PG2016-0005,
See below for Finance Revenue Codes
ENCROACHMENT PERMIT
jfl%V. S
PUBLIC WORKS CONSTRUCTION
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and otherS like public
works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS.
DATE: 3/15/2016
LOCATION OF CONSTRUCTION (Street address or Description): CALLE TAMPICO
PURPOSE OF CONSTRUCTION: TURF REMOVAL AND NEW LANDSCAPE INSTALLATION.
DESCRIPTION OF CONSTRUCTION: CIP 2015-05 & 2015-14; TURF REMOVAL/NEW LANDSCAPE
DIMENSION OF INSTALLATION OR REMOVAL: N/A
APPROXIMATE TIME WHEN WORK WILL BEGIN: 3/21/2016 TIME OF COMPLETION: 5/20/2016
ESTIMATED CONSTRUCTION COST: S321.300.00 (Including removal of all obstruction, materials, and debris, backfilling, compaction
and placing permanent resurfacing and/or replacing improvements) S
COMMENTS: SEE PROJECT CONTRACT AND SPECIFICATIONS FOR CIP 2015-13 FOR PERMIT CONDITIONS. CIVIC CENTER CAMPUS & FIRE STATION #70
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
( urs 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.
of Applicant or Agent
KEVIN ROCKER - CONSERVE
LANDCARE 72265 MANUFACTURING ROAD THOUSAND PALMS, CA 92276
Name of Applicant (please print) Business Address
CONSERVE LANDCARE 72265 MANUFACTURING RD THOUSAND PALMS, CA 92276
Name of Contractor and Job Foreman Business Address
(760)250-7639
Telephone No.
Telephone No.
AEC398
Contractor's License No.
WESCO INSURANCE COMPANY
Applicant's Insurance Company
Finance Revenue Code
TOTAL: $0.00
LIC-0108534
City Business License No.
WPP1242999 00
Policy Number
PERMIT NO: PG2016-0005
DATE ISSUED: I IS I i.
EXPIRATION DATE: JJL /17
By WIRK 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.
5.
PUBLIC WORKS DEPARTMENT
APPUCATION FOR PERMIT
Date: March 10th, 2016
Tract No: _______ __ Project Nme:
Vicinity: c1vi - 1fl 1
Purpose olConstruction (i.e.: Rough Grading. Offsite Street, etc.)______
Turf removal and new landscape installation
Description of Construction (i.e.: See Plan Set No. 01234)
Turf removal and new landscape installation
Dimension of Installation or Removal: Civic Center Campus and Fire Station #70
Approximate Construction Start Date: 3/21/2016
Approximate Construction Completion Date: 5/20/2016
Estimated Construction Cost: S 321,300.00
Estimated Construction Cost shalt irclude the remo a! ut all obstructions. materials, and debris, back-hll inc. compaction and
p1 aeins permanent resuriac inc and or rep! ae Inc imploN enents
Contact Name: Kevin Rocker Phone Number: 760-250-7639
Name of Applicant/Owner: Conserve LandCare
Applicant Address: 72265 Manufacturing Rd. Thousand Palms, CA 92276
Applicant Telephone Number: 760-343-1433
Applicant E-niai I Address. krocker@conservelandcare.com
Name of Contractor: Conserve LandCare
Contractor Address: 72265 Manufacturing Rd. Thousand Palms, CA 92276
Contractor Telephone Number: 760-343-1433
Contractor State License Number: 958748
Contractor City Business License Number:
Contractor E-mail Address: krocker@conservelandcare.com
COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED I
Applicant or Contractor General I .iability Insurance Company:
Wesco Insurance Company
Applicant or Contractor General Liability In
WPP124299900
Office Use Onl y:
Inspection Fee
Permit Fee
As-Built
Deposit
Dust Control
Deposit
Credit
Amount.
Policy Number:
Office Use Only: I
Assigned Permit Number
Approsal Date
- I
E'piration
Date.
Iss lie
Date
Administrative Authorit\
TOTAl. FEE DIE
I 1rn1II hO5"VIItQ - plication fo