1770NOTE:
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
DATE: 6/18/93
LOCATION OF CONSTRUCTION West End Keller Pit Rd
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment
DE4C%IPTION OF CONSTRUCTION D-9 Dozer
14 6 High, 12 Wide, 85 Long, 190,000 Abs
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
East City Limits over 58th &
Keller Pit Rd to West End Keller
Pit Rd & Return Unladen
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.
Signature of Applica t or Agent
Cattrac Construction 15030 Slover Fontana 92335
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No. a+
On File
On File
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I 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
Penalty
Cash Deposit -Surety Bond
if requir4ed
TOTAL:
Receipt No.
10.00
$ 10.00
Received by Date
PERMIT -'VALIDATION
PERMIT NO. 1170
DATE APPROVED 6/18/93
EXPIRATION DATE 6/21/93
DATE ISSUWED 6/.l#/93
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
P.1
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:
Subdivialon.lmprovament Permit —Class III
"—'--~---� Minor Imp;9vement Permit Class IV
LOCATION OF CONSTRUCTION __ 1A t'^�
(Street eddress or Description of location)
PURPOSE OF CONSTRUCTION _Wlovr- Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION �.�� >ozKV-1
DIMENSION OF INSTALLqqJ ION OR REMOVAL
S12E OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN _- -
FrOqi QW:
4*f 7a � -
APPROXIMATE TIMEOF COMPLETION � LRV
ESTIMATED CONSTRUCTION COST
(Including removal of all obatructlon, materials, and debris, backfilling, cont.
priCtlOn and placing permanent resilefgcing and/or replacing Improvements)
.�. r
,hr-coriiilderativn of the grantltig of obis: perilSit, this 0001i cant hereby 80reeS tici '"
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless, from and against any and eu
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 undartoken under the permit granted purauent 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 ell applicable rules and regulations of the City of
Le Quints and to pay for any additional replacement necessary at the result of this work,
Name of Applicant (please print)
Signature
Business Address
`�cic 3 S
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 III
P, thiln imnmvamPnts: R% trot, p�4i ,itRrl rYlnafri�rrinn rare
0
Minor Improvement Permit ... Clsr,-. IV: See attached
Inspection Fee
Permit Fee
Penalty
Cash deposit -Surety Bond
If required
TOTAL:
Receipt No,
Received
.6V ia'... -
Recorded by
Extended Page 1.1
Nb
P644MIT VALIDATION
PEF4,101T NO,
DATE APPRMVED
FXPIRATION DATE
DATE ISSUED
By
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0
11