1850�^ it
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
I 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: 8/24/93
LOCATION OF CONSTRUCTION Keller Pit Road
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Eauipment Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 657B Scraper
15'6" H, 14'6' W, 75' L, 215,000 lbs
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)
In consideration of the granting of this permit, the applicant hereby agrees
Indemnify, -defend and save the City, its authorized agents, officers, representati
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.
ROUTE: Keller Pit Rd - 58th,
Monroe St to Ave 50,
Washington St & return
unladen.
DATE: 8/24/93
i�
PILOT CAR REQUIRED
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.
Sign/re 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 On File
Contractor's License No. 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 VALIDATION
Permit Fee 10.00 PERMIT NO. 1850
Penalty 8/24/93
Cash Deposit -Surety Bond DATE APPROVED
if required EXPIRATION DATE 8/24/93
TOTAL: $ 10.00`
DATE IS UE $f 24/93
Receipt No.
ByaYt
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
�. Subdivision Improvement Permit – Class III —.,,_.–..,.....
' DATE: Aj Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION West End of Keller Pit Road] La Qui.nta
ISireet 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)
TRANSPORTATION PERMIT
LOAD: -6,57B Scraper
DIMENSIONS: 15!6" high, 14'1611
wide; 751 long
WEIGHT: 215,000 #
nd- Kedl id-�
imi o
ROUT. Ke..1ler Pit Rd - 58th Ay
-s Monroe St to North-;:
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ Ave 50 – Washington St and
(Including temoval of all obstruction, materials, and debris, backfilling, corm return.unladen
Faction and placing pertmant nt resurfacing aud'or replacing 4norr,vitrnents)
In Conalderetlol 4t the glitntlrg'ot this prrinit, rhe appflcant hereby agrees tc.:
. • - , i ' 9, ... , 1 i i ■ rn B i P e r Bell 1101111,000 n min nu RePtn01 will •flu all
Penalties., liabilities or lose resulting from clulrns or court action and ofising out of, any aecident, loss or darnage. to persons or property
happening or Occurring at a proximate result o+,any work undertaken under the permit granted pursuant to this Q&)hC6110n.
Notify the Administrative Autholity at least twenty-four t24) hours In advance of the time when work will be 61arted.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and re.'gulatl0ns of the City or
La Ouinta and to pay for any addtllonal replacument necessary as the result of twork.
t llrir�/ji/DIS
„Sat.tXdg Construct
Name of Appiicant (please print)
Business Address . Telephone No,
Name of -Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.'
City Business License Nb�– –
Applicant's insurance Company � � � Policy Number
FEES: Subdivision Improvement Permit —Class III
P -Mir irinl'ptM1!t,tP„ntt'»7^' na _fllrilfr,'i �,.nASt+'llrrin., mutt
,,... ... ,,,,�., �8�„la, na. v•V v, rp�utlp lCU LUt1,)UUt.tlyit uULID
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee��
Penalty ..._
Casfi Di6posit•Surety solid
if required
TOTAL:
Raceipt No.
Received by ,,..�_....._..,.:... Date— -
Accofd6d by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED 4.G_r�3
TELEPHONE: (619) 564.2246
;Administrative A} thority
Z ' d , CNI NonDnl aswo3 ou6iieo 6Z : EZ 66, be one
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