2149NOA
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: 4/26/94
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
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)
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
TRANSPORTATION PERMIT
Load: EZ 240 Backhoe
Dimensions Legal Ht. - 12'0"W -
65' Long
Weight: 119,000 Lbs.
Origin: Vista Laguna & Eisenhower
Destination: East City Limits
Route: Eisenhower -Washington - Ave.50
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PILOT CAR REQUIRED ;�/ U
A
In consideration of the granting of this permit, the applicant hereby agrees to: Py
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and agains,
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to person,
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.
2
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any and all
or property -
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable ru s and regulations of the City of
La Quinta and to pay for any additional replacement necessary as theres of this work.
nature 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 II I
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.
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.
Receipt No.
Received by Date
Recorded by
2149
PERMIT VALIDATION
PERMIT NO. 2149
DATE APPROVED 4-25-94
EXPIRATION DATE _Lg
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246
•rtoy„.
i
a
-
i
.. • d Subdivision Improvement Permit - Class 111.-.-
DATE --,r T2� f
Mild It Permit Cess IV ._„^�......._,_
LOCATIONOf CONSTRUCTION �w.._.:.. •+-M�••-� —�^•�
Igtreat ■ddrm,or Desbrlpthm of (.ocstion)
PURPOSE OF'CONSTRUCTION Sketch llattach construction plans if appropriates
DESCRIPTION OF, CONSTOUCTION
DIMEN$ION OF INSTALLATION OR REMOVAL '
SIZE OF EXCAVATION, IF' I'44WEb
&Rj �+� YI �T L 1' 1
APPROXIMATE TIME WHEN WORK WILL BEGIN .. � i_� 1 ��„r �M
14t fib,
APPROXIMATE TIME OF OMPUTION �/,..�',J�� d.«.�r
ESTIMATED CONSTRUCTION COSTS '�t,
(including removal. of all obstruction, materials, and debris,*bockiilling, com• �/7t)
4 4
paction and placing permanent resurfacing and/or replacing ImproyemeMss .... ,».....1.^_..;,. rr�.)l»���•-• �'`1 - r' 11VLAI r`-� 7�
+.
in considetatior of the viiintir-Q of this parioil. the. applicant Weby :agrdes It's
indemnify, defend and i 6a the City, its authoriead �Wnt%, 'oflloan, rapresantatives and' 1lmployam, harmless from and poaanst any end aft
Penalties, Nef�llltilr or loss tesiultine Irom clalrrlj or Court action and aridnsi oul of any aeerderll, Ipss or d11 to par}one Or property
hatppening or, occurring h 'a ptgxlmsta result of :any work undertaken under the permit granted pursuant to this appaketlon,
Notify the Adminittratios Authority at least tv""100ur I241 hours in �adv*nce oi'tho tow whiln wotk will be started,
Compty vwth ail ai;►plioable City ,Ordinances, the farms and conditions of thO perrnit and an oppi
REQUEST FOR INSPECTION
C OF a 24 HOUR ADVANCE NOTICE
DATE
PROJECT LOC dON
- L, ----505�irn�z
PERMIT NUMBER
-� -�:) /.D
CONTRACTORS NAME
f /-KV14 �P
PHONENUMBER
S -
COMPACTION TEST
COMPACTION TEST
Subgade.................. 0
Base ........................
❑
Grading ....................
❑
Curb & Gutter .......... ❑
Drainage ..................
0
Formwork..................
❑
Trenches ................ ❑
Striping ....................
❑
Structural Steel ........
0
Paving (Asphalt) ...... ❑
Signing ....................
0
Backfill ......................
0
Paving (Concrete) .. 0,,
Landscaping ............
0
Excavation ................
0
Driveway Approach.
MONDAY( TUESDAY) WEDNESDAY THURSDAY FRIDAY
78-105 CALLEtSTADO-• LA QUINTA, CALIFORNIA 92253 • (619) 564-2246