DRVA2019-0012ta 0ab (r
See below for Finance Revenue Codes
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DRIVEWAY APPROACH
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 CONSTRUTlON(Street address or Description): 53450 AVENIDA CARRANZA
PURPOSE OF CONSTRUCTION:
DESCRIPTION OF CONSTRUCTION: APPROACH PERMIT
DIMENSION OF INSTALLATION OR REMOVAL:
MATE 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 authoried 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 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
JZ CONCRETE. 42760 MADIO STREET INDlO, CA 92201 . (760)775-1234
Name of Applicant (please print) Business Address Telephone No.
CORONEL ENT 42760 Madio St Indio, CA 92201 (760)775-1234
Name of Contractor and Job Foreman Business Address Telephone No.
727199
Contractor's License No.
ASSOCIATED INDUSTRIES
Applicant's Insurance Company
Finance Revenue Code
Credit Card Fee $2.97
PERMIT INSPECTION
DRIVEWAY RESIDENTIAL $160.00
TECHNOLOGY ENHANCEMENT FEE $5.00
TOTAL: $0.00
City Business License No.
AES-1022833
Policy Number
PERMIT NO: DRVA2019-0012
DATE ISSUED: 6/4/2019
EXPIRATION DATE: 12/29/2019
BY: EDWARDHERNANDEZ
WORK INSPECTED BY*:
PERMIT COMPLETION DATES:
51f the work is covered by a Subdivision Improvement Agreement,
Subdivider shall request final acceptance of improvemen ts from the
City Council. -