9070 (2)See below for Finance Revenue Codes
4 v � ,
ENCROACHMENT PERMIT
OFT�� 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 IMPROVEMENTSand APPROVED SUBDIVISIONS.
Subdivision Improvement Permit - Class- III
Minor Improvement Permit - Class IV
DATE: 10/16/2009
LOCATION OF CONSTRUCTION: Sunline Transit Agency; Phase 3; 6 Locations; See Attached List for Locations of the Bus Shelters
PURPOSE OF CONSTRUCTION: Installation 6 New Bus'Shelters at Existing Bus Stops
.DESCRIPTION OF CONSTRUCTION: See Attached LNI Drawings
DIMENSION OF INSTALLATION OR REMOVAL: (2) 6'x 9' and (4) 6'x 13'
APPROXIMATE TIME WHEN WORK WILL BEGIN: 12/14/2009
TIME OF COMPLETION: 12/31/2009
ESTIMATED CONSTRUCTION COST: $54,676 (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 occuring 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 a1.dvance of the time when work will be started at (76,0).77,7-7.
7097. To submit an inspection request, leave a message on the Inspection Request .liotluie at (760) 777 7097 pnor to 1,:30 P M:: at'
least twenty-four (24) hours prior to the anticipated inspection.
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. ,
- ignature of Applicant or Agent
LNI Custom Manufacturing.- Carlos Mora 12536 Chadron Ave, Hawthorne, CA 90250 (310) 978-2000
Name of Applicant Business Address Telephone No
LNI Custom Manufacturing . 12536 Chadron Ave, Hawthorne; CA 90250
Name of Contractor and Job Foreman Business Address
773599
Contractor's License Number
(310) 978-2000
Telephone No.
105245
City Business License No
Peerless Insurance Company CBP8283414
Applicant's Insurance Company Policy Number
FEES Subdivision. Improvement Permit - Class I
Minor Improvement Permit - Class I
Finance Revenue Code.
Inspection Fee E_1
$0.00
Permit Fee E_1
$0.00
As -Built Deposit E-A
0.00
Cash Deposit -Surety Bond, EE=B
$0.00
if required
TOTAL
$0.00
Public Improvements: 3% of estimated construction costs
Private Improvements: 3% of estimated construction costs
PERMIT NUMBER: 9070
DATE ISSUED: L -
EXPIRATION TE: 2 Z4 7111
BY:
WORK INSPECTED BY'
PERMIT COMPLETION DATE*:
* If the work is covered by a Subdivision Improvement Aglieement, Subdivider
shall request final acceptance of Improvements from the City Council.