CIP2017-0002'S
See below for Finance Revenue Codes
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.
DATE: 2/9/2017
LOCATION OF CONSTRUcTlON(Street address or Description): SILVERROCK
PURPOSE OF CONSTRUCTION: INSTALL TEMPORARY FENCE FOR BIGHORN SHEEP
DESCRIPTION OF CONSTRUCTION: CIP 2016-07 SILVERROCK RESORT BIGHORN SHEEP TEMPORARY-FENCE
DIMENSION OF INSTALLATION OR REMOVAL: 6.300 LF OF 8FT HIGH CHAIN LINK FENCE
APPROXIMATE TIME WHEN WORK WILL BEGIN: 3/1/2017 TIME OF COMPLETION: 3/30/2017
ESTIMATED CONSTRUCTION COST: $496.206.00 (Including removal of all obstruction, materials, and debris, backfilling; compaction
and placing permanent resurfacing and/or replacing improvements)
COMMENTS: SEE PROJECT CONTRACT AND SPECIFICATIONS FOR CIP 2016-07 FOR. PERMIT CONDITIONS
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) 777-7097. To
submit an inspection request, leave a message on the Inspection Request Hotline at (760) 777-7097 prior 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 and
to pay for any additional replacement necessary as the result of this work.
fflear ugnature plucant or Agent
AMERICAN FENCE COMPANY INC-
JASON PRICE
Name.of Applicant (please print)
AMERICAN FENCE COMPANY INC
Name of Contractor and Job Foreman
682667
Contractor's License No.
LIBERTY INSURANCE CORPORATION
Applicant's Insurance Company
1075 GRAND AVE SAN MARCOS, CA 92078 • (760)744-4124
Business Address • Telephone No.
P 0 BOX 19040 PHOENIX, AZ 85005 • • (602)352-7613
Business Address Telephone No.
3663
City Business License No.
TB7-Z61-064580-026 S
Policy Number
Finance Revenue Code
TOTAL: $0.00
PERMIT NO: CIP2017-0002
DATE ISSUED:
EXPIRA DATE: S
WORK INSPECTED BY*:
PERMIT COMPLETION DATE:
*If the work is covered by a Subdivision Improvement Agreement,
Subdivider shall request final acceptance of improvements from the
City Council.
Tract No:
Vicinity:
Purpose of Construction (i.e.: Rough Grading, .Offsite Street,
1 0
Description of Construction (i.e.: See Plan Set No. 01234) PRMA
.'v S"r 3 Dimension of Installation or Removal [63OQnearfeet of 8' hlghchaln(Ilnk fence '(
;4.
Approximate Construction Start Date: I
Approximate Construction Completion Date IMarcf ]
Estimated Construction Cost $4962O6 OO(
Estimated Construction Cost shall include the removal of all obstructions, materials, and debris, back-fl IIing compaction and
placing permahent resurfacing and or replacing improvements S
Con tactNamë: F .
Name of Applicant/Owner rAnen FenciCo,ipny lric
Applicant Address 754rand Av'è San Mrcós CA92O78
Applicant Telephone Number [70C-744`4.1*,4 -
Applicant
Name of Contractor: fAme fl!
Contractor Address 11075 Grand AveSan MarcdX 92b78z
.- -_- -
Contractor Telephone Number [760-744-4 124'
Contractor State License Number:F62667: ..'. •:.:.: :1
Contractor City Business License Number: ELIC-0003663: ,
Contractor E-mail Address: rinfèncê.cdm.
A COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED 4
Applicant or Contractor General Liability Insurance Company:
qfty On Cor t,hl drb
Applicant or Contractor General. Liability Insurance Policy Number:
-S
Office Use Only:• S : Office Use Only: S
Inspection Fee: .
.
Assigned Permit Number('(f 0 002..
Permit Fee: • S Approval Date: .
As-Built . Expiration
Deposit: . S . Date:
Dust Control . S Issue S
Deposit: . . Date: .
Credit
Amount: S Administrative Authority:
.
TOTAL FEE DUE: .
.
S •
Urive/UflecKlists - i-orms AlICtIOflS Application for.ermit postea -z-u •
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