4140NOTE:'.
With proper validation
this form constitutes an
encroachment permit;
CITY OF LA QUI,NTA
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
— w - -;.-
' Subdivision Improvement Permit,— Class II I
_
DATE: " 3/25/04 Minor'lmprovement Permit Class IV
LOCATION OF CONSTRUCTION Avenida Bermudas
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Soap Boat Derby (face Sketch (attach_ construction plans if appropriate).
DESCRIPTION OF -CO . NSTRUCTION Temporary street closure,
.ramp assembly, straw for safety *See Attached Conditions*
DIMENSION OF INSTALLATION, OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN May 1, 2004
APPROXIMATE TIME OF COMPLETION May L Zu 4
ESTIMATED CONSTRUCTION COST $ N A
(I'ncluding 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,.defen6 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
a. La Quinta and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
Don Berry Memorial. Greater Coachella Valley Soap Boa. Derby
Name of Applicant (please print) Business Address Telephone No.
c/o B&G Club - 'of .CV, 42400 Cook Street #120., Palm; Desert, CA 92211 (760) 564-3761 (Lucia)
Name of Contractor and Job Foreman Business Address Telephone No.
N/A N/A
Contractor's License No. City Business -License No.
NIA N/A
Applicant's Insurance Company Policy Number
FEES:. Subdivision Improvement Permit— Class 111
Public improvements: 3% of estimated construction costs �7
Private improvements: 3% of estimated construction costs
Minor. Improvement Permit — Class IV: See attached schedule
PI/A
Inspection Fee $
N/A
Permit Fee
N/A
Penalty Penalty
Cash Deposit -Surety Bond
N/A
if required
N/A
TOTAL: $
Receipt No.
Received by Date
Recorded by-
044140
PERMIT VALIDATION
PERMIT NO. 4140
DATE APPROVED6�
EXPIRATION DATE S,13 1LI
DATE ISSUED Gf 7.G L)4
By
t Administrative Authority
Telephone: (760) 777-7075
GENERAL CONDITIONS --PERMIT NO.4140
--GREATER COACHELLA VALLEY SOAP BOX DERBY --
This. permit authorizes special event activities to be accomplished within City of La Quinta
right-of-way ONLY. Whenever the special event activities extend into private property, it is
the responsibility of the applicant; or their agents, to secure permission from•abutting property
owners. "Such authorization must be. secured by the applicant prior to staring the special event
activities.
1. The applicant, Lucia �Moran, shall be available during the event,by cellular phone at 805-
1603; pager.836-6135 or a message can be left at 347-1412.
2. The necessary traffic control signage, barricades, and cones identified on the approved traffic
control plans will be provided and• set up by the City. The applicant shall -notify the City
immediately if replacement equipment is needed.
3. The applicant shall be responsible.to have volunteers, at the intersection of Bermudas & t
Nogales at all times during the event to allow,residents, living on Avenida Bermudas within
the event'area, their guests, mail carriers, and.companies delivering to them, access to, the
southbound one-way fire lane provided on the traffic control plans.
p.
4. The applican"t shall also assign volunteers to regularly monitor the intersections of: 1)
Bermudas & Chihuahua, 2) Bermudas & Monterey,- 3) Bermudas & .Colima, and 4)
Bermudas & Arroba.
E
Page 1 of .1
TAMDEMEncroachment Permits\Numbers 4000\4140_Soapboxderby\SoapBoxDerby_.conditibn.doc i
PUBLIC WORKS DEPARTMENT
APPLICATION FOR PERMIT'
Date:
Location of Construction: A vq-N i bA Be-Rrnu D AS
Purpose of Construction: �.(�. A So � 1o65 �e r 6 Ra C
Description of Construction:' L��-�- . (os tom- RF_ , q
R SA F,�5
Dimension 'of Installation or Removal:
Approximate Construction Start Date: 1R� �. 0240
Approximate Construction Completion Date:
Estimated Construction Cost: $ ^�®
Estimated Construction Cost shall include the removal of all obstructions, materials, and debris, back -filling, compaction and
placing permanent resurfacing and or replacing improvements
Name of Applicant: VSo 13ERR P A �RE.AT�FZ CaA A . A
PP a-p -Dox ne-R"l14
Applicant Address:-R+6:ClOU,
'Applicant Telephone Number -.An td -7(; ( (o�, L,_,R1 q I /
Name of Contractor::.S4 o. s wool
Contractor Address:
Contractor Telephone Number:
Contractor State License Number:
Contractor City -Business License Number:.
kppli a t or Contractor General Liability Insurance Company:
kpp nt or Contractor General Liability Insurance Policy Number:,
f� A
Office Use Only:
Inspection Fee: I I�
Permit Fee:
As -Built
Deposit:
Dust Control
Deposit:
Credit
Amount: 1 '
TOTAL FEE DUE:
Office Use Only:
Assigned Permit Number:
Approval Date:
Expiration
Date:
Issue
Date:
Administrative Authority
0
flrtERtG-�ti Berry
oMemorial
Greater CoachellaVal ley
Soap Box -Derby
The Honorable President A Program of the Boys & Girls Club:of Coachella Valley
Gerald R. Ford
Honorary Chairman
March 25, 2004
Faxed & HandDelivered
Dodie Horvit:t
City of La Quinta
Re: Date -change for the Soap Box Derby
Dear Dodie:
This letter is to confirm our,conversation on the change of date for the 10" annual Don Berry
Memorial. Greater Coachella Valley Soap .Box Derby. Due to unanticipated scheduling conflicts
with Racers and Volunteers, we were forced to move the scheduled race of March 27`h to May
We have.gotten the word out to the news media and they are announcing the date change on air
and in the newspaper.: I've already gotten several phone calls from kids and parents that want to
participate, so it seems like this date'change will be ve ositive
b ry p for our race. •
I hope'this has n4 caused any inconvenience for the .City or any of the Staff. We will be holding
several construction clinics and we anticipate a great turnout with this new,date.
If you have any questions, please don't hesitate to give me a call or refer people to my phone
numbers or ;,rive out my email address. They are 564-3761 (home) or 805-1603 (cell),
LuciamCCdc.rr.com.
Sin rely; l_
Lucia Moran, -Race Director:
cc: Mayor & City. Council Members
City _1Vifanager
Public Works,
Plan.niiag Department
42-600 Cook Stre
et, Suite 120, Palm Desert, CA 92211
760.564.3761 Fax: 760.564.8350
E-mail: luciam.@dc.rr.com