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DRVA2018-0020ta Qa ig & - GEMofthDESERT - DRIVEWAY APPROACH - PUBLIC 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. DATE: 9/10/2020 LOCATION OF CONSTRUCTION(Street address or Description): 53920 AVENIDA MARTINEZ PURPOSE OF-CONSTRUCTION: DESCRIPTION OF CONSTRUCTION: DRIVEWAY APPROACH DIMENSION OF INSTALLATION OR REMOVAL: APPROXIMATE TIME WHEN WORK WILL BEGIN: TIME OF COMPLETION: ESTIMATED CONSTRUCTION COST:S200.00 (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 prsuant 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 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 CORONEL ENTERPRISES INC 42760 MADIO STREET INDIO, CA 92201 Name of Applicant (please print) Business Address J - Z CONCRETE CONSTRUCTION INC 42760 MADIO STREET INDlO, CA 92201 Name of Contractor and Job Foreman Business Address 813261 (760)775-1234 Telephone No. (760)775-5550 Telephone No. Contractors License No. City Business License No. Applicant's Insurance Company Finance Revenue Code Credit Card Fee $2.90 PERMIT INSPECTION DRIVEWAY RESIDENTIAL $156.00 TECHNOLOGY ENHANCEMENT FEE $5.00 TOTAL: $0.00 Policy Number PERMIT NO: DRVA2018-0020 DATE ISSUED: 8/24/2018 EXPIRATION DATE: BY: WORK INSPECTED BY*: PERMIT COMPLETION DATE*: 12/12/2018 1f the work is covered by a Subdivision Improvement Agreement, Subdivider shall request final acceptance of improvements from the City Council.