45404-�Owa �-�
NOT����,.
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
DATE
November 14, 2005
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Miles Avenue (City of La Qui.nta)
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Walk; Procession to Church
DESCRIPTION OF CONSTRUCTION Walk on Miles Ave. in
honor of our Lady of Guadalupe.
DIMENSION OF INSTALLATION OR REMOVAL Miles Ave. that
belongs to the City of La Quints.
SIZE OF EXCAVATION, IF NEEDED
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME WHEN WORK WILL BEGIN Dec8mber 12, 2005
Approximately 2:00 PM
APPROXIMATE TIME OF COMPLETION December 12, 2005 Approx.
ESTIMATED CONSTRUCTION COST $ Non Profit
(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:
41 L'' 1
;y-we 11 . �vt_
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 theresultof this work. /
_ZIP(_ S17Z
Jesus Mora 324-440-cell 902-2096 Signature fYApplicant or Agent`
Our Ladv of Solitude Church 69365 McCallum Way"325 3816
Name of Applicant (please print) Business Address Telephone No.
N/A
Name of Contractor and Job Foreman Business Address Telephone No.
N/A
Contractor's License No.
Self —Insured
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111
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:
Receipt No.
Received by
Recorded by
$ No Fee
$ No Fee
Date
11
P. - 4540
. PERMIT VALIDATION
t
PERMIT NO. 4540
DATE APPROVED � I /?- �12S
EXPIRATION DATE
DATE ISSUED
By \� &�.
Administrative Authority
Telephone: (760) 777-7075
x"
With proper validation
. _ F..
this form,'donstitutes an
.-encroachment permit'
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
Subdivision Improvement Permit— Class III
DATE: November 14, 2005 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Miles Avenue (City of La Quinta)
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Walk; Procession - Church
DESCRIPTION OF CONSTRUCTION Walk on Miles Ave. in
honor of. our Lady of Guadalupe.
DIMENSION OF INSTALLATION OR REMOVAL Miles Ave. that
belongs to the City of La Quinta. '
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN December 12, 2005
Approximately 2:00 PM
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION December 12, 2005 Approx.
ESTIMATED CONSTRUCTION COST $ Non Profit I
(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:
ENTERED
4:00 PM
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 71
,rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as..wthe result of this work.
�`D l ? f<'(- 71 %
-7 ' /7
3esue Mora 324-14". .Cell 902-2096 Signature of Applicant or Ageiit'
Our Lady of Solitude Church 69365 McCallum Wny'325-3816 '
Name of Applicant (please print) Business Address Telephone No.
N/A
Name of Contractor and Job Foreman Business Address Telephone No.
N/A
Contractor's License No. City Business License No.
Self -Insured
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 schedule IN e
3 ii
4540
"'Inspection Fee $ No Pee PERMIT VALIDATION
Permit Fee PERMIT NO. 4540
Penalty I �`
Cash Deposit -Surety Bond DATE APPROVED
if required ` EXPIRATION DATE I
TOTAL: $ No Pee DATE ISSUED
Receipt No.
By
Received by Date Administrative Authority
Recorded by Telephone: (760) 777-7075
4
PUBLIC WORKS DEPARTMENT
APPLICATION FOR PERMIT
Date: / Z — 9. Z — D,
Location of Construction:
Purpose of Construction:
Description of Construction:-,/p,�.c
Dimension of Installation or Removal; PI-1
i rug zs..• f,.�:, -,r
Approximate Construction Start Date:
Approximate Construction Completion Date: ,� j — �Z®o Pal..
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
Contact Name: Phone Number: &o) Z/9:_I'1
Name of Applicant: 044E L.2v7-rloq-e—
Applicant Address: /A!/ ,ro ,�� �irz� �-1�5
Applicant Telephone Number: CyW ?,7� Rom .
Name of Contractor:
Contractor Address:
Contractor Telephone Number:
Conttractor State License Number: -
Contractor City Business License Number:
►_ A COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED -4
Applicant or Contractor General Liability Insurance Company:
Applicant or Contractor -General Liability Insurance Policy Number: _*1'F1
Office Use Only:
Inspection Fee:
Permit Fee:
As -Built
Deposit:
Dust Control
Deposit:,
Credit
Amount:
TOTAL FEE DUE:
Office Use Only:
Assigned Permit Number
Approval Date:
Expiration
Date:
Issue
Date:
Administrative Authority:
Datc:
Location of
11/09/05 10:08pm P. 002
A
of
PUBLIC WORKS DEPARTMENT
APPLICATION FOR PERMIT
L�
Purpose of C�nstruction:
Description 6f.Construct•on:�j/
Dimension of Installation or Removal: fl 4
1-4
Approximate Construction Start Date: /� /��- v
Approximate Construction Completion Date: ,
Estimated Construction Cost: $ �J ePro ; �-
Estimated C,tmshttction Cost shall include the removal of all obsttuctiOnl% materials, and debris, back filling. compaction and
placing Permanent resurfacing and or replacing improvements
Contact Name: 5// f f' I�UPh,onc Number:
Name of Applicant:
Applicant Address: 4 ,�avA-7
Applicant Telephone Number: /r� i
Namc of Contractor.:
Contractor Address:
Contractor Telcphone Number:
Cohtra.ctor ;state cnSe Ni,�,bci:
Contractor City Business .License Number:
► A COPY OF THE CURRENT INSt1.RANCE CERTIFICATE MUST BE PROVIDED -4
Applicant or Contractor General Liability Insurance Company:
Applicant or Contractor General Liability Insurance Policy Number:
Office use 021l
Ltspecuon Fcc:
Pormit Fee:
J F7 `
As-Etuilt
iNPOelt:
Dust Control
'
Deposit:
Crain
`
Amount:
TOTAL FEE DUF.:
I V O Fe e—
omce rlve gnty:
Assigned Permit Number. PPror t STO
Av4l Date: "� _ .
) xpiratioll
Date:
Issuc
Dato:
Administrative Anlhority:
t
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100 'd Wd80:0Z S0/60/ZZ
•TOPS
N PLEASE REMIT TO:
BA R R I CADL TOPS N BARRICADES
INC. m . 44-631 JACKSON ST., INDIO, CA 92201
Cont. Lic. # 787664
(800) 852-TOPS
CONT RAC T
BILL TO: COD-PEREGRINACION'GUADALUPE
SHIP TO.:START ALEJO & PALM CANYON
THRU CATHEDRAL CITY, RANCHO
MIRAGE, PALM DESERT TO
COACHELLA
MAIN OFFICE:
44-631 JACKSON ST.
INDIO, CALIFORNIA'92201
(760) 347-2111
FAX (760) 347-3680
BRANCH OFFICES:
EL CENTRO (760) 353-6628
VICTORVILLE (760) 949-5991
:.CONTRACT #: 35625
DATE PRINTED: 12/07/2005 11:39
REF: DESI
PO#: MARCH
CUSTOMER:
TEL: 219-.5178
TERMS: DUE IMMEDIATELY
PAGE : - ' 1 MEA
DATE DUE 12/13/2005
MONDAY DECEMBER,12, 2005 START.@ 6:00 AM
MOVING LANE CLOSURE; 4,800.'00 PLUS DAMAGE & OR LOSS
CUSTOMEA'WILL PROVIDE PERMITS FROM CITIES
CUSTOMER RESPONSIBLE FOR ANY DAMAGE & OR. LOSS
MINIMUM RENTAL $15.00
--------------- --------------- ------- ------------------------------------------------------------------------------------------------
----------- RATE PER.UNIT--------------
PRODUCT I DESCRIPTION DAILY WEEKLY. 4 WEEKS LANE CLO DBL LANK DATE/TINE OUT QTY MOUNT
-------------------------- -----------------------------
AT ARROW TRAILER # NON DEC 12/05 2
LCL LANE CLOSED W/BARR NON DEC 12/05 2
C28 28' TRAFFIC CONE NON DEC 12/05 Be
VRCA VINYL RD. CONST. AHD. W/STAND NON DEC 12/05 2
VRTLCA VINYL RT.LANE CLOSED AHEAD NON DEC 12/0.5 4
Rental agreement and conditions on the reverse side are
accepted by customer
#%-,
DEPOSIT: :@0
CUSTOMER SIGNATURE
DATE
DRIVER
DATE TIME
AMR STAND-BY FORM
fvamt Name
Wc& for God Ig jd4 0 Todays Date:
Location None
Our Lady of Solitude Church Date Sent to Ops:
Location Address
151 W. Alego Rd., Palm Springs, CA 92262
SponsodnD Organization
Our Lady of Solitude Church
Date of Even:
Dare Day Times) Totd hm On Scene Tine
Monday 12/ 12/2005 06W -18:00 12
Se1viC0 reglfested:
Demo Find -Aid Health Fair Other Medical Standby
Medical
Level of Service:
ALS BLS Speaker #of staff DMsjon
1
x . 2 P01m
'oR dedicoted events must be reviewed Business Deveiopment
Dedicated PAID X o unit/AMR stop► must remoh ordte of or tknes
Dedicated non -paid a urw/AMR stun must remain onstte at at times
Non-dedicaled o system unit moy cover event but remWn avaNabte
Event Contact Person Jews Mora Event Coorcrinator CAD Entry date:
Phone/Pager 760-902 2096 cell CAD Entry By. -
Other (ees. Fox pow) 760-324-1449 hm
Billing hdormatlon• : Has EveM been Bffled? (if so. attach copy of irwolce for bitting dept.)
Off Scene Time
Altn/Contact Jests Mora Event Coordinator Phone;: No
Address 151 W. Alego Rd Response Fee $305.00
City, zip Pdm Springs Mourty $99.95
Charge . if 12
y,.::,� :..:...:.:.... .
Upon a±iriyalr crew b neporF fo for diredioit`aiW posting csdgnmeril' Tots God $1 `:504' 40
Crew to complete standby ticket and drop off .to dispatch prior to clocking ovt
Crew must be released prior to leaving venue _
UNIT TO FOLLOW PROCESSION FROM START TO DESTINATION
Form C.ornpleted by: GGeorge Stone
To Vendor,
Thank you for considering our service(s). Please add/correct any information above, authorize with a
signature and fax to _ (951) 782-5610 Attn: George Stone
Print Name: Date:
NOTE— ALL REQUESTS MUST BE RECEIVED 9M PROCESSED AT LEAST 2 WEEKS PRIOR TO EVENT DATE
cc�Brt rKM Development, Operations. Scheduling, Communicof'om support Service
PERMIT NO.4540
Our Lady of Solitude Church / Walk / Along Miles Avenue
1. The applicant agrees to defend, indemnify, and hold harmless the City of La Quinta (the
"City"), its agents, officers and employees from any claim, action or proceeding to attack,
set aside, void, or annul the approval of this temporary use permit. The City shall have
sole discretion in selecting its defense counsel.
The City shall promptly notify the applicant of any claim, action or proceeding and shall
cooperate fully in the defense.
2. Prior to the issuance of an encroachment permit, the applicant shall notify the following
public agencies of the event route and estimated times and duration:
• Fire Marshal
• . Public Works Department (Encroachment Permit)
• Desert Sands Unified School District
• La Quinta Police Department and 911 Emergency Response Units
• SunLine Transit Agency
• Homeowner Association of Communities on the south side of Fred Waring Drive
The applicant is responsible for any requirements of the permits or clearances from those
jurisdictions. If the requirements include permit approval, applicant shall furnish proof of
said approvals prior to obtaining Public Works encroachment permit.
3. The applicant shall submit traffic control plans for any.lane closure along Miles Avenue and
its intersection if La Quinta Police Department staff does not accompany event participants
through these intersections.
4. The applicant shall provide for moving 'traffic control as proposed plus any additional
requirements of the Riverside Sheriff Department.
5. Streets shall be kept clean. They shall be completely cleaned at the end of each working
day and more frequently, if required.
6. 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.
Saturday .8:00 a.m. to 5:00 p.m.
May 1 st to September 30: Monday -Friday 6:00 a.m. to 7:00 p.m.
Saturday 8:00 a.m. to 5:00 p.m.
1"
r') .
7. Work within 500 feet of a 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 (951)
955-6894 if signal operation at the intersection is to be altered in any way.
8. 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 Permittee's.responsibility to appropriately detour and barricade
all construction sites.
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.
9. The permittee is .responsible for obtaining a valid separate permit from the California
Department of Transportation Department (CalTrans) if any of the work or traffic control
devices extend into the CalTrans right of way.
10. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced
to its original condition. Access and egress to all local properties shall be maintained at all
times.
11. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time.
12. 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.