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2163E , •L - NOTE: 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 Subdivision Improvement Permit — Class II I DATE: 5-6-94 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 245 Backhoe DIMENSION OF INSTALLATION OR REMOVALI5'8"'h 14'w 99'11"1 218,0001bs 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) In consideration of the granting of this permit, the applicant hereby agrees to: Haul Route: Sinaloa east to 52 to Jefferson North to City Limits jD PILOT CAB REQS • MAYO 6 1994 B � Y Haul Date: 5/6 or 5/9 one AU7only 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 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. e Signature of Applicant or Agent Cattrac Construction Co. 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 2163 PERMIT VALIDATION PERMIT NO. 213 2163 DATE APPROVED 5-6-93 EXPIRATION DATE 5-9-94 DATE ISSUED/.5/76-94 By � - Administrative Authority TELEPHONE: (619) 564-2246 13 i 1 • ..iLt.. � ., �. � SubdivJslon Im " .DAT f:; _,;Q ' 0 S, 9 4i provettent,Permft - Class t t! Mfnor.lm roe p w meet Permit IV LOCATION OF CONSTRUCTION. .i '' '(tt fell atldran,or Deroriptlon of �oatlgnt PURPOSE OF CONS TAUGTJON : Skatch alta 1 ch construction plans-if appropriate) . DIrSCRIPTiON OF CONSTRUCTION' TRANSPQRTh► jON •PERMIT ' COAD:' ' .245' backhoe `' • .: i. : D�MBNsONS :: •TSI 811 h�,gli; .;14' laid OIMFN$lON'OF•INSTALLATION'ORREMO AL. 9"9 11It ?0, g' I WEIGHT: '.". f21 g ,.0 0 0. lbs ORZiienhower. &''Calle Sind: f SIZE OF EXCAVATION, IF.., EED,ED DESTINAVONJ� 'Korth City Lima'ts.' ..' A0UTE: CAI. a .Sinelda" — Ave: 52 i APpRQKIMATE TIME WHEN WORK VilfLl B fN +Jefferson "St'''and. rettrr.n ung - 52 en A�P.PROXIMATE Time .OF:C MPLETION, ' -ESTIMATED CONSTRUCT idN'COS7 S f lrit;ludlr .►orno.val o1.e11 obsiouctlon, materiais,� And debris, backfilling, Com•: 'i ° pactiart dnd placing permanent rest,rforir7 end or replacing _ 9 p 0 improvements) In 0116440t1or !�t..tfie Itieno •^�^��- �9 of this perrnii appficaht herebyagrees ta; . . ttiderAklty., defend. and Iava.the t:h Its a tho,laed Y, ; u , agant0:' oflieertl, r9prlltantatives. and amployee�,;htirMI@$tl;'from and aearnet any and all ' pef111tiat,:llabtliliatl Or •lotltl retlurting'figrn clal. s or court action and erIsing,out. ar any, eecident, loss or damage to pdr�ontl or property ;:'� . happeAlnq or' occurring-at i proximate ra„uli 0y:ifW work` undertaken uridsr. the permit' granted pursuant to ahh bppl�cption, . { Noii:fy tfia gdtninle'tretiw'Aluthority at ;lacer ni�eAty•four (241 •hours Iri advance of., the -time when work will:be started. i. Comely; with ail• spa'- for Clay Ordinance; ah urme' enq condit'iontl,o(• the 06Mn t and all pppliaable'rules and ►equistion� of tNe.Clty, of . Uinta and to !pay for in ml- replacement-neceeasa i ry .ae the r+lult gt thi work. Signature. df IGnt or Agf;ht i .. tl ,�It. 0 v ; Nimi.tif Appllcrsnt (pJeesti pr►ntJ a a 2- �yslnees. Address . :Telephone {Vp, . ,j Name of Conttactor and Job F0&..' an �. Business Address Telephonti,No.. 14 Contractors License No. City Busiheas Liente. No. �. Applioant's In jI tiurancr'Cr mpiny. ' Policy Number F.EEa: Subr1?vl�ion ImEro�vem4Iivt p4i'rrtf lass III I~ �thlir Intnrtivemerltc,� 9oc na n,ofl�r+�tori'CrinStrllrr'lnn hn�te w•. !...Niwru omf11>1.:r�Yv. diUriwlib:WlII►UUi:.la011 Wali ,*' Mlnor, Improvement Permit -�:Class IV; a attached schedule: is • Inspection :Fee'..,. POM1 1. VALIDATION Penalty . PERMIT NQ.- ; Daposl't-Stirety abad i (SATE APPJROVI:D riq'uired EXPIRATION DATE: TQTAL;' S No Recef t DATA ISSU,Eb p : . ReCelad; vby bete {' By .Recorded: by Administrative Authorl'ty: TE LJ;PNON�� fe1>it1694�a?a8: �•C•=A \tz: ipY�r-7�C •r IYIL=.ls�.1w+�� •, . 1 '9NI woiionNiswo 3Udiid9 9E:80 ,b6. 90 J.dW` ry Ll we ., 4ht D 4 Q9 Wo REQUEST FOR INSPECTION 24 HOUR ADVANCE NOTICE // L DATE/ PRQIECT LOCATION may- 7062 O&OC67okI PERMIT NUMBER aJ6 CONTRACTORS NAME & L. �d.i/s7rcucTioIJ PHONENUMBER COMPACTION TEST COMPACTION TEST Subgade.................. ❑ Base ........................ ❑ Grading .................... 0 Curb & Gutter .......... ❑ Drainage .................. 0 Formwork.................. 0 Trenches ................ 0 Striping .................... 0 Structural Steel ........ 0 Paving (Asphalt) ...... ❑ Signing .................... ❑ Backfill0 ...................... Paving (Concrete) .. 0 Landscaping ............ 0 Excavation ................ ❑ Driveway Approach . s/v�9yA�1. TUESDAY WEDNESDAY THURSDAY FRIDAY ESTADO • LA OUINTA, CALIFORNIA 92253 • (619) 564-2246