1467rte..:.
NOTE:
With proper validation
this form constitutes an .
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
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
i.
Subdivision Improvement Permit— Class III
DATE: June 17, 1992 Minor Improvement Permit Class' IV
LOCATION OF CONSTRUCTION Washington and Calle Tampico to Washington N/B and return
unladen to Hwy. 111.
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move 235C Backhoe Sketch (attach construction plans if appropriate)
DESCRIPTION.OF CONSTRUCTION 12'Wide 14'8" high PILOT CAR REQUIRED.
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 6/17/92
ti
QQ5182 0 0538 06-17-92
11 VV 13
CASH i TOTAL i i0.00
MOVE DATE: �'June.17, 1992
APPROXIMATE TIME OF COMPLETION
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.
ure of Applicant or Agent'
Cattrac Conautruction Inc. P.Sig Box 2069 Upland, CA (714)355-1146-
Name
714)355-1146Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman , Business Address Telephone No.
00 file
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs 1467,
Minor Improvement Permit — Class IV: See attached schedule is
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
10.00
TOTAL: $ 10.00
Receipt No.
Received, by Date
Recorded by
0
PERMIT VALIDATION
PERMIT NO. 1467
DATE APPROVED 6/1'7/92
EXPIRA ION DATE 6/17/92
DATE SH U/92
r
t Administrative uthor4y—
TELEPHONE: (619) 564-2246
K,
•11
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
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
//o Subdivision Improvement Permit — Class I I I
DgTE: ,L� �'U G -Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 1ZZA,5�y67 6 I%IT
7n 17'w V J,0
(Street address or Description of Locationf"
PURPOSE OF CONSTRUCTION //'90 e LILL Z 1;X� Sketch (attach construction plans if a r' t )
DESCRIPTION OF CONSTRUCTION ' %
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN .�
APPROXIMATE TIME OF COMPLETION ✓I 2 -
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:
pp oprla e
V�,LO' uArc
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 Quinte and to pay for any additional replacement necessary as the result of this work.
Name of Applicant (please print)
Business Address
icant or Agent ,
Telephone No.
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 111
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ „
Receipt No.
Received by '...Date
Recorded by _
Y 1236
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority `
TELEPHONEc,(619) 564-2246.1 -,a.