■; y t _ c -:, r , - - ' I `y • _ - • - .
0 •ao«, EVENT PARKING AREA =_
SC 5
R-69 PM
ONLY . �G"'r1 SKINS GAME
r
V Y . • a: ..Ohly • . - .� - , PARKIN° I ® �Iam -
Y I �• \AH610
0
TENT 500 FT
Qlar _._ 1�—•—•— �— —•—._. T
AVE. 60 '
csle��voC�q�oa�od �CSo���c��� a���~��� � j�� � � ����� �� a vr� �cav � �v000000c�r�ooac♦vv
500 FT- 500 FT_ 500 FT' - » 1000 FT-'� R, T0'MDNRDE ST>
600 FT
C-20 (Rn ff
E °
-
i i `\ /pGNruwE, PARKING '^ E "` CROSSWALK
F _ ��Ea�� �PoGNrIANE' ao� \ ■ TURN LEFT MAIN ENTRANCE INSTALL 12 WIDE
SKINS GAME TO TRILOGY i : LINES (LOCATION TO BE DETERMINED
- PARKING IN THE FIELD)
�— VEHICLE DIRECTION'
NOTES: 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE INACCORDANCE WITH THE STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION (CALTRANS) y " Date �umft
MANUAL OF TRAFFIC CONTROLS FOR CONSTRUCTION AND MAINTENANCE WORK ZONES. f 55
•.2. TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL, TRAFFIC CONTROL MAYBE REQUIRED TO FACILITATE PUBLIC SAFETYAND _ Nam
TRAFFIC FLOW IF DEEMED NECESSARY BY CITY OF LAQUINTA REPRESENTATIVE - - The Skins Game Parking at Trilogy .
3. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL: (SIGNS, BARRICADES AND DELINEATORS) AND MAINTAIN SAME IN F� convacw T,� Ca"w Calftdor
ACCORDANCE WITHTRAFFIC CONTROL PLANS. - . '.` , _ N I , - . , Shay Homes _' Tops N Barricades, Inc.
4. CONTRACTOR SHALL MAINTAIN AMINIMUM I2'TRAFFICLANE WIDTHATALLTIMES. . 4 -a1 - Fay,�ay, ease<,onsrerderd
5. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINEDATALL TIMES.- . x - ; " " �`' •', (800)852-TOPS Ron Fifield - CALTRANS T-11
6. THIS TRAFFIC CONTROL SHALL BE LEFT IN PLACE 24 HOURS A DAY FOR DURATION OF THE EVENT.. _ shwmlmDef Dale -peffA Number
7. IT IS RECOMMENDED THAT THE SPONSOR HAVEAFLAGGER TO DIRECT E VENTATTENDEES AND NORMAL TRAFFIC TO PROPER LANES 11 /21 /03 To Be Issued on Approval
Y= . ry ' F ��� - - , » . .• f.. _ [ .e t� - • { ' M . ' . _..F' t .s - - . Y • 4 • , t - S .: ' e • ♦ - »