ENC2018-0023Misc
See below for Finance Revenue Codes
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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: 9/10/2020
LOCATION OF CONSTRUCTION(Street address or Description): ADAMS ST 300FF N OF MILES AVE
PURPOSE OF CONSTRUCTION: INSTALL WATER SERVICE LINE
DESCRIPTION OF CONSTRUCTION: CVWD INSTALL WATER SERVICE LINE WF726005-001
DIMENSION OF INSTALLATION OR REMOVAL:6' X8' EXCAVATION
MATE TIME WHEN WORK WILL BEGIN: 5/1/2018 TIME OF COMPLETION: 8/1/2018
ESTIMATED CONSTRUCTION COST: (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing
permanent resurfacing and/or replacing improvements)
COMMENTS: CITY OF LA QUINTA WILL INVOICE THE PERMI1TEE FOR TIME AND MATERIAL EXPENSE TO BE DETERMINED
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 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
CVWD -JOSEPH BLOCH 75525 HOVLEY LANE EAST PALM DESERT, CA 92211 (760)832-2264
Name of Applicant (please print) Business Address Telephone No.
CVWD 75525 HOVLEY LANE EAST PALM DESERT, CA 92211 (760)832-2264
Name of Contractor and Job Foreman Business Address Telephone No.
AEC266
Contractor's License No.
SELF INSURED
Applicant's Insurance Company
Finance Revenue Code
TOTAL: $0.00
City Business License No.
SELF INSURED
Policy Number
PERMIT NO: ENC2018-0023
DATE ISSUED: 5/17/2018
EXPIRATION DATE:5/17/2019
BY: ARMANDOMAGALLON
WORK INSPECTED BY*:
PERMIT COMPLETION DATE*:
1f the work is covered by a Subdivision Improvement Agreement,
Subdivider shall request final acceptance of improvements from the
City Council.