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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 p-Ohfir imnrovemente TQC .,r „rrimaro.f n e ► rtinn rn•tc • —1146 {�' ,.... � � ,,,.� �.. a i u`y �,. ;� Extended Page 1.1 ,­rpn r.nnetrtirton.. rn•t• ., ••�•� •.N•urViueta. a.uurcaNnm"U"Ull,to UatlUUt.WIa �.. !. 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 f .xt-?ager.. �:si.s- — ^mss •_� __ s I