503'NOTE:
With proper Validation,
this for' rnconstitutes an
-,CITY, OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
�PLIBLIC.'WORKS CONSTRUCTION, JENCROACHM ENT),
OF
For, the construction of public or, private curbs, *driveways, pavements, sidewalks, parking'Jlois, sewers; water mains
and'606r like public 'works improvements in connection With MINOR,IMPROVEMENTS and APPROVED SUBDIVISIONS
4�1 Subdiviiion Improvement Permit =Class III
OATE: ti
1:11119.0 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION dt' 24890'Boundary and' Jefferson Street Annroximatpiv
700 feet 'North of Avenue 52
(Street address or Description of Location)
Temporary.Entrance To,.
PURPOSE OF CONSTRUCI.ION ' ..Sketch (attach construction plans if appropriate)",,,
f,,-Ccinstructic ice,,,Trailor
DESCRIPTION OF CONSTRUCTION gntry Paving.. and, .1.(SEE 'ATTACHED PLANS)
Dece.leration.-Lane
3'..'(SEE ATTACHED GENERAL PROVISIONS.
AND.SPECIAt CONDITIONS)'
DIMENSION OF INSTALLATION -OR REMOVAL '13 f 6et
None.
'-SIZE OF EXCAVATION, IF NEEDED
TE -J/1Z/W
APPROXIMA -TIME WHEN,WORK WILL BEGIN
APPROXIMATE TIME'OF COMPLETION 8 nours
6_63.00.
ESTI MATED CONSTRUCTION COST, e
0'
backfilfing,'com.'
n ..cluding removal of all obstructior�, materials, and debris,
paction and placing permahent'res'urfacing;and/6r replacing improvements)
In considerati6n of the granting of this permit, the applicant hereby agrees to:
lndemnify,idefend and save the City, its auth6rized agents, officers, representatives and employees,- harmless from and 6gainst'any and all
% penalties, liabilities or 16ss resulting from claim'; or court action and arising ou't" of any accident, loss or damage to persons -or -property
happening or�occurriing as,a P*roximaie result of'any work undertaken und'er'the �er'it ranted pursuant- to this application:,
Notify the Admi nistrative Authority at,least twenty-four (24) hours in advance of the tim' 'e,when work will be started.
'I Comply
y with
I all La Quinta and to pay,.for any
applicable,City Ordinances, the terms and ,clonditions'of the permit and all. applicable rules and regulations of,the City of
"" additional replacement necessary as the res6li'of this work. 4".
Signature of Aj;plicAfor Agent
T) r i xy P -'.q;; ii ra .921 'Ah A Ri _nRwr
"T M Ppt-t-r.q- 0 -2. E; H i C.Th R111f f
Name of Ap t) 0. p!icahtl�lease print) Business Acldress..��, T61ephone N
-�J - 4"
Pin cl n R 9 Q Coiral ('_ons-Friir_t-_j.on ro. Box' 17 6,7'. i Q 2 2102 77c;
of,Contr'actor and Job Foreman Busineis Address Telephone N6.
449981 '7
6'r's 6_�ense No. -'City Business 41 Contra ct License No.'
Mr-1 Pnnan Can nPV11 170 i P1?;rA*1 5- i _.'r.T,pqnAr1r,,9,.
i_, 'Applicant's Insurance Company P61icy.Number
if
.FEES: -Subdivision' Improverne'rit'Permit,— Class III
t., 005i8l -09 oi-i
0
Public .improvements:13% of estimated construction costs r io, 'AL i
Private improvements: 3% of estimated construction costs
113
Minor: Improvement Permit — Class IV: See attached schedule'.
Inspection Fee PERMIT VALIDATION
Permit Fee 0
PERMIT TNO. '503
•Penalty
Cash Deposit -Surety , o . sit -surety Bond, .-PATE APPROVED1./ b
if required- ., 7
EXPIRATION DATE 7/31/90
TOTAL: 46.00.
R6ceiptNo. '
Received by Date
Recorded by"
-90'.
46.00
DATE ISSUED 1/11/90
By
Administrative Authority'
TE L,EPHON E: - (619) 564-2246
t
4,
T
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 improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class II I
13ATE: 1�12/g0 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 'tract Eoundary and aTeff� �_rson Street Annroximatnl v
700 kG:ot North of Avenue 52
(Street address or Description of Location)•
PURPOSE OF CONSTRUCTION �omporcxy l'Intrance To Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION entry ,�I ving and 1 ®(SrL ATTACKED PLANS)
ll cel- ratlon Lane
D . (S£E ATTACHED CENERAL PROVISIDD?S
DIMENSION OF INSTALLATION OR REMOVAL 7 ann cr•r,14;n"� fnet AND SPECIAL CONDITIONS)
SIZE OF EXCAVATION, IF NEEDED wone
APPROXIMATE TIME WHEN WORK WILL BEGIN
x / :! u
APPROXIMATE TIME OF COMPLETION C tiours
ESTIMATED CONSTRUCTION COST $ bb.� . U1J
(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. A.
Signature of Applicant or Agent
J.V1. Pr_tern Co 12526 Hiah Zluff Drive Sim Dinah Ca 92136 l�r/�F1 AR1—n9rin
Name of Applicant (please print) Business Address Telephone No.
Coval Construction Co., Bo . 1767.1ndio Ca. ,922n2 777-non
Name of Contractor and Job Foreman Business Address Telephone No.
449983. 688
Contractor's License No. City Business License No.
Boma lndenmity.March alclon.n.an. San Bernzdino.Ca., CCLR90ArIAF)
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:
Receipt No.
�46. 0�
$ 4Z.00
Received by Date
PERMIT NO.
PERMIT VALIDATION
503
DATE APPROVED 1-111 /qO
EXPIRATION DATE
DATEISSUED
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
The following General and Special. Provisions are attached to and made a part.of Permit No.
GENERAL PROVISIONS
The following shall always apply:
ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within City of La Quints right of way.
ONLY. Whenever construction extends within private property, it shall be the responsibility of the permittee (or his contractors) to
secure permission from abutting property owners. Such authorization must be secured by the permittee prior to starting work.
TRACKLAYINGCONSTRUCTIONEQUIPMENT: 'Cleated tracklay'ing construction equipment shall not be permitted t8 operate on any'
paved surface unless fittedwith smooth -faced street pads. All mechanical outriggers shall be fitted with rubber street shoes toprotect
the paving during excavations. Rubber -tired equipment only shall be used in backfill operations in paved areas. If the existing
pavement is scarred, spalled, or broken during the term of this contract, or if the pavement is marred, City of La Quinta shall request
that these portions of road be 'resurfaced over their entire width. Resurfacing shall consist of one coat of two inches (2") of A.C:
surfacing plus appropriate seal coat as specified above.
PROTECTION OF TRAFFIC: All excavations and work areas shall be properly lighted and barricaded as deemed necessary by the City .
Engineer or La Qui nta City Public Works Inspectors. Suitable.detours a nd detour signs sha 11 be placed and maintained for the duration
` of the project. The City shall be notified.24 Hrs. in advance of any traffic detours or delineations.
CARE OF DRAINAGE STRUCTURES' Any drainage'structure including corrugated metal pipe, concrete pipe, steel culvert and
concrete structures encountered during excavation which necessitate removal shall be replaced in kind. In the event -it becomes
necessary to remove or cut existing drainage structures; City of La Quinta shall be notified prior to commencement of this work.
Drainage structures and open drains shall be kept free of debris at all times for proper drainage:
RIGHT OF WAY CLEANUP: Any surplus material resulting from excavation and backfill operations shall be removed from the right of,
way. All paved surfaces shall be broomed clean of earth and other objectionable materials immediately after backfill and compaction.
Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shall be removed
prior to paving. Water tanker shall be used, as required, to sprinkle the job site to keep down dust conditions and shall be used
immediately after backfill.
DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing water on City of La Quinta roads'- it shall be
the responsibility of the permittee (contractor) to control this water'and to provide off-street barricades when necessary.'
CLOSING STREETS: No street shall be closed. A minimum of one lane of traffic shall be maintained at all times to provide limited
access for the adjoining property owners and emergency vehicles. In the event it isfelt bythe permitteethat he must close a streetfor
any length of time, permittee shall contact this office to obtain the necessary permission.
SPECIAL PROVISIONS
The follwing shall apply ONLY when indicated:
R1 NOTIFICATION: Permittee shall notify the City at 564-2246 at least 48 hours in advance of starting construction.
R2 CASH DEPOSITS OR BONDS: A cash bond or an approved surety bond in an amount of not less than $
shall be furnished in the name of City of La Quinta to cover all work involved in the restoration of the various La Quinta
roads and survey monuments. This bond shall be continuous until cancelled by the City Engineer. This bond must be
posted prior to commencement of any work on this project .
R3 UTILITY CLEARANCE: (Substructures) Priorto making any excavationwithinthe City of La Quinta right of way authorized
by permit, the permittee shall contact all concerned utility companies relative to the location of existing substructures.
Damage to existing substructures resulting from operations conducted under this permit shall be the sole responsibility
of the permittee.
R4 UTILITY CLEARANCE: (Surface structures) No work shall be done under this permit until all utilities are clear, of the
proposed work site. The permittee shall notify all concerned utility companies of the proposed work.
R5 AVEMENT WIDENING: Area'between the proposed concrete gutter -line and the existing road pavement shall be
surfaced with inches of A.C. paving placed on inches of class aggregate subbase course
having an "R"value of not less than and in conformance with�ty of La Quinta d•lynprovement Standards
and Specifications, Ordinance #461. .See SP!e'c i a t, rzbvi � '4
R6 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of
1/4 inch to one foot (1').
R7 GRADES & STAKES: City of La Quinta shall establish grades and stakes for the proposed concrete curb and gutter
construction.
R8 GRADE CHECKING: City of La Quinta shall check grades upon receiptof plan and pFofile and/or grades asestablished by
a licensed engineer.
R9 CURB REMOVALFOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( feet)shall be
removed. Curb and/or curb and gutter shall be saw cut prior to removal. Depressed curb, matching concrete gutter and
concrete driveway approach shall be constructed in conformance with City of La Quinta Standard #207.
810 DRIVEWAYS, A.C.: Driveways shall be constructed as not to alter existing drainage pattern. Surfacing between the
property line and the existing road paving shall be 2-1 /2 inches of A.C. paving placed on ( ") of class
aggregate base. Driveway construction shall conform to attached drawing.
R 11 CULVERTS: A inch diameter( ) culvert shall be installed with the invert approximately 1-1 /2
inches below and in line with the existing flow line. Culvert installation shall conform to the attached drawing.'
R12 SIGHT CLEARANCE: Sight clearance of 600 feet in either direction shall be assured and maintained.
R13 SOIL STERILIZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall comply with the
manufacturer's specifications. • ''
R14 COORDINATE WORK: The proposed work shall be subordinated to any operation which the State of California or
City of La Quinta may conduct in this area during the period of this permit. Work shall be coordinated with the State or
Citv of La Quinta forces to preclude delay or interference with State or City of La Quinta projects.
R15 SURVEY MONUMENTS: Prior to excavation'or beginning of construction, all survey monuments which exist on the
centerline of all streets or property lines when involved shall be completely tied out so they may be readily and correctly
be replaced by a licensed civil engineer or surveyor at the expense of the permittee. A complete set of notes showing the
ties to these monuments shall be furnished to the City Engineer prior to the removal of any monuments. Thisoffice shall
be notified upon completion of replacement of all survey monuments for proper project clearance.
RD-31
k
R16 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments shall be tied out by City
of'La Quinta and suitable payment or guarantee of payment shall be made as reimbursement for all work involved.
R17 PAVEMENT CUTTING: Pavement will be mechanically cut to a straight edge prior to excavation. Method of pavement
cutting shall be approved through the office of the City Engineer. (Under no circumstances shall excavating equipment
be used to excavate prior to cutting of pavement). Excavation material shall be placed in such a position as to best
facilitate the,general flow of traffic. Prior to final paving operations, any damage to pavement straight edge shall be
corrected. '
R18 PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations, any damage to,
pavement straight edge,shall be.corrected.
R19'LIMIT OF EXCAVATIONS: Excavations shall be limited to 1,000 lineal,feetof opentrench before backfill operations must
begin. All excavations shall be properly barricaded with lights overnight, on weekends and holidays for the protection of
the traveling public: The Public Works inspector shall determine the suitability of excavation barricading in each case. No
excavation shall remain open for a period exceeding five (5) days. No excavationshall be made unless the construction
material is actually on the work site. {"
R20 BACKFILLMATE RIAL:BackfiIIshaIIbefreeofbrush, roots orother organicsubstarice detrimen taIto its use for purposes
of producing an adequately consolidated backfill. Any material which the City of La Quinta deems unsuitable (spongy or
saturated material) which is encountered during excavation shall not be used for backfill, but shall be supplemented or
replaced by an.approved sand or gravel.
R21 BACKFILL SAND: Backfill shall be approved transit -mix sand or equivalent and shall be placed in lifts of notgreaterthan
three feet (3') and vibrated using vibrotamper or equivalent equipment. Alternate methods maybe substituted, but in any
case a relative compaction of 95 percent shall be attained within the structural section of the roadway.
R n22R22 BACKFILL PLACEMENT: Backf ill shall be applied in layers of not more than 50 percent of the total depth of the trench
before flooding or a maximum of five-foot (5') lifts where trenches are of excessive depths. Care is to be exercised that the
b backfill material is not subjected to extreme swell by flooding operations.'Backfi11 material shall be placed so that the
resulting compaction shall be not less than 90 percent or equivalent to the surrounding ground, whichever is the greater
compaction. Where ponding or flooding is used for a maximum settlement, adequate dikes will be constructed to retain',
the water. Where jetting is used, the jets shall be of sufficient length to reach the bottom of each layer and the water
F supply shall be continuous. "
R23 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made at intervals of not more than 1,000
-feet and a minimum of one (1) test on each road. One (1) copy of eachtest shall be forwarded to the City Engineer for
approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Section 6.3.01 of the
Standard Specifications, Division of'Highways; State of California, dated January 1973..
R24 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line.
One (1) copy of each test shall be forwardedtothe City Engineer for approval and filed prior to making permanent repairs.
Compaction tests shall be made as outlined in Section 6.3.01 of the Standard Specifications, Division of Highways, State
of California, dated January 1973.
R25 • TEMPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporaryi patch
°consisting of 2 inches of SC-800 shall be placed on a prepared subgrade. The SC-800 temporary paving shall be placed
after a maximum of 3,000lineal feet of trench has been excavated and backfill operations completed, but in no case shall
the placement of the temporary pavement exceed a five (5) day limit.
R26 PERMANENT PAVEMENT REPAIR: After backfill and compaction operations have been completed, a temporary patch
consisting of two inches (2") of SC-800 shall be placed immediately. A permanent patch_ of inches A.C.
" surfacing placed on a inch class - base shall be placed no laterthan days after completion of
temporary road repair.
R27 PAVEMENT REPAIR: F.A.S.: Upon completion of backfill and compaction, a temporary patch consisting of two inches (2")
of cold mix paving (SC-800) shall be placed immediately. A permanent patch of three inches (3") of A.C. surfacing shall
be placed on six inches (6") concrete base as directed, but not later than fifteen (15) days after completion of temporary
paving. Concrete base shalt be of five -sack mix and shall conform to the City of La Quinta Road improvement Standards
and Specifications, Ordinance #461.
R28 FOG SEAL: A fog,seal coat consisting of an application of asphaltic emulsion shall be applied over all patch areas as
determined.by the City Engineer.
R29 SEAL ARMOR COAT: A seal coat consisting of an application binder and screenings shall be applied on all patch areas
where such seal coats existed prior to issuance of this permit.'Seal orarmor coats shall be applied as specified in Section
37, Standard Specifications, State of California, Division of Highways, dated January 1973. Work of pavement repairto
be accomplished by a licensed contractor engaged in the business of pavement repair.
R30 STREET RESTRIPING: Where street striping is.still visible on streets to be excavated, such striping shall be replaced upon
completion of permanent repairs.
831 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quinta road right of way shall be accomplished
} by a licensed, bonded and insured tree service, and handled safely without interference or hazard to the traveling public.
It shall be the responsibility of the permittee to maintain the tree in a vigorous growing condition at its new location
Trees to be removed shall be removed in sectionswhich can be handled safely without interference or hazard to highway
traffic. The entire width of the tree stump shall be removed and disposed of so that no debris remains in view of the
highway. The stump hole shall be backfilled and thoroughly compacted as specified in the following paragraph. Where it
becomes necessary to restrict traffic, the work shall be restricted to a maximum of 500 feet at any one time. Adequate
signs, flagmen`and/or barricades shall be provided to protect the traveling public at all times.
•
Large holes resulting from tree removal shall be backfilled and compacted to not less than 90 percent or equivalent to the
surrounding ground, whichever is the greater compaction as determined by the impact or field method. Compaction
tests shall comply with Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated
January 1973.
R32 TREE'TRIMMING: -
a. Only the necessary trimming shall be accomplished to provide clearanceof the facility for one calendar year.
All. broken or weak sections within the trimming shall be removed.
b. Where it becomes necessary to restrict traffic, the work shall be restricted to a maximum of 500 feet at anyone time.
Adequate signs, flagmen, and/or barricades shall be provided to protect the traveling public at alltimes.
c. If tree trunks are partially outside of the City of La Quinta road right of way, permittee shall make his own
arrangements with adjoining property owners for consent to the trimming in addition to the authorization provided
by this permit.
d. All tree trimming on EVERGREEN TREES, PALM TREES; and other ORNAMENTAL TREES shall be accomplished to
the satisfaction of the City Public Works Inspector.
e. ;ouiting property owners snau oe contacteo, in an instances, prior to trimming or topping trees.
f. Pruning shall; in.all.instances, be at the shoulder of the crotch to insure even, fast healing in all cuts of two inches
(2") and above in size. Sealant shall be applied to all cut sections as directed by the City Public Works Inspector.
f
C.>
/y •S' • • -
7.
Tit' cvl�
`yOF.Tf� 78-105 'CALLE ESTADO. — 'LA QUINTA, .CALIFORNIA ,92253 �- (619),.564-2246 r'
' - FAX (619);'564-5617
ADDITION COND • ITIONS
.,,-ENCROACHMENT. PERMIT,' NO.. 503
• R3 3 Contractor- shall7 comply,,with., the 'local noise ordinance ••�'
with regard to'construction'operationsland.maintenance of
K equipment -within one mile.!tof human occupancy shall be `
•performed only'during«the,: time periods as '-•follows
October 1'to`April,30 .M6'nday-Friday-7:00a.m.=5:30p.m:•-
' '" '•r Saturday ' 8.0'0a9m.-5 00p.m.
,. • . � M-onde .- FridaMaY' l to.'Se tember 30's Y 6:00 a.:m.-7:00 .-
m .a ;.-
,
Sato -
rda• . y., 8.0Oa:m. 5:0Op.- M.
Work shall* be prohibited an on ,Sunday. and 'Federal '
holidays . r ,
R34 The Permittee•shall pr.ovide'and`maintain-traffic control,
in accordance.the„-Caltrans •Traffic;.Manual. Field
' adjustments •. in detouring shall be', accomplished ; a_ s directed
r in order=,to.�adjust to actual •.field 'conditions. , It shall
i'# ,be `the Permittee!s` responsibility,' to adequatelye'barricade.
and detour.the'.`construction:=site:},` '
I:r R35 Permittee' shall 'be'.VresPon'sfor° d ustcontrolible .. '
,
F Construction water:source 'shall be`subject'to the approval
:of C. V : W . D.: and.: they ;City Engineer t
..
' R36 Permittee ,shall assume responsibility for repair- of 4
existing-pavement".that may<bieakdown°at the access point
` ..to_ Jefferson Street, as well' -as : any:dame a ,�to of her Ci g ty
streets 'that - may• be.: caused by the. Permittee'. Y
R37 Perinittee shall furnish, install'; .and" maintain -a stop
sign,. painted' •stop' bar .and' message. on the' access road to'
!' r stop •,traffic °prior,to', entering Jefferson Street.
R38 Permittee shall paint --an 8=inch wide:.,delineator ;strip
`between the;:'thrugh-traffic, lanes and. the decele
orator lane ,4'
as directed by.'the C-ity,•Engineer.
R39 Grade control ^for ;the .construction "shall be `.set-` by- a i
,.. .registere`d-' civil engineer employed-by",;the Permittee and
shall be cerified by the same. engineer following., r .
r .. construction,. �.,
NOTE:
With proper validation
this form constitutes 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 SUBDIVISI
Subdivision Improvement Permit -.Class III
DATE: January 11 .1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Tract 24890 toundry and Jefferson Street,
„Ap .rp; 7 0 0 f et,,#6rtk,.i of avenue 52
�4QRtely i e
(Streel k15'eess'or Loescription of Location)
Tempory Entrance to Cons Tfaijor
PURPOSE OF CONSTRUCTION tSielcMiaRanch cobfUr4teton pans irappropriate)
DESCRIPTION OF CONSTRUCTION Entry Paving andDecueration -Lane
DIMENSION OF INSTALLATION OR REMOVAL .3 300 Squa-in Feet
SIZE OF. EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 1 9 1990
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ 00
(Including removal"of all obstruction, materials, and debris, backf illing, com-
paction.and placing permanent, resurfacing and/or replacing improvements) ya
In' consideration of the grantiAg 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 T!''
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 leasi 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 Quints and to pay for any additional replacement necessary as the result of this work. n. 41
Brian L. Devlin Project Supt''
Signature of Applicant or Agent
''J. M. Peters'.Co. .,12526'High Bluff Drive', San Diecio Ca. 92130 481. 08.0.
Name of Applicant (please print) Business Address Telephone No.
Coval'.Construction Co. ,..Box, 17671- Indio'Ca. 92202 775-8200
Name of Contractor and Job Foreman
449981
Contractor's License No.
.-Home Indemity, March McLennan
'Applicant's Insurance Company
Business Address
Telephone No.
City Business License No.
San Bernadino ea 1GLR9086165
FEES: Subdivision improvement Permit—. ClassIII
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 Date
Recorded by
Policy Number
'5D3
PERMIT VALIDATION
PERMIT NO.,
DATE APPROVED
EXPIRATION DATE
DATE.ISSUED
By
Adr6inistrative authority
TELEPHONE: (619) 564-2246
I
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