4289NOTE:
With proper validatian'�""
this form constitutes an
encroachment permit ,
Y'
CITY OF LA QUINTA
2�'l
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
.t
12-29-4)4 Subdivision Improvement Permit— Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION W HIDEAWAY Tract 29894-3 and 29894-•4
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION ROUGH GSADING Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION SEE 'PLAN NET 1►f0. 04054 and 04055
DIMENSION OF INSTALLATION OR REMOVAL
wSIZE OF EXCAVATION, IF NEEDED N
APPROXIMATE TIME WHEN WORK WILL BEGIN 01-03-05
APPROXIMATE TIME OF COMPLETION_6 WEM
ESTIMATED CONSTRUCTION COST $ 1 11tiLLIOA
(Including removal of all obstruction, materials, and debris, backfilling, com-
„paction and placing permanent resurfacing and/or replacing improvements)
'tln consideration of the granting of this permit, the applicant hereby agrees to:
D JAN 132005 ID
CITY OF LA QUINTA
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 of 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 Vs Work.
d
Si6nature'of Ap�hcant o 44gent
THE HMEAWAY LA QUTLNTA, CA (760) 391-5072
Name of Applicant (please print) Business Address Telephone No.
O KNG114MING /. 79--811 COUNTRY CLUB DR. (760)345-1778
Name of C4Qntrraaccttor and Job Foreman Business Address O�T�I1,ephone No.
Contractor's License No.
L=NG'= INSURANCE GO.
City Business License No.
1070397
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
r�
Receipt No.
Received by
Recorded by
100.00
$ 19,630.00
Date
ENTERED
4289
PERMIT VALIDATION `)
4289
PERMIT NO.
DATE APPROVED 01-12-05
EXPIRATION DATE 41-12-06
r
DATE IS�UED � �•�
Administrative Authority
Telephone: (760) 777-7075
f ,
NOTE:,
this
o With proper validation p
this form constitutes an CITY OF LA QUINTA f�
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
1212— Subdivision Improvement Permit —Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONPTRUCTION
it�d�af,.>,�;...► �i-af�- 29Sq "3 a-•d�• Z98`i�'t-�t
(Street address or Description of Location)
PURPOSI OF ON UCTI Sketch (all't construction plans if. appropriate)
DESCRIPTIO OF•CONSTq� TION
O(�� Ste �( •S N n_ Va 5!1 d R 035
\ DIMENSION OF INSTALLATION OR REMOV
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
M
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
.(Including removal of all obstruction, materials, anddebdf, ackfilling,com-
paction and placing' permanent resurfacing and/or replacing improveme
In consideration of the granting of this permit, the applicant he _ ree to.
Indemnify,. defend' and save the City, Its, authorized agents en, r tots ployess, harmless from and against any and all
penalties, liabilities or loss resulting from claims or ct anng p ny accident, loss or damage to persons or property
happening or -occurring as a proximate result bf n or nd ken nder t permit granted pursuant to this. application.
Notify' the Administrative Authority at lee en •f r ( ou dvonce of the time when work -will be started.
JU\\ \ Comply with all applicable City Ordinance th or d dltions of the permit and all placable rules and regulations of the City of
La. Quints end to pay for any additional re a nt spry as the result of t b or
Signatu of Ap licant or Agent
t "u' . So7
Name of Applicant (please pr nt) Business Address
Te ephone No..
V P plc, ►may y _nit, i�rU l (I �i^i n 3 �7 7
�N.m.'\
pgr- oar and Foremanv Business Addrqls ^ Telephone No. •
License No.
Business License No.
Applicant's Insurance Vompany Policy Number
FEES: Subdivision Improvement Permit —Class III � q
Public Improvements: 3%of estimated construction costs Z 3)-730 -100 4100 11153.0
Private Improvements: 3% of estimated construction costs
Minor Improvement Permiit�Claass IVY: See attached scheduleInspection Fee PERMIT $ti"9--�ttiTy �✓�� T PERMIT VALIDATION
Permit Fee y Z�
Penalty A,5 �<kf-
d
1
TOTAL: $ f
Receipt No.
Received by Date'
Recorded by
PERMIT NO. - /
DATE APPROVED
EXPIRATION DATE _ 1112,106
DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075
coo
NUEV_O ENGINEERING, INC.
79-811 COUNTRYCLUB DRIVE • BERMUDA DUNES, CA92201 •760/345.1778 • FAX 760i345.67o4
GENERAL ENGINEERING CONTRACTOR • UCENSE#t438834
PROPOSAL & CONTRACT Page No. of Pages
TO
Hideaway
PHONE
DATE
12/8/04
JOB
81-100 Ave 53
Tract #29894-3
La u' to CA 92253
We hereby submit specifications and estimates for:
REGRADE PADS 1 THROUGH 19 AND 54 OF TRACT #29894-3 $ 49,740.00
PROPOSAL NOTES:
1. Bid includes listed items only. .
2. Bid excludes: a) Engineering, inspections and permit fees
b) Soil testing
c) Construction water costs
3. Proposal excludes the Madison Street berm and the well site.
4. Import to come from stockpile adjacent the site.
5. Bid based on one move only. Grades to be certified to +/- one tenth of a foot of planned
elevations prior to move out.
6. Owner to provide source for sufficient supply of construction water at construction site
boundary.
7. Nuevo Engineering, Inc. will be responsible for dust control only while working on the
job site.
We 11rupuse hereby to furnish material and labor -:—complete in accordance with above specifications, for the sum of:
dollars
Payment to be made as follows:
All material is guaranteed to be as specified. All work to be completed in a workmanlike Authorized
manner according to standard practices. Any alteration or deviation from above specifiea- Signature
g
tions involving extra costs will be executed only upon written orders, and will become
an extra charge over and above the estimate. All agreements contingent upon strikes,
accidents or delays beyond our control. Owner to carry fire, tornado and other necessary Note: This proposal may be withdrawh
insurance. Our workers are fully covered by Workmen's Compensation Insurance. by us if not accepted within days.
Acceptance of 11ropoold—The above prices, specifications and
conditions are satisfactory and are hereby accepted. You are authorized to
do the work as specified. will be made as outlined above. Signature
1Payment
Date of Acceptance: l2� l� ' 0 Signature