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CIP2019-0005ta Qa iA ra See below for Finance Revenue Codes - GEM ofth,DESERT - 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: 9/10/2020 LOCATION OF CONSTRUCTION(Street address or Description): AVE 52 CETRINO TO JEFFERSON PURPOSE OF CONSTRUCTION: AVENUE 52 PAVEMENT REHAB FROM CETRINO TO JEFFERSON AND MISC STRIPING THROUGHOUT THE CITY DESCRIPTION OF CONSTRUCTION: 2018-07 PMP AVE 52 PAVEMENT REHAB AND MISC STRIPING FY 18/19 DIMENSION OF INSTALLATION OR REMOVAL: APPROXIMATE TIME WHEN WORK WILL BEGIN:5/28/2019 TIME OF COMPLETION: 7/29/2019 ESTIMATED CONSTRUCTION COST: (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 4) 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 4) 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. Signature of Applicant or Agent SUPERIOR PAVING CO INC./UNITED PAVING 1880 N. DELILAH ST. CORONA, CA 92879 Name of Applicant (please print) Business Address UNITED PAVING COMPANY 1880 N. DELILAH ST. CORONA, CA 92879 Name of Contractor and Job Foreman Business Address (714)949-3960 Telephone No. (714)949-3960 Telephone No. Contractors License No. City Business License No. Applicant's Insurance Company Finance Revenue Code • TOTAL: $0.00 Policy Number PERMIT NO: C1P2019-0005 DATE ISSUED: 5/21/2019 EXPIRATION DATE: 11/17/2019 BY: CARLEY ESCARREGA 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.