1859II *s
_ 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
Subdivision Improvement Permit — Class I II
DATE: 8/26/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 79-253 WeNtIMICA 112
F
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 140" MUIR " Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 45 Tcm Tadana Crane
14110" B, 12' W. 99'11" L, 185,000 The Roues From North City Linits,
over Jefferson - Westward
DIMENSION OF INSTALLATION OR REMOVAL No to destination 4 return
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 to:
Indemnify, defend and save the City, its authorized agents;• officers, representatives and employees, harmless from and against any and all
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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 %no 15010 Slover Foutans (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 Pile �.
Contractor's License No. City Business License No.
On File On Bile
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 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
Receipt No.
$ 10.00
Received by Date
Recorded by
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31 1993
PERMIT VALIDAT16
PERMIT NO. 1859
DATE APPROVED 8/26/93
EXPIRATION DATE 8/26/93
DATE ISSUED 8/26/93
By ��
Administrative Authority
TELEPHONE: (619) 564-2246
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Subdivision Improvement Permit — Class !II
DATE:—.,r ,0$/��/93 Minor Improvement Permit Class IV _..
LOUT16NOF CONSTRUCTION 79255 Westward Ho
(Street addross or Description of Location)
fi
PURPOSE,OF CONSTRUCTION Sketch (attach construction plans if appropriate)
-----
DESCRIPTION OF CONSTRUC71ON .______—,_„e TRANSPORTATION PETIT
DIMENSION OF INSTALLATION OR REMOVAL w
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Load: 45 Ton Tadano crane
Dimensions: 14110 high,
121 wider 9911111 long
Weight: 185,000 lbs
Route: From North City limits
over Jefferson - Westward.Ho
to destination and return.
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
oactlsn and plai.ing uettilarient routfacing a.id!or rtpiacing irnl)rc•viiments)
In cotwderatior I)t the granting of this perinit, the applicant hereby agrees te•:
indemnity, defend and save the City, its authorised agents, officers, reorusentarlves and employees, harmless from and against any and all
penalties, liabilities or foss resulting from claims or court action and arising out of any accident, loss of damage to twisom or property
happening of r.cculring as a ploriimale insult of ally womk unclortaken under the permit gra(fud pur5Uaitt to this dNplicauon.
Notify the Administrative authority at least tyvenly•four 124) hours in advance of the time when work will be siaited.
Comply with oil apolicabte City Ordinances, the terms and conditions of the permit and all agpl¢oble rules and re9uletion.s of the City of
La Quinla and to pay for Orly additional tehl4cenient necespary as the result of this Work,
IF
Signator Applicant or Agent i”'
__Csdt_tr4c C�)Ljstruc;ti,on, 119ce J.5Q3fl�2Vtrr Fgn ita ._Caiy()9 355—
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and ,Sob Foreman Business Address � Telephone No,
Contractor's License No.
City Business License No.,
Applicant's insurance Company � � Policy Number
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FEES: Subdivision Improvement Permit —Class III
Phlir if*1nrnV('it1P.nfe' 7R/, �r ne9iiT�PM� r Rrt¢tryir tion �nric
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PC 144, V, tokru t.urialiu6Uuir 6U:1kb
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Ruceipt No.
A0
$.... —._ 9
Received by __,�.,., ,. ,,,.,...� Date _._—.... _
Recordud by ..___ �._. _....,......w......,� —� .
170
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE 'ISSUED
By�.....r . r.....«., . .
Administrative Authority
TELEPHONE: (619) 564.2246
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