4078NOTE
With proper validation
this form constitutes an
encroachment permit
,r ' CITY OF LA QUINTA
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
DATE: JAnumry 30. 2004
LOCATION OF CONSTRUCTION 78-900 Avenue 47
Subdivision Improvement Permit —Class I I I
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION INSTALL, AND MAINTAIN Sketch (attach construction plans if appropriate)
12 — V WATER SERVICE
DESCRIPTION OF CONSTRUCTION WATRR SF.RRTi^R USA i1A260454 110 501.4
SEE ATTACHED CONDITIONS
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED 8' E 8'
t
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION 2-27-04
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 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
CM (Maatnuel, Mendez Jr.) P.O. Anx L,n5$t _ Cnaohot l a e rA 09114 (aam 102_ sae L
Name of7Applicant (please print) Business Address Telephone No.
Manuel Mendez Jr. (760) 398-2651
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
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ �� }
Permit Fee 0
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No
Received by
$
Date
0
*_ 4078
PERMIT NO
PERMIT VALIDATION
4078
DATE APPROVED t—�A
1-30-05
EXPIRATION DATE
DATE ISSUED h�—
By .1V
Administrative Authority
Recorded by 11 Telephone: (760) 777-7075
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WEEKLY INSPECTION REP
PROJECT NAME C U D 79-- 919QO ?V f 4/7 'DIN
PERMIT NO. 7 6 %� PLAN SET NO. INSPECTOR _ An u) ;? Y L4 OrT7_ 7
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MEDIAN
PERIMETER
up �' U41W Page 2 of 2
Robert C. Monroe and Co:
REAL ESTATE INVESTMENTS
October 19; 1988
City of La .Quinta
P. 0. Box 1504 .
La Quinta, California 92253
Attention:. Jerry.'D._ Co.ffey....._.-
Engineering Supervisor
Dear Jerry: ."
.Enclosed is A. copy of the CVWD letter indicating.work has been
completed to their satisfaction. Other arrangements.mentioned in
the letter have been.accomodated.. I would appreciate the -release to
me of my::letter of credit given to the city.in conjunction with the
Infringement Permit for the 'necessary -street work:
Thank you for your cooperation.
I
Sincerely,
R T C. ONROE
RCM:cs
Encl:
78M CALLE ESTADO
POST OFFICE BOX 1040
LA OUINTA, CAUFORNIA 92253-1040
(619) 564-2422
ESTABLISHED IN 1918 AS A PUBLIC AG...:CY
OISTRIC1
C0ACHELL.A.."VALLEY WATER DISTRICT
POST OFFICE.BOX 1058 • COACHELLA, CALIFORNIA 92236 • TELEPHONE (619).398-2651
DIRECTORS : OFFICERS
RAYMOND R. RUMMONDS, PRESIDENT r, THOMAS E. LEVY, GENERAL MANAGER -CHIEF ENGINEER
TELLISCODEKAS VICE PRESIDENT BERNARDINESUTTON,SECRETARY
JOHN P. POWELL " KEITH H. AINSWORTH• ASSISTANT GENERAL MANAGER
DOROTHYM.NICHOLS August 10,. 1988 ,. REDWINE AND SHERRILL, ATTORNEYS _-
THEODORE'J.FISH
E
File: 0421.2• .
0721.2
Robert C. and Mary Alice Monroe
Post Office'Box'1040
�La Quinta,'California 92253
Dear Mr,.'.and.Mrs..Monroe: n
-Subject: Domestic Water and Sanitation:
Service for the Monroe Building. Il Pro ect
Transmitted.are,the-following documents as indicated:
Tinal.Inspection Report, "(Form CVWD-182)
Declaration, (Form CVWD-139).
Guarantee. Bond, (Form CVWD-215)...`........_-
The`•amount of.•the'bond shall be $2,500 or 10 percent of.the amount"of the
construction'.contract,.whichever is greater:"
You are authorized.to make payment to.the Contractor for all work in accordance with
the construction contract.
Upon.receipt of the following items,, we will recommend.to our Board of Directors that.
the domestic water and sanitation system be accepted and that the guarantee of
completion deposited by you be released:
Guarantee Bond,. (Form CVWD-215). .
Declaration, (Form CVWD-139).
Final Inspection Fees will be billed at a••later.date.
,
If you have any questions please contact Mike Tanner, Technical -Service' Technician.
Yours very truly,
Dale Bohnenberger.
Deputy Chief •Engineer.
CS:lmf
Enclosures/3/as
CERTIFIED MAIL NO. P 138 146 138.. TRUE CONSERVATION:
RETURN RECEIPT -REQUESTED. USE WATER WISELY