2015NOTE:
With proper validation
this formconstitutes 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
DATE: 12/17/93
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIPMENT
DESCRIPTION OF CONSTRUCTION 245 BACSHOE — 16 H,
140W, 101%, 220,581 LBS
f
DIMENSION OF INSTALLATION OR REMOVAL
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)
HAUL ROUTE: HASHZNGMN AND
EISENHOWER NORTH BOUND TO HWY 111
EAST BOUND TO JEFFERSON NORTH BOUND
TO MILES WEST BOUND TO DUNE PALMS
SOUTH BOUND TO WESTWARD HO
HAUL DATE: 12/17 OR 12/20
(1 DAY ONLY)
APPROXIMATE TIME OF COMPLETION PILOT CAR REQUIRED
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
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.
Signatu a/of Applicant or Agent
CATTRAC CONSTRUCTION, INC. 15030 SLOVER AVE., 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 PILE t
Contractor's License No.
ON FM
City Business License No.
ON
Applicant's Insurance Company Policy Nu al1i l 0 n
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: $ 10.00
Receipt No.
Received by Date
PERMIT NO
DEC 2 0 1993
PERMIT VALIDATI
2015
DATE APPROVED 12/17/93
EXPIRATION DATE 12/20/93
DATE ISSUED ,,�� -2 1,2 � 92�
By r_ J
Administratiiv,� Authority
Recorded by 11 TELEPHONE: (619) 564-2246
,DEC 17 '9:
It"' brand fsx tr�
- - - - - - - - - -
:52 CAT
Al memo
CONSTRUCTION, INC.# of p4gits k If" I
QUII
li
PPLI.JWATION ;'FO'A.'p
'PU*B Ll C *0111K
$.-:CoNST.AU6t:1dN
pnL (2-Lp
L
For the coriitr,Jctiio-n of public- or prigli a curbs, 'driveways,p4vem
and other' like PWb)ic works' i.rhpro'Y.e:. .'
ments n connei iion". W'ilh U NO R- I
DATE:,...
S�A.UCTION'
6 TION:
OF �CiN
L04
is
i
PU
I lidldliess or• Description of Location)
IOSE .O,F-PONStIRUCTIO'N WOVE—
:R0-16` 6F.cdN ST RU''C'T 10 N MrV
ASION OF INi;;LLAi1O N* OR RiMOV'A
OF 9XCAVAT19'N, IF NEEDED
APP, OXIMATE TIMElWH.EN WORK WILL B,EdIN
-APP. OXIMATt TIME1101F COMPLETION
-ESTI ATED CONSTRUCTION COST
:(Inch ding removal. of ell cibitruiction, materials, a
.1nddebris, kkfi
pectin and placing pqmanent iesuli and/dr replacing! improvements)
lridlsrinnify,�dlaferid and save the City, its authariied agents, olfficars. representat
Pqnalliag, Ijabilitles,or loss resulting or court a' and arising oL
!r0m Claim dtion an
happening
:'or occurring as a Proximate result of any work undertaken under th
Notify the:Admini'ltrative Authority at least twenty-four 1241'hours in advance
Comply W10.411:0poflialble City Ordirliam.ces, the terms and conditions of the 01
U Quinta and to pay for any addizio'iri replacerrent MeC41sery as the result 0' I
P 1.
7
ITA I....
(ONC'.O.ACH
.11MENT!
ii sidowall ' ks, parklilio lots'. ower,,[water:'ri�aIris
AOROVOMENtS and APPROVEDSqBDIv
u4dlyisi4n, lmproverns!i; Permit _10 2 1:
Minor l.mp►overrtent Permit Ca '1�1
SkE
t!tt (attach con$tr;jction plahs-if iwolpii
n1 Y W 6S fi`> 015-STW.
and is, harmiess from and agallinst any: and all
f a loss o damage to perwit or property i
permit: U anted pursuant to thisP
.applicati: n.-
If ill when work Will be started.
tnd all ali
a . a rues and regulation of the:City of
,h I wo
Signature f APlIc' or Agent
11
k -ac 150301 $'-lover Avel 1F0 V., ii ane Ca; 9233:5- ('Oqu:55-;-1146
of 'Applicant Weis@ Print) Business Addr si i Teleph' no No'
0
of -CdnfriCt& and Job Foreman Business Addr s I Telephiiiii No',
City Business License No.
ant's' Insurance mp.any, Policy Nun!tber
SubdiiAi6ill-I'movetirli Permit —:.Class III
11
11
f,s
,..... uruuvcou►bvoy wo 0bunia►eUluuli4VU L 101 O-Ub1b
-t Minor, tmproVe ant Permit — Class,IV: See attached schedul
6
Ina tion Pee.
Perm! Fee
•• PPnel y • .. ' '
Caih; apocft•Sureiy'9o�+d
• if red Iced � . �
TOTAL:17
$ .
R'acej t No,:
qeceh ed bY: Data
Recon Jed by__,
Extended Page 1,1
I
��• �p is .. �
I
PERMI ; VALIDATIO�Y
PE
R IT'
NO.
006 APP OVER
E PIRAI'ION DATE'.
DATE IS QED !' I
8
Ad m i ny stra.tive'Authority
I
TFLPHO � E: (819) 684.2248
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