2123NOTA:
With proper 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: 4/7/94
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
Subdivision Improvement Permit - Class I II
Minor Improvement Permit Class IV
PURPOSE OF CONSTRUCTION MAYO 801111 ?tnont Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION F.T. 9441 CAT RAMOR
Legal HT, 121W, 651L, 120,000 lbs
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
Orgin: Vista Laguna & Eisenhower
Destination: East City Limits]
Route: Eisenhower to Washington
Ave 50 to East City Limits
Haul Date: 4/11/94
APPROXIMATE TIME WHEN WORK WILL BEGIN y LOT %"AR ��Q LA
APPROXIMATE TIME OF COMPLETION f t l�t�
ESTIMATED CONSTRUCTION COST $ Da
(Including removal of all obstruction, materials, and debris, backfilling, com-
pa7nction and placing permanent resurfacing and/or replacing irovements) I
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}n�_and agaA-or-prop-
and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or Itlamegeyto.perertyhappening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this applica,. ,
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.
.tm,& 4 � , - C -Y\ -
\�.
Signature of Applicant or Ag t
Cattrac Construction, Inc. 15030 Slover Ave, Fontana, CA 923 5 (909)355-1146
Name of Applicant (please print) Business Address Telephone No.
On File
Name of Contractor and Job Foreman
On File
Contractor's License No.
00n File
Business Address
Telephone No.
On File
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 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
$ 10.00
Date
2123
PERMIT VALIDATION
PERMIT NO. 2123
DATE APPROVED 4/7/94
EXPIRATION DATE
'DATE ISSUED
gy
Administrative Authority
TELEPHONE: (619) 564-2246
0
03
0
Subdlvllion Impro �ement�Perr,~t'it` Glais I11 .�._.:� '
Minor Impnovemert P4t<mit Class IV
r ` ;LOCATION OFCONSTRUCT•!
• • (Sueetaddnss ar'bascriplton of LoClation!
PURPOSE OF CONSTRICTION Sketch -(attach constr ctl n plans iLappropriate) '.
...�
.I7f;SGRIPTION Of. CONSTRUpT10N
OIMSN.SION OF INVSTALLAT16N OR REMOVAL �i+ i ;Imo" i;�t.'�t4L
vo
' :..SIZE OF 9XCAVATION, IF NEEDED
AP.PRO_ XIMATE'TIMI 'WHEN U ORK�WI,LL
I
APPgOXIMATE�"TIMO,OF CQNkPLETIQN -
ES'TiMATED CONSTRUCTION !COST $ 'I f � � i r;
(including i•errioval-of.ell.obstruttion, materlals, pind debris, backfilling; corn• � .
pactlan 'and piac:inQ. permanent :resurfacing andlor replacing imnroverr,ents)
In consideration :ot the. gfantlr+i of this:peripit, the applicartt.tiorrrby'.{cgreec 'ta; . ,
t II �'
)ndamnify,'defend end savii,the.City,, its aulhorii�ed events, off{isers;.raprtlsentatl�as and am'01oyeas lermlesi from'ond Ageintt any and.efl'
Penalties, liebttltlas. or IOts rtlsulting }ram:gldms pt court action- and #r{sing out of any accident, I s>i or 44, to perions ;or property
happening or occurrin4 es a proximate (ewli' of sny'.work undertaken pndsr the: permit granted pun want io thi; aipplicat�on, :
Nosily the:Admfnistrativa Authority at teaiit twenty -)our (241 hours in;ildyan6� of the'�ima when irk MI) be etarted.
Canipiy with •ell .epplicable City Ordlnanees; the terms and conditions 4f the' rerilt end all appil ' is rulas land t�qulationt of :the City of:
:La. t]ulnta and to ply for ini� additional r'eplacemtnt •ni4escisy� si the'taiult of .this work,
$i¢n flut`e of icant or Agtfint.
• IrAve.:, 6
Name of Applicant tplease print)! Business- Address !�'Telephona 'No,
i
Name'Qf Coritrac4or;an JabiFo►prrian 'Busine'siAddress' i 'Telephone`No,
Coritractor's License No, Clty Busine s Lice seJi . ;.
l Appllcarit's: Insurance Company Policy Numb r, I'
FLEES:; SubdivisNort Impiovemorit-Permit r• Class Ili
• A,thlirtmnrs��emenf`r; vo4 �c �rtlit+Rfpr1 cnitf:irlf�t►r►n rr�^t1 .. I • ., i „ .
' .:4.., „nNiuv�„�otnp. J,M v, •elulldlvV I;UI1111UU10t711 �Up�>t ,T '
Minor Im rovement. Permit ,» Class I.V; See attached schedule I �� Q
Inspection Kee` $ ' PE MIT AIbATION s
+ Permit: Fae
Penalt -- PERMIT NO. I
i
y DATE APPROVED
.
Cash Qepolit•Surety. Brand ' ,
It required..
' EXPIRATION OAT
TOTAL; ' ,
$----i DATE ISSUED
Rocelpt No.
'. Rtice'Wed by DateI!Admin strative.Authorlty
R#corde$ by
i . TELEPHONE; {819ir 664.146
cvat�ct+:arre.saa�wu:_ !miOf1Y,.•.ti�.+�....�..•.
i Z ' d • DNI `woilondiswoo oddllt D 6b : bT 06, LB ddd''�"'s"�
i.
NOTE;: '
With proper. validation
.this form.ponstitutes an .i
' mli
CITY'. OF • LA ' OUINTA
encroachment per '
APPLICATION FOR PERMIT .. '
PUBLIC ,WORKS CbN$TRUCT11ON (ENCROACHMENT):
, - the construction at: public. or :private .curb:,, drlveweys , pavements, sidewalks, p rking j lots' ; sewers, water mains
.arid other 'llk-'e puhile..war".lmprov®ments in connectlon with MINOR IMPROVEMENTS nd APPRQ�/Eg SUBaIV.1510NS
L 'Z : 860d p*apua�Xg
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