21441
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With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
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: 4/19/94
LOCATION OF CONSTRUCTION
(Street 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
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
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:
TRANSPOI2UTION PERMIT
Load- EL 240 Backhoe
Dimensions- 121W - Legnth Ht. -65'
Weight- 119,000
Origin Hwy. 111 & Washington
Destination: Eisenhower & Washington
Route- Washin n /� a
Pilot Car Requ edAPR 19 1994
(�
By 1 1 n i
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and a ainst any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons 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 (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. 01
gnature 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.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License 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.
Received by
10.
$ 10.
Date
2144
PERMIT VALIDATION
PERMIT NO. 2144
DATE APPROVED
EXPIRATION DATE
4-19-94
4-19-94
DATE UE 4-1 �94
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
Im
4.
Subdivision Improvement Nt.mlt
Minor Improvement Permit. Class {V ..,..�..._.+
i
LOCATION OF•CO STR CTIQN
• IStrnt addreis of Oeserlprion Ot't.ocitlanl : 4 i j
uctio
Sketch (e�taFh, aQn;tr ion plan! 'f approprlatt)
,
PURPOSEOF;CQNST'RUOTiOfil ,
•
l7ESC-AWTION OF Ct3N8TRUCTION.1. _._.......-...... _ .. ..r..- ..... .........:.: _.,... - ... ... .. .
6IMtN3igN-00 ItOTALLATION Oli rtt:MOVAL
SIZE OF EXCAVATION', IF NI:I DEV
APPROXIMATE TIME MAN WORK•WILL BEGIN
• I ,.r i %+�'r3ff` JAS �?"� � � � ...
APPROXIMATE TIME OF COMPLCTIOIN:. -
..ESTIMATED CONSTRUCTION COST
(Including'(10' Moval of alt obsitructlon materials, and debris, be.ekdNlin9, eorn;
paction and placing perrriarivnt rpsuriacirig•andlor.replacing Irnwavemotitsl •--�• - .--- .. '�'^^"•�"'
{n: consitlgriitor at the .yranU!, of, yids perNt, the' applicant horoby agrees
Indemntly. defend and. lave: the �llyr nf- auihorii;ei!' e�bms,' 011icers; tBprpsent>ltivel-9nd .emP1oY88e,-harrrH811-•from.lnd.apamet,tanY-.BncLell _....._...'.:.
penalties, liabilities or toss itelulting (rout: claims or court action end arlUnp ;out .4f .any; aeciilent,. tots or datna0e to peasant of Property
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d'{J:Ji11110 ;l.t e� PP51:11ilalu f/tUlt Ul ally rrulk ■uwal ophoil rnrhn fist �t ... 1'•r•�..t N'St.'tnt tt` ,thie anerieeftnn. �
Nott(y; the- Adminietretiw Authorityat IeeN twenty lout (141-:hour.t. In edvanctt 01 th6 tirr►e Vvhen work will be uerted.
1 @.., , i
Comply with oil' auplicable':CCty Ordinances.' the terms and. conditions of the pei'rn t -A. ail-sooUcobl rule ei+d. re0ulatlons, ol.the Clly Of
We Cwinsa end's? ,,�y (nr }ny additional reu(aeement necessary as the N/ult:ol work..
vt
n IltlrAnt' or Aoant I
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I.. . _......- ...- ---.- ,- ..... .. 1� �j 9 l� 3�5 �— X4_6 .._ ...-.
Name'ot-Applicant (please prlirt)
Nameot Coritrictor;and Job Aor-eman
I
dontrettor's License No,
Appllcant-'% Insurance Company ;
I
�. a u � -9 —
Business Address Telephone No.` '
Business i4ddrast I '1 el6phbi%A N&
City. Business License No.
Policy Numbir ;
FEES: •5ubdlvislon Improvement Permit —.Class III ;
1� p��hllr Irnnrovertte!ni�•'9�^a.^efimAtn•irtnnatrtlr+tn•+r,,:�fe ,� � � � ' '
,.,�•..1nt+, VIM"141N. 40M r,/1 aoilli utlU 16116111 ltUNtttllt t.011100.41
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Mlllur lur luvetnot�Psimlt �. CIAOIVs >r9i attester
P&r'
:.. RMIT VALIDATION
Inspecdon�Fee , S ' l � _ -
Perrtdt Keir ! PERMIT hip. �� �y -•. —
l Perielty I - -
DATE APl'11OVEQ �- S
..Caih•Diposlt•Surety Bond ;
;il ioqult`ed' ! EXPIRATION DATE
..TOTAL:. .. -$ DATE- ISSUED ,
I, , �'RecviNt'Nu, � � 6y I , . •.� . •
! 'Adlninittrstive Authority
Re'ceived'by pate
t�ecorcled by TELEP14ONE: M181664.2246
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