1974NOTE:
® With proper validation
this form constitutes an
encroachment permit
9
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 I I
DATE: 11/15/93 ( Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION `
(Street address or Description of Location) Y,
PURPOSE OF CONSTRUCTION R' EQUIPMENT Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 769 BOCK TRUCK '
DIMENSIOR OF INSTALLATION OR REMOVAL 14'6"H, 12'W,
65%, 126,725 LBS
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
ORIGIN: BAST CITY LIMITS
DESTINATION: KEI.L.EB PTT & 58TH
HAUL ROUTE: AIRPORT — MADISON —
58TH
HAUL DATE: 11/15/93
t PUM CAB RWPIRED 3 "
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) Kim/ ! 10r)l
In consideration of the granting of this permit, the applicant hereby agrees to:
i 0,—
Indemnify, defend and save the City, its authorized agents, officers, representatives and employYan �Wiroperty and allpenalties, liabilities or loss resulting from claims or court action and arising out of anv accide,oss or a//mag o
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant X 5`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.
CATTRAC CONSTRUCTION, INC.
N f A I'It( I int)
Signat!ye of ApIlicantor Agent
15030 SLAVER AVE., FONTANA. CA 192335 (909) 355-1146
Business Address
ame o pp can pease pr I Telephone No.
Name of Contractor and Job Foreman Business Address j 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 Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
10.00
$ 10.00
Date
r
1974
PERMIT VALIDATION
PERMIT NO. 19714
t
DATE APPROVED 11/15/93
i
EXPIRATION DATE 11/15/93
DATE ISSUED rr 11/15/93
Administr ive Authority
TELEPHONE: (619) 564-2246
i t
.. _ r � ���