1961�A
NOTE
»\ yth proper validation
th%6 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: 11/8/93
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQU P11M
DESCRIPTION OF CONSTRUCTION 245 BACKHOE
DIMENSION OF INSTALLATION OR REMOVAL 154"H, 1399"Wo
99' 11"La 219,581, L$0
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)
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
.r
Sketch (attach construction plans if appropriate)
ORIGIN: JEFFERSON & FIESTA
DESTINATION: EISENHOWER & WASHINGTON
HADL ROME: JEFFERSON TO HWY 111/
FROM HWY 111 — WASHINGTON AND
RETURN UNLADEN
HAUL DATE: °,11/9/93
PILOT CAR RQUIBBD
CITY OF LA UUINTA
ri,-lI!,
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 SLUM AVE, FONTANA, CA 92335 (909) 355-1146
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman
Contractor's License No.
Business Address
Telephone No. . '
City Business License No.
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
Receipt No.
101 ru
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 1961
DATE APPROVED 11/8/93
EXPIRATION DATE IZZ f - 93
DATE ISSUED _
By
Ad inistrative Authority
TELEPHONE: (619) 564-2246
NOV 08 '93 15:06 CATTRAC CONSTRUCTION, INC.
Post -it"' brand tax tran8.rmttal memo 7871 M of pWaa ►
•
To
.:...�... �. -- o.
r -r V I'rAr J l l►1eol
NOTE:
With proper validation
this form constitutes an
encroachment permit
P.1
F LA QUINTA
NOV
CITY OF LA QUINTA ,
APPLICATION FOR PERMIT PUBLIC WOR
PLISLIC WORKS CONSTRUCTION (ENC'ROACHMEN'T)
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: V MinorAmprovement Permit Class IV
,LOCATION OF. ON TRUCTION - --•
(Stree( address or Description of Location),
PURPOSE OF CONSTRUCTION W�1�-►1TC►� Sketch (attach construction plans if appropriate) i
:-'. DESCA IP.TION OF CONSTRUCTION =�
OIMENSIOi OF INStALLATI.ONOORRSEMOVAI,1•S'22A /Al lial
+ SIZE OF EXCAVATION, IF NEEDED'�C;�ljS'11�r,�'
APPROXIMATE TIME WHEN WORK WILL BEGIN
/i� rtTtD7`' �� ��iHO�`Ij WRSF�II�TI1I
APPROXIMATE TIME OF COMPLETION.._, t
.ESTIMATED CONSTRUCTION COST $ Qvm-�
(including removal of all obstruction, materials, and debris, backfilling, com• tT�'
' paction.and placing parmanent.'resurfacing and/or replacing improvements) --(j s �)' ,
9/0
(n consideratio'r of tete granting of this.permit, the applicant horeby agrees tc.: l `'`� ( `-'�' � � �' I
Indemnify, defend and save the City, its authorized agents, officers, represeritellves and employees, harmless from and ass mnst any and all
penalties, liabilities at loss resulting from claims or court action and arising out of any accident, loss or darmage to persons or property
-happening or occurring as. a proximate result of any work undartaken-undar the permit granted pursuant to this application,
Notify the Administrative Authority at iaast.twenty•four I241 hours in advance of the time when work will be started.,
Comply wl'th all applicable City Ordinances, the terms and conditions of the permit and oil applicable rules and rsgulations of the City of
La Duinta and to pay for any additional replacement necessary as the result of this oek. �I n
Signature of Appljynt or Agent
—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 Business License No.
Applicant's insurance Company Policy Number
FEESt Subdivision Improvement Permit — Class III
11
p,"hile imnrovemenre• 9k -' wtimA+vri cnnewirtinn rn.n
ir"wu necks. ra w. opuum►ru UWjj411U.UUU11 ►.uskh
Minor improvement Permit — Class IV: Sie attached schedule
•t,
Inspection Fee $
Permit Fee
'Penalty
-Cash Deposit-Su'rety Bond
if required
TOTAL: S. �� --�•
i Recoipt No.
Received by - — — Date
'Recorded by -^~^
_-._�-=-:xr.�-susNranua:a+.__�c_�.:e..0 .. ud• c,»..��r.a_-::a �::nrrty.�'—= s
a
Extended Page 1.1
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED ll 4 -
EXPIRATION DATE
DAVE ISSUED
SY •
Administrative Authority
TELEPHONE: (619) 564.2246
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