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1788-441 NOTE: With proper validation this form constitutes an encroachment permit ,-A - 1. I 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 Subdivision Improvement Permit —Class I I I DATE: 6/29/93 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 Sketch (attach construction plans if appropriate) Load: 623 Scraper - 12' wide, 110,000 lbs, all else legal. Route: From west ehd of Keller Pit Rd over Keller Pit and 58th to east City Limits. 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 Applicant or Agent 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 f ile City Business License No. On file On file Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class III 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 PERMIT VALIDATION PERMIT NO. 1788 DATE APPROVED 6/29/93 EXPIRATION DATE 7/2/93 DATE ISS+ ED 6/29/93 By Administrative Authority Recorded by II TELEPHONE: (619) 564-2246 Subdivision Improvement Permit — Class III ;TE: 6 29/93 — 7/2/93 Minor Improvement Permit Class IV ..�� LOCATION OF CONSTRUCTION West End of Keller Pit Road La Quinta (Street address or Oescriptlon of E ocetionl PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attach construction pla'ns if appropriate) Transportation Permit Load.: 623 Scraper Dimensions: 121 wide, Legal height legal length, Weight: 110,00D lb Route: From the west end of Keller Pit over Keller Pit and 513th to east city*limits APPROXIMATE TIME OF COMPLETION. -. ESTIMATED CONSTRUCTION COST $- (Including removal of all obstruction, materials, and debris, backfilling, cam• paction and placing permanent resurfacing and/or replacing improvements) In consideratlor of the granting of thio. permit, the applicant, hereby agrees tc,: Indemnify, defend and We the City, its authorized agents, officers, representatives and employees, harmlest from and against any and all panaltles, liebilities or loss' resulting from clairne 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—�� Qattra Gconatruction, .1tic, 15030 Glover, Ever F'ontan_a. Gd- 92.335 (909)3 -1146 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman • Business Address Telephone No, Contractor's License No. . . City Bum s� iness License No, ,Applicant's Insurance Company Policy Number .Ntrvtmennc: __ ....,....,,wrr.•�•z•=r—..___�_.__—. ��s..,....._..,,.....o...,�,�._�.rsaasi.:._...._......._�c.._..'....�,=weaatnrcaea��-:•__—:_ FEES: Subdivision Improvement Permit -- Class I I I P,,hlir irrtnrnvernenrc, 104 nt Cnrtctrurtinn r7n,rt4 W. La. -,Q V. V,atfFfi6tau l:UlfbtoLit; LIU]I t'.Vbtb Minor Improvement Permit , Class IV: See attached schedule Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No, S e.. Received by -- _ -- peter, Recorded by 4.. e:x".--:==:::d�,r�zLc_.:a:...�a�a s..•v.:..k.�.:4.a ,U k s.a:.,aA•r3YWvu4ALi ftifiF'.:.�.....•q.NW'.n :r PERMIT VALIDATION PERMIT NO, ..s DATE APPROVED EXPIRATION DATE 2 R3 DATE ISSUED By Administrative Authority TELEPHONE: (619) 564.2246 '�.::T . a..... ......+,uVIW.Ct::::_:.._::'e:. �:� a::a G•µ:ip,MLHl^+diS__:�..:::: •.:_l.:f:lc::�2 `NGI o laiswoo 31:18iit13 S©: 6© 66, 62 Nflt• v.