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5043��Finance Revenue Code E-1 `yOF [ ENCROACHMENT -PERMIT PUBLIC WORKS CONSTRUCTION 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 Minor Improvement Permit Class IV DATE:March 9, 2006 ' LOCATION OF CONSTRUCTION (Street address or Description): Soap Box Derby; Avenida Bermudas PURPOSE OF CONSTRUCTION: Street closure to hold 121 annual Don. Berry Memorial Greater Coachella Valley Soap Box Derby DESCRIPTION OF CONSTRUCTION: Close street and temporary construction of ramps used to run race DIMENSION OFINSTALLATION OR REMOVAL: APPROXIMATE TIME WHEN WORK WILL BEGIN:April 15, 2006 TIME OF COMPLETION:April 15, 2006 ESTIMATED CONSTRUCTION COST: $0 (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing permanent resurfacing and/or replacing improvements) COMMENTS: 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 at (760) 777- 7075. Comply with all applicable City Ordinances, the terms and conditions of the permit and all apg4cable rules and regulations of the City of La Quinta and to pay for any'additionail replacement necessary as the result of this wor ig ture of Applicant or Agent Lucia Moran P.O. Box 1305 (760) 805-1603 (760) 564-3761 Name of Applicant (please print) Business Address Telephone No. NA Name of Contractor and Job Foreman Business Address Telephone No. NA NA Contractor's License No. City Business License No. Philadelphia Indemnity Ins. Co. PHPK115806 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit - Class III Minor Improvement Permit - Class IV Inspection Fee Permit Fee As -Built Deposit Cash Deposit -Surety Bond, if required TOTAL $Non -Profit $0 S S $0 Public improvements: 3% of estimated construction costs . Private improvements: 3% of estimated construction costs See attached schedule PERMIT NO.5043 DATE PPROVED: CJ/S /O G EXPIR 10 ATE: 0 BY: _ Ur . \\ - Administrative Authority GENERAL CONDITIONS --PERMIT NO.5043 --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. The applicant, Lucia Moran, shall be available during the event by cellular phone at 805- 1603; r ger- 8�6 6135 or a message can be left a S6,4 — 3 `7(,i 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 & Nogales at all times during the event to allow residents living on Avenida Bermudas within the event aria, their guests, mail carriers, and companies delivering to them, access to the southbound one-way fire lane provided on the traffic control plans. 4. The applicant shall also assign volunteers to regularly monitor the intersections of. 1) Bermudas & Chihuahua, 2) Bermudas & Monterey, 3) Bermudas & Colima, and 4) Bermudas & Arroba. 5. The permittee is responsible for making sure that temporary no parking signs along the parking area affected by the special event is existing. The signs shall be placed along the area 48hrs prior to the start of closing the area, and removed immediately after the construction completion date. 6. The City of La Quinta reserves the right to revoke, suspend. or void this permit at any time. 7. 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. Page 1 of 1 T:\PWDEMEncroachment Permits\Numbers 5000\5043 Soap Box Derby Avenida Bermudas\SoapBoxDerby_condition.doc T-Vf 4 4auArw PUBLIC WORKS DEPARTMENT APPLICATION FOR PERMIT Date: g U�o Tract No:. Project Name: <'e)ED L ' q> Vicinity: j k c `E� AS P se of Construction (Ex: Rough Grading, Offsite Street etc.) S'Ie� 01_ a1¢.E, H o IQtK Description of Construction (Ex: See PIgn Set No. 01234) i&56 3-{-P- P -� Dimension of Installation or Removal: Approximate Construction Start Date: Approximate Construction Completion Date: — — Estimated Construction Cost: $ I� 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: U C-i0—MO P-1q A Phone Number: 8 O S - D3 Name of Applicant/O er: C.' . M'0 Applicant Address: - O . ('��>c ' b, Da4- l Applicant Telephone Number: (00)6_?0 ik' 5 _76�1 ( Name of Contractor: Contractor Address: Contractor Telephone Number: Contractor State License Number: Contractor City Business License Number: ► A COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED A )plicaq?r Contractor General Liability Insurance Company: Applicant or Contractor General Liability Insurance P licy Number: Office Use Only: Inspection Fee: . Permit Fee: NO Pq�_' 7z� As -Built Deposit: Dust Control Deposit: Credit TOTAL FEE DUE: Office Use Only: Assigned Permit Number. Jr0 4 3 Approval Date: Expiration Date: Issue Date: •�dministrative-Authority.-- GENERAL CONDITIONS --PERMIT NO.4400 --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 & 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. 4. The applicant. shall also assign volunteers to regularly monitor the intersections of: 1) Bermudas & Chihuahua, 2) Bermudas & Monterey, 3) Bermudas & Colima, and 4) Bermudas & Arroba. 5. The permittee is responsible for making sure that temporary no parking signs along the parking area affected by the special event are existing. The signs shall be placed along the area 48hrs prior to the start of closing the area, and removed immediately after the construction completion date. 6. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. 7. 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. S��e� l�eGr 'T,.�e S Page 1 of 1 TAPWDEPT\Encroachment Permits\Numbers 4000\4400 Soapbox Derby 2005\SoapBoxDerby_condition.doc EXHIBIT'A' . ,. cene tea, DON BERRY MEMORIAL GREATER COACHELLA VALLEY SOAP BOX DERBY Cane clihualiva W. q z W Ll LI.Ll I Calle Colima 9 Mon Berry Memorial reater Coachella Valley SoapBox Derby' The Honorable President A Program of the Boys & GhIs Club of Coachella Valley Gerald R. Ford Honorary Chairman Hand Delivered � _� `7 C)_�' �) March 28, 2006 City of La Quinta Mayor & City Council Members City Manager, Tom Genovese Planning Department t�Engineering Department J Public Works Department Re: Date Change For The 12t' Annual Don Berry Memorial Greater Coachella Valley Soap Box Derby Honorable Mayor, City Council Members, City Manager and all Departments: Phis"letter is formal notification that we are changing the 12t Annual'Don---,, nPri, Greater Coachella=Valley-SoapBox�Derby ftom April ,lth�to-7 752006. — ate of April 15t' will not conflict with your Household Hazardous Waste disposal at the City Yard and will better accommodate our needs for drivers and the Final Inspection/Impound/Registration location the night before the race. I appreciate everyone's cooperation with the date change. If you - have any questions, please contact me at one of the numbers below. Sincerely, *Icia'moran, Race Director (760) 564-3461 Home/Office or (760) 805-1603 Cell 42-600 Cook Street, Suite 120, Palm Desert, CA 92211 760.564.3761 Fax: 760.564.8350 E-mail: Luciam@dc.rr.com