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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 • VAO :-60 rC�ap• �au�ri1 .. •3uj'&UO9:D 4suOO OW44=0 EE t t