2077NO�E:
With.pro per 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: 2/24/94
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit— Class III
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate)
D 154 8jFH,144 W, 99' 11�PL,I 210, 9065lbsckhoe
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Haul Route: 8lsenhower & Sinaloa
To Ave 52 to Jefferson to 54th Ave
to Monroe Airport to Madison to
Ave 58.
Destination: Keller Pit & Ave 58
2 PILOT CAR REQUIRED
(1) Forward (1) Back
APPROXIMATE TIME OF COMPLETION Haul Date: 2/
ESTIMATED CONSTRUCTION COST $ D
(Including removal of all obstruction, materials, and debris, backfilling, com
paction and placing permanent resurfacing and/or replacing improvements) sy— —
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, harm]m ajq,& i st any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or -My
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 Slover Ave, Fontana, CA 92335 (909) 355-1146
Name of Applicant (please print)
Business Address
Telephone No.
Same As Above
Name of Contractor and Job Foreman Business Address Telephone No.
On File
Contractor's License No.
On File
City Business License No.
On File On File
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.
$ 10.00
$ 10.00
Received by Date
Recorded by
PERMIT NO
247?
PERMIT VALIDATION
2077
DATE APPROVED -- --2/24/94
EXPIRATION DATE
2/24/94
DATE IS UED 2/24/94
By
Administrative Authority
TELEPHONE: (619) 564-2246
T
r - •
INC.
encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways,
and other like public works improvements in connection with MINOR IMPROVEMENTS andIng APPROVED SU DMS ONS
P.1
DATE:._;13g Subdivision Improvement POrmit — rigs, III
Minor improvement Permit Class IV
LOCATION OF CONSTRUCTION �_
fStreet address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
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,
paction and Placing backfilling, coni•
P g permanent resurfacing and/or replacing improvements)
In consideratior• of the granting of this permit the
Sketch (attach construction plans if appropriate)
TRANOORTATION PERMIT
LOAD'! 205 BACKHOE
DIMENSIONS: 15t8" high,
14'wide,'99t11'i long
WEIGHT: 210,906 lbs
ORIGIN: 'EISENHOWER & SINALOA
DESTXNATION: KELLER PIT &
AV 58
ROUTE: SINALOA — AV 52 —
JEFFERSON — 54th AV MONROE
AIRPORT — MADISON — AV 58
. applicant horeby agrees tc.:
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 oI any accident, loss or damage to prisons 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 1241 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 appWable rules and regulations of the City of
La Quints and to pay for any additional replacement necessary as the result of this yrork.
lJ� i
Name of Applicant (please print)
Signature of �1-kant or
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
FEE$: Subdivision Improvement Permit —Class III
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—1146
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Minor Improvement Permit— Class IV': See attached schedule j� j�. i
Inspection Fee $
Permit Fee
PtRMIT,'VALIDATION
� '
Penalty PERMIT 'NO:
Cash Deposit -Surety Bond
f required PATE APPROVED
EXPIRATION DATE
TOTAL: $
ieceipt No. DATE.* ISSUED
ieceived by. Date BY
liecorded by
Administrative Authority
TELEPHONE; (619) 564.246
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