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1970NOTE: Pith 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 DATE: 11/16/93 LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION HAOI. BQDIPIII = DESCRIPTION OF CONSTRUCTION 769 RiOIIX TRUCK DIMENSION OF INSTALLATION OR REMOVAL 14"6"H, 12% 65%, 126,725 LBS SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV Sketch (attach construction plans if appropriate) 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: ORIGIN: BAST CITY LIMITS DESTINATION: KBLLRB PIT A 58TH HAUL ROVrE: AIRPORT - MADISON — 58TH EM DATE: 11/15/93 '-PILOT CAR REQUIM I p NOV 15 1993 Indemnify, defend and save the City, its authorized agents, officers, representatives and employees; aymless f o d 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 permitgranted pursuant to this application. 1 . 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. / Siggn/azure of Applicant or Agent CATTRAC CONSTRUCTION, INC. 15030 SLOVEB X ., FONTANA, CA 92335 (909) 355-1146 Name of Applicant (please print) Business Address Telephone No. SAME Name of Contractor and Job Foreman Business Address Telephone No. ON FM . ON FILE Contractor's License No. City Business License No. ON FM ON FM 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 1970 Inspection Fee $ PERMIT VALIDATION Permit Fee 0�10.00 1970 PERMIT N0. Penalty DATE APPROVED 11/15/93 Cash Deposit -Surety Bond if required EXPIRATION DATE 11/15/93 TOTAL: $ l 1/15/93 DATE1IS GE Receipt No. 4 ' 'BY Received by Date Administrative Authority Recorded by TELEPHONE: (619) 564-2246 4 f No L4 .. t! Subdivision Improvement Permit -•• Class II I ,..,. _.....r...�. DATE: --' Mlno Improvement Permit Class IV _..�,. `LOCATION OF CONSTRUCTION e IStrG1.t4ddrass or Description of Location? .PURPOSE OF CONSTRUCTION Sketch (attachiconstruction plans if appropriate) DESCRIPTION OF CONSTRUCTION' DIMENSION OF INSTALLATION OR REMOVAL', tZ 6?6rlft--r 61 7_25 4t - 7i PA ­TrV4 iiar►��sf�•�— •lt�' 6 tr --tz' la -- � s `� AA"tv� SIZE OF EXCAVATION; IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN: APPROXIMATE TIME OF COMPLETION ESTIMAtEO CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, com- paction and planing permanent resurfacing and/or replacing improvements) "In,,etMsidtratlor' of the giantirg of tflis'permit, the applicant lh:areby•..agrees_tc.: Indemnify, defend and save the City, its euthorize4 agents, officers, representatives and employees, harmless from and against any and all penalties, liablllties or Ipss resulting from claims or court action and arising out of any accident,,loss or damage to persons or property 'i hapgeninq or occurring as a proximate result of any work undertaken under the permit granted puisuant to this appitcation. Noti;N the Administrative Authority at least twenty•four (24) hours in advance of the time when work will .be started. Cor 01V with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of L.6 6ulnta and to pay for any additional reolacemgnt necessary as the result of this work. A _ _ - .r Signature of Appliqnt 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 Busindss License No. ApplfcanVs Insurance Company Poticy Number FEES: Subdivision improvement Permit — Claes I II P­hlir irnnrovemente,- 104 „s ctlrrAtm,4 rnnetrm%tinr, rmett I-- ,10,N.WruMV410. ,rrgN, aauntdleu v IMIukWoll wata N� Minor Improvement Permit — Glass IV: See attached Schedule a Inspection; Fee $ Permit Fel Penalty. Cash Deposit -Surety Bond if required TOTAL: $ Receipt No. Received by Date Recorded by i•d PEhMIT VALIDATION PERMIT NO DATE APPROVED EXPIRATION DATF DATE ISSUED 1 By Administrative Authority TELEPHONE: (61915134-2246 YM6 Hlai':.N'IWW:�.•H,muralww.v��._.:::__,�::-r.:_._:.:>ismcaa:_/M1••NM1!',Nnr•�'11t:s_eM:a^as:q�! •ONI wonofldiswoo ouaiiuD 0Z :60 66. ST A0kI D 2�' ''