4372•. NOTE: —
With proper validation
this form constitutes'an
'encroachment permit
M
CITY., OF LA QUINTA s
APPLICATION FOR PERMIT i
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
Subdivision Improvement Permit —Class II I
DATE: �a-5 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Accomafiae v - th°cle raffl Sketch (attach construction plans if appropriate)
to and f ma the PirApir + Polo -Club
DESCRIPTION OF CONSTRUCTION Directional Sign Placement
See attachad coal tiorm
DIMENSION OF INSTALLATION OR REMOVAL
Type III $arricadoo
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN'����
APPROXIMATE TIME OF COMPLETIONpt
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
Start to Finigh 1728 Gree voou Ave, 'for ao,c o, CA 90503
Name of Applicant (please print) Business Address Telephone No.
1 y ida gaoter-ilaba sh (310) 782- 7586 C*11 (310) 780- 363f
Name of Contractor and Job Foreman Business Address Telephone°No.
Contractolr's License No.. City Business License No.
Cortif
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs '^
Private improvements: 3% of estimated construction costs ,—,
Minor Improvement Permit — Class IV: See attached schedule110
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
$115.00.
TOTAL: $
Receipt No.
' Received by Date
Recorded by
APR 2 9 2 R ALIDATION
�3 =2
5-2-05
EXPIRATION DATE
4 -28-05
DATE ISSUED X
a
Administrative Authority
Telephone: (760) 777-7075
0
NOTE:
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 improvementsin connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement,Permit— Class I II
DATE 4-28"0. 5 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Accommodate vehicle traffic Sketch (attach construction plans if appropriate).
- to send- from the Empire Polo Club
DESCRIPTION OF CONSTRUCTION Directional Sign. Placemirn
See attached conditions
DIMENSION OF INSTALLATION OR REMOVAL
Type III Barricades
SIZE OF EXCAVATION, IF NEEDED '
.: APPROXIMATE TIME WHEN WORK WILL•BEGIN 4-28-05
APPROXIMATE TIME OF COMPLETION 5-1-05
ESTIMATE_ D CONSTRUCTION COST $
1Including removal of.all obstruction, materials, and debris, backfiIIing, 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
Start to Finish 1728 Greenwood Ave, Torrance, CA 90503
Name.of Applicant (please print) Business Address Telephone No.
Ly.de Easter —Habash (310) 782-7586 Cell (310) 780--3637
Name of Contractor and Job Foreman Business Address . Telephone No.
Contractor's License No. City Business License No.
Certificate on File
Applicant's Insurance. Company r` Policy Number
FEES: Subdivision Improvement Permit.- Class III n i
Public improvements: 3% of•estimated construction c
Private improvements: 3% of estimated construction t
•Minor. Improvement Permit— Class IV: See attached.sch ul APR 2 9 2005 . •
4372
Inspection Fee $ CITY OF LAQUINTA pE MIT VALIDATION
> - FINANCE DEPT,
Permit Fee
1.15.00 4372
PERMIT NO.
Penalty 4-28--05 .
Cash Deposit -Surety Bond DATE APPROVED
if required EXPIRATION DATE 5-2-05
TOTAL: $ $11.5.00
Receipt No.
Received by Date _
Recorded by.
DATE ISSUED A 4-28A-05
By /, tl
rj Administrative Authority'
Telephone: (760) 777-7075 .
f ,
T
i PERMIT NO. 4372
Start to Finish/Directional Signs
In addition to thestandard permit conditions; the following shall apply:
1. Pursuant to Section 14.16.320 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982),'all
work shall be performed in accordance with the latest edition of the Standard Specifications For Public
Works Construction (SSPWC) and as directed by and to the satisfaction of the City Engineer.
2. Start to Finish hereinafter referred to as "Permittee", shall be responsible for providing continuous
dust and erosion control.
3. Streets shall be kept clean. They shall be, completely cleaned at the end of each working day and more
frequently, if required. !
.4. Pursuant to Section 6.08: 050 of the La Quinta Municipal Code (Ordinance' 18 § 1, 1982), throughout the
work site, the Permittee shall comply with City regulated work hours. Operation and maintenance of
equipment within one-half mile of human occupancy shall be..performed only during the following time
periods:
October 1st to April 30: Monday -Friday 7:00 a.m. to 5:30 p.m.
I
Saturday 8:00 a.m: to 5:00 p.m.
May' lst to September 30: Monday -Friday 6:00 a.m. to. 7:00 p.m. •
Saturday 8:00 a.m. to:5:00 p.m.
Work shall be prohibited ion legal holidays and Sundays. :
Note: Construction work (including setting up traffic. control'devices) is not permitted on any Arterial
street (ie any 4 lane street) before 8:00 a.m.
5. Work within 500 feet of al signalized intersection shall be performed between the hours of 9 a.m. - 3 p.m.
Traffic control shall be set up. after 9 a.m. and removed before 3 p.m. The Permittee shall contact the
Riverside Country. Traffic Signal Maintenance'Department,at (909) 275-6894 if signal operation at the
intersection is to be altered in any way:
i
6. Pursuant to Section" 14.16.110 of the La Quinta Municipal Code (Ordinance .10 § 1 (part), 1982),
Permittee shall assume responsibility for repair of any pavement.damage to any public or private street
and for any damage to other City streets or facilities as a result of work performed under this permit.
l •
7. Pursuant to Section 14.16.250 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), .
advance warning signs and traffic control shall be installed and maintained in accordance with Cal Trans
Standards or the Work Area Traffic Control Handbook (WATCH Manual). A traffic control ,plan
shall be prepared in accordance with the WATCH Manual and submitted, to the City for review
and approval one (1); week prior to starting any construction. It shall be the Perrnittee's
responsibility to appropriately detour and barricade all construction sites.
Special Conditions Page 1 of 2
` PERMIT NO. 4372
Start to Finish/Directional Signs
Pursuant to Section 14.16.290 of the La Quinta Municipal Code (Ordinance 10 § 1 � (part), 1982), street
closures shall not be permitted. A minimum of two (2) travel lanes of paved surface shall be
maintained at all times.
-8. Prior to excavating, if required, the Permittee shall contact Underground. Service Alert at 1-800-422-
4133. It shall be the Permittee's responsibility to notify the Public Works Department of anticipated
excavation which impact City facilities,including but not limited to traffic signal conduits and loops,
irrigation lines, electrical conduits, and storm drain facilities.
9. Should additional work,` materials, or modifications of the ,work be required in order to meet City
standards, safety requirements, signage requirements, or to'fit actual field conditions, the work shall
be performed by the Permittee as directed by and to the satisfaction of the City Engineer at no cost to
the City of La Quinta: ;
10. Pursuant to Section 14.16:370 of the La Quinta "Municipal, Code (Ordinance 10 § 1 (part), 1982),
backfill compaction within street rights -of -way shall conform with Section 306-1.3 of the latest
edition of the Standard Specifications For Public Works Construction (SSPWC), except as otherwise
specified herein.
11. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to.its
original condition. '
12. Access and egress to all local properties shall be maintained at all times.
13. Permittee shall. permanently stabilize any and all soil that,was disturbed as a result, of work performed
under this permit with an 'approved dust control treatment. Soil stabilization shall be done immediately
after completing the operation.
.14. Pursuant to Chapter 12.56 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982) the City
has designated certain city streets as Truck Routes. The'weight limit for restricted streets (i.e., streets
not part of the Truck" Route network) is three (3) tons- trucks exceeding. the weight limit may use a
restricted street if making a delivey or pickup on the subject street, or if this permit specifically grants
permission to use the streetto deliver- street construction materials and/or equipment.
15. The City of La Quinta reserves the right to revoke, suspend. or void this permit at any time.
16. The permittee shall indemnify, hold harmless and assume the defense of the City from all
damages, delay costs, costs or expenses in, law or equity that may arise out of work under this
permit.
Special Conditions Page 2 of 2