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NOTE:
'With proper validation
this form constitutes an
encroachment permit
il
CITY OF ' LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP OVERSIZE LOAD PERMIT
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
Subdivision Improvement Permit — Class I'll
DATE: November 8, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move eauir ment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION T)ju Ca.} a^:z^Y
,"bESCRIPTION OF CONSTRUCTION 1 4 tire,. (1 6 oa i 1 u
lona, aross weiaht 185.000
DIMENSION OF INSTALLATION OR REMOVAL
Sketch (attach construction plans if appropriate)
HAUL ROUTE: MILES AND DUNE PALMS
TO WASHINGTON STREET, SOUTH TO
Hwy 111
Haul date: 11/8/90
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK -WILL BEGIN
2 Pilot ate}%2reST@4-c I —Og -90 14
APPROXIMATE TIME OF COMPLETION i AMOUNT TENDERED, iO.00
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
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.
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 U
Cattrac Construction 15030 Slover Ave. Fontana, CA 714/33541146
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
on file on file
Contractor's License No.' City Business License No.
on file
Applicant's Insurance Company Policy Number
R
FEES: Subdivision Improvement Permit — Class I II .
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule N2 091)-3
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
10,00
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 0903.
DATE APPROVED 11/8/90
EXPIRATION DATE 11/8/90
DATE ISSUED AD ,^
Administrative Authority
TELEPHONE: (619) 564-2246
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NOTE: '
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP OVERSIZE LOAD PERMIT
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
Subdivision Improvement Permit — Class III
DATE: November 8, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Mo'Ve eguivment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION DAX Cat r10=91- Sketch (attach construction plans if appropriate)
","DESCRIPTION OF CONSTRUCTION 1 A I r"In _ 1 7 I F 1-1-Y.
long, cross weight 185.000
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
HAUL ROUTE: MILES AND DUNE PALMS
TO WASHINGTON STREET, SOUTH TO
Hwy 111
Haul date: -11/8/90
2 pilot qia7r�eq>aed. (}8_g0 14
APPROXIMATE TIME OF COMPLETION 1 AMOUNT TENDERED 10.00
ESTIMATED CONSTRUCTION COST $ '
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
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.
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. 1 ��
Signature of Applicant or Agent 6
(:attrac Construction 15030 Slover Ave. Fontana, CA 714/39541146
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
on file on file
Contractor's License No. City Business License No.
on file
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class II I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00 `
Receipt No.
Received by Date
Recorded by
PERMIT NO,
PERMIT VALIDATION
0903
DATE APPROVED
EXPIRATION DATE
11/8/90
11/8/90
DATE ISSUED 11/8,/190
By. /ll/tttXn 12,WA`-
y Administrative Authority
TELEPHONE: (619) 564-2246
Subdivision provement Permit — Claw iII ._,.;....,._._,o
DATE. litm.,�._. Ml no[,`'nprovem®nt Permit Class iV fi
LOCATION OF CONSTRUCTION � � 1 -- '-
IStrest address or Description of location1l
PURPO E F CONSTFkIUCT N Sketch (attach construction piens if appropriate)
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED.
1 • f
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(including removal of all obstruction, materials, and debris, backfilling, com-
pactlon and placing permanent resurfacing andlor replacing Improvements] _..,�......,�d
in consideration ttf the granting of this permit, the eppiicant hereby agrees to:
Indemnify, defend and save the City, Its authorized agents, officers, representatives and employeea, harmless from and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loge or damage to persons or property
.happening or occurring as a proximate result of env work undertaken under the permit granted pursuant to this application.
(Notify the Administrative Authority at least twenty-four I24) hours in advance of the time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the,permit and all applicable rules and regulations of the City of
La duinta and to pay for any additional replacement necessary da the result of this work.
Slonaturtf Applicant or Agent
Name of Applicant (please print)
Business Address
Telephone No.
0- j
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No, City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision improvement Permit —Class IIi
Public improvements::' of wirrated emmgructlon nnara
i,ve,w ifiipruvaineimi,. -j,o vi esutsus wu wnstruvciutr cusc► �
Minor Improvement Permit — Class IV: See attached schedule '
Inspection Fee $ f PERMIT VALIDATION
Permit Fee I PERMIT NO.
Penalty DATE APPROVED
Cash Deposit -Surety Bond
if required EXPIRATION DATE
TOTAL: $ DATE ISSUED
Receipt No. By
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564.2246
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