2020NOTE: J�
,With pimper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
CSL ue?_5
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: 12-21-93
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipnent
DESCRIPTION OF CONSTRUCTION 988 loader
DIMENSION OF INSTALLATION OR REMOVAL 12vv 15 1 `h
99'11"1 185.000 lbs
SIZE OF EXCAVATION, IF NEEDED
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
Haul Route: k,eller pit rd to 58th
to Madison to Airport
to East City Liaits
and return unladen
APPROXIMATE TIME WHEN WORK WILL BEGIN PUM CAR REQUXM
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:
A �
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, hjr®f�%ff _ e a II
penalties, liabilities or loss resultingfrom claims or court action and arising out of an accident, loss ror�d
9 Y ge-to- 7erto or property
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant t this ppl;on.
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.
Signa�e of Applicant or Agent
Cattrac Const. 15030 Slaver Foutana, CA 92335 (909) 355-1145
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address
Contractor's License No.
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.
10
$
10
Received by Date
2020
PERMIT VALIDATION
PERMIT NO. 2020
DATE APPROVED
EXPIRATION DATE
12-21-93
12-21-93
DATE IS UE 12-21-93
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
e
E .�
r
iSubdivision Improvement Permit;= Class 111
DATE:_.Minor Improvement Permit Class IV
r LOCATION OF CO STRUCTIONa> I
(Street address or Deser{pilon of Location)
PURPOSE OF CONSTRUCTION y� Sketch (attach construction plana if appropriate)
DESCRIPTION OF CONSTRUCTION 164
DIMENSION OF INSTALLATION OR REMOVALt �� �' I. `
Stc3lQS fZ (�
SIZE OF EXCAVATION, IF NEEDED CtN;
APPAOXIMATS:TIMIE WHEN WORK WILL BEGIN
APPROXIMATE TIME QF. COMPLETtON
ESTIMATED CONSTRUCTION COST $r ' / YCd tK ( N4
(Including removal of all obstruction, materials, and debris, backfilling, com• f
Paction and placing permanent resurfacing and/or replacing improvements)
In conaideratior of"'ffie giantir;�' of ahis'pennit, ttis Applicant haraby agrees to:
Indemnify, defend and save the City, Its authorised aganes, officers, representatives and rmpipvees; harmless from and r+Q�inaj any and all
penalties, liabilities or loss resulting from claims or court Dation an'd' irisinQ out of .any accident, loss pr damage to parsons or property
flbppening or Occurring as a proxjmote result of any work undertaken under the permit granted pursuant'to ihis application,
Notify the Administrative Authority at least twenty-four 1241 hours In advance of the time when luork will be started.
Comply with all applicable City Ordinancgs, the farms and condltloni of the permit and el! applicable rules and regulations of the City at.
La Q] Inta and to oav for any additional. replacement nacessary es the result of this wo
3{gfteturo•df Appli or Agent
uL.LU11 LrIC:e ausu ��i,gyme. r's2!j&jthea. Cd 92335 1goal�355-11446
Name of Appllcant'(please print) Busiireas Address i Telephone ft,
Name of Cantractor and Job Foreman 9u10e13 Address Telephona No. '
Contrecibr's �,icense. No., City Business Lit ente, No,
Applicani'a Insurance Cofttpany P0110 Number'
MW
- 1..7Y.Yt3tS�1,�1t!Il.fl'iIi!•ItlF�=lY-S3ri�1f��
FEES: . Subdivision Improvement Permit'"'Class. III j
nithlir Lrnnreverrmenty 'At ^s metin►rHprl rnnitriirrinn rnrto
:.r,vrw��a�na. J/Y �, eaN�i�rttlu cuUalltlUtlUsi vubcb:
Mino�provement Permit w Class IV: Stie attached schedule
Inapectibn free
Permit Fae
Penalty '
Cash• Deposit;SurOy Bond
It required.
TOTAL:
Receipt:Nc,
S --
Received by Date
tiecorded�tiy .
�1��s�•a5wiwiusar,�mw,wues.�►'+::-'f..A x'o.ri.{N' YIHi1�1�IrAY.N� YYY :•..f.:.C�'�aa
PERMIT VALIDATION
PERMIT NO:
DATE APPROVED
EXPIRATION .DAfiE___ _.
DATA ISSUED
By •'
Administrative Authority
TEL$PHONE; f6101 564-2240
'DWI NOIiondiswoo ouNiiuo ZE : Zti 6E, tiZ 03G
NOTE;'
With proper validation
this form constitutes an CITY OF LA GUINTA
oncrodchme'nt pilmlt
APPLICATION FOR .PgAMIT ..
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
L -L aged papu04x3