CIP2017-0006VI
See below for Finance Revenue Codes
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CIP
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: 11/9/2017 -
LOCATION OF CONSTRUCTION(Street address or Description): POINT HAPPY STORM DRAIN & ROUDEL DR
PURPOSE OF CONSTRUCTION: POINT HAPPY STORM DRAIN OUTLET STRUCTURE AND ROUDEL DRAINAGE IMPROVEMENTS; DRAINAGE
IMPROVEMENTS TO OCCUR IN COACHELLA VALLEY STORM WATER CHANNEL
DESCRIPTION OF CONSTRUCTION: 2014-12 & 2015-06 POINT HAPPY & ROUDEL
DIMENSION OF INSTALLATION OR REMOVAL: LESS THAN 1 ACRE
APPROXIMATE TIME WHEN WORK WILL BEGIN: 11/13/2017 TIME OF COMPLETION: 12/19/2017
ESTIMATED CONSTRUCTION COST: - (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 2014-12 AND 2015-06 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) 777-1097. 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.
Signature of Applicant or Agent
VALLEY PIPELINE SERVICES INC 47-110 WASHINGTON ST STE 201 LA QUINTA, CA 92253 (760)564-9220
Name of Applicant (please print) Business Address. Telephone No.
VALLEY PIPELINE SERVICES INC 47-110 WASHINGTON ST STE 201 LA QUINTA, CA 92253 (760)564-9220
Name of Contractor and Job Foreman Business Address Telephone No.
988742
Contractor's License No.
FIRST MERCURY INSURANCE COMPANY
Applicant's Insurance Company
Finance Revenue Code
TOTAL $0.00
LIC-0112397
City Business License No.
CA-CGL-0000041529-01
Policy Number
PERMIT NO: C1P2017-0006
DATE ISSUED:
EXPIRATION DATE:
2RK INSPECTED BY:
IT COMPLETION DATES:
If the work is covered by a Subdivision Improvement Agreement,
Subdivider shall request final acceptance of improvements from the
City Council.
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CIP
PUBUC WORKS CONSTRUCTION
See below for Finance Revenue Codes
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.
111912017 -
ION OF CONSTRUCTION(Street address or Description): POINT HAPPY STORM DRAIN & ROUDEI.. PR - --
SE OF CONSTRUCTION: POINT'HAPPY STORM 0RAINOU1].ETSTR6CTURE'AND ROUDEL DRAINAGE IMPROVEMENTS DRAINAGE
DESCRIPTION OF CONSTRUCTION: 2014-12 & 2015-06 POINT HAPPY & ROUDEL
DIMENSION OF INSTALLATION OR REMOVAL: LESS THAN 1 ACRE
APPROXIMATE TIME WHEN WORK WILL BEGIN: 11/1312017 TIME OF COMPLETION 12119/2017 -
ESTIMATED CONSTRUCTION COST: - (including removal of all obstruction, materials, and debris, backfllling, compaction and placing
permanent resurfacing and/or replacing improvements)
COMMENTS: SEE PROJECT CONTRACT AND SPECIFICATIONS FOR CIP 2014-12 AND 2015-06 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.
Signature of Applicant or Agent
VALLEY PIPELINE SERVICES INC 47-110 WASHINGTON ST STE 201 LA QUINTA, CA 92253 - -' , (760)564-9220
Name of Applicant (please print) Business Address.
'
'Telephone No.
VALLEY PIPELINE SERVICES INC 47-110 WASHINGTON ST STE 201 LA QUINTA, CA 92253, - (760)564-9220
Name of Contractor and Job Foreman Business Address - - - - -- Telephone No.
'988742 ,• -_--- -. LIC-0112397 -
Contractor's License No. City Business License No. - -
FIRST MERCURY INSURANCE COMPANY CA-CGL-0000041529-01
Applicant's Insurance Compa ny •- Policy Number -
Finance Revenue Code
- TOTAL: $000
PERMIT NO: CiP2017-0006
DATE ISSUED:
EXPIRATION DATE:
BY21
WRK INSPECTED 8Y:
PERMIT COMPLETION DATE:
if the work is covered by a Subdivision Improvement Agreement,
Subdivider shall request final acceptance of improvements from the
City Council. - - -