1787NOTE `
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: 6/29/93
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION West end of Keller Pit Road
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
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)
Sketch (attach construction plans if appropriate)
Load: 657 Scraper - 15'6" high,
106" wide, 75' long, 215,000
lbs.
Route: East City limits over 58th &
Keller Pit Rd to the west end
of Keller Pit Rd and return
unladen.
In consideration of the granting of this permit, the applicant hereby agrees to:
PILOT CAR. REQUIRED
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
k
Cattrac Construction Inc 15030 Slover Fontana (909) 355-1146
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
On File
Contractor's License No.
On the
City Business License No.
On File On File
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 required
TOTAL
Receipt No.
Received by
10.00
$ 10.00
Date
1787
PERMIT VALIDATION
PERMIT NO. 1787
DATE APPROVED 6/29/93
EXPIRATION DATE 7/2/93
'i
DATE ISSUED 6/29/93
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
A
PATE; 6/29/93 — 7/2/93 Subdivision Irhprovament Permit — Class 111
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION west lEnd of Keller Pit Road La uinta
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
.I_
DESCRIPTION OF CONSTRUCTION
i
DIMENSION OF INSTALLATION OR REMOVAL
i
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
Transportation permit
Load: 657 Scraper
Dimensions: 15'6" high, 1416" wid
75' .long
Weight: 215,000 lbs
Route:
From East city limits over
58th Ave and Keller Pit Rd
to the wrest tvnd of Keller Pit Rd
APPROXIMATE TIME OF COMPLETION and return unladen,
i ESTIMATED CONSTRUCTION'COST $ _
(Including removal of all obstruction, materials, and debris, backfilling, cpm. �� L(j� G� ��Q Lt. 1 (Z9 D
paction and placing permanent resurfacing and/or replacing improvements)
In .consideratidR of the granting 'a# this permit;'tI°e app!'ic:aint (tieiek�y a�ri>es �c`
_ . _... .
Indemnify, defend anti save the City, Its authorized agents, officers, representatives ant! amoloyeea, harmless from end 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 124) hours in advance of the time when work will be started.
Comply with ail applicable City Ordinances, the terms and conditions of the parmit and all applicable rules and regulations of the City of
Li Rulnta and to pay for any additional replacement necessary as the result of this work.
Name of Applicant (please print)
Applicant or Agent
Business Address
-1._1 4 6
Telephone No.
Name -of Contractor and Job Foreman ausir.@ss Address
Telephone No,
Contractor's License No,
City Business License No,
Applicant's Insurance Company
Pollcy Number
FEES: Subdivision Improvement Permit -- Cies ill
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Minor improve ant Permit — Class IV! See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No,
Received by pate
Recorded by
E•d
N�
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE Z q 3
DATE ISSUED -
By
Administrative Authority
TELEPHONE., (619) 504.2740
DNI NOIl ndiSNm ouNiikl"), E9:60 E6, 62 Nnf
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