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1922V 1 i ( NOTE: NWith 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 Subdivision Improvement Permit — Class I II DATE: 10/12/93 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION AVEmA BERMAS AND SDULGA (Street address or Description of Location) PURPOSE OF CONSTRUCTION HOVE BQUIPlI W Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 245 BACOOE HAUL ROUTE: FROM BAST CITY LIMITS DIMENSION OF INSTALLATION OR REMOVAL 1519" No OVER AVENUE 52 TO SUULOA AND B AND RETURN ADEN 12.6" W, 99'11" L, 210,906 LBS SIZE OF EXCAVATION, IF NEEDED PILOT 9Ag REQUIRED APPROXIMATE TIME WHEN WORK WILL BEGIN 10/12/93 APPR'OXI'MATE TIME OF COMPLETION 10/12/93 Ff ESTIMATED CONSTRUCTION COST $ 12 1993 (Includingremoval 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 at any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to p sons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this applic tion. , 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— �J CATTRAC ge t-- CATTBAC CONSTRUCTION, INC. 15030 SLOVER AVE., FONTANA, CA 92335 (909) 355-1166 Name of Applicant (please print) Business Address Telephone No. SAME Name of Contractor and Job Foreman Business Address Telephone No. ON FILE Contractor's License No. ON FILE ON FILE City Business License No. 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 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date Recorded by PERMIT VALIDATION PERMIT NO. 1922 DATE APPROVED 10/12/93 EXPIRATION DATE 10/12/93 DATE ISS' ED 10/12/93 By Administrative Authority TELEPHONE: (619) 564-2246 J I NOTE: With proper validation this form constitutes an encroachment per reit CITY' OF LA OUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCHOACHMENT) 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 III DATE:_,_ M3 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 6Iyl�� f (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) 5�- APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST DM i� b'[-eP- S It'i Pc.uvij (+�c—ccftS (Including removal of all obstruction, materials, and debris, backfilling, com- ` (taction and pla.:ing petmai,unt resurfacing a:i(l!or replacing iinotr.ventents) _9 In conslderatlor of the granting of this permit, the applicant hereby agrees tc: 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 -tour (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 Ouinla and to pay for any additional replacement necessary as the result of t rs work. ow LU4 Signature of A licant or Agent Q_dtrac Construction, Inc, :I-5030 Slover Ave, >,outana, Ca 92335__L909) 355-1]_46 Narne of Applicant (please print) — Business Address Telephone No. Name of Contractor and Jot) 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'.hlir improw.,mentc- 10! ^4 nctirriitnei rnnctrllrtinn r•nctc Minor Improvement Permit--, Class IV: See attached schedule Inspection Fee $ Permit Fee - Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by —_— Recorded by fid PERMIT VALIDATION PERMIT NO DATE APPROVED /D —1Z - 93 EXPIRATION DATE �0 -�z 9.3 _ DATE ISSUED By TELEPHONE: (619) 564.2246 Administrative Authority