0071NOTE: -
With proper validation
this form constitutes an
encroachment permit
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t:
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
Subdivision Improvement Permit — Class I I I
DATE: January 4, 1985 Minor Improvement Permit Class IV X _
LOCATION OF CONSTRUCTION Within the paved and earth sections of various La Ouinta roads
within the boundaries of GI'E•onerating area.
(Street address or Description. of Location)
PURPOSE OF CONSTRUCTION BLA2W PERMIT Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL Not more than 80
Lin. Ft. excavated under blanket permit.
SIZE OF EXCAVATION,. IF NEEDED 31 X 4' Bell Doles and
installation of new services.
This authorization does not include
excavations of GAS Raads.(rajor roads)
Permitee shall notify Ccu mmity
Development -Department a min. of
34 hours prior to start of work.
APPROXIMATE TIME WHEN WORK WILL BEGIN Notify City Sdparate permits are required for
24 hours in advance of anv work. �,roads.As
APPROXIMATE TIME OF COMPLETION Pernit eXPires .Jan.4, 86
ESTIMATED CONSTRUCTION COST $ N/A
(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: o
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.
Signature of Applicant or Agent
G.T.E. '83-793 Avenue 47 Indio, CA 92201 619 347-2711
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
. f
FEES: Subdivision Improvement Permit — Class I I 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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
$ —0-
-0-
$ -0- NO FEE
Date
t .O 071
PERMIT VALIDATION
PERMIT NO. n/a
DATE APPROVED 1-4-85
EXPIRATION DATE 1-4-86
DATE ISSUED 12-2-7•c-84
gy
Administrative Authority
TELEPHONE: (619) 564-2246
General Telephone Company ,
.
of"California:,
F r
83-793 Avenue,47u" ,
'
Indio, 'Cal 92201 7099
.•
•
619.347 2711 - . � -
v
In Reply Refer To.
-December 26, 198,4 ;'
' 3710E C,17 -
CITY OF LA QUINTA
78-105 .Calle : Estado ;.•.
La Quinta,,.CA.. 92253
. Gentlemen
Reference' Annual,Blanket Permit) Number;ror,'1985
,
' Please issue, us a' annual permit number:
Very truly. yours
x.
C
A.. GUTIERREZ
' �Resident :'Engineer
' A part of GTE Corporation's
• ,
:. OA: ;,
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I
EXCAVATION REPORT - SOUTHERN CALIFORNIA GAS CO.
To:
LA QVINTA
L
Calle Rosari.ta.Poo1
T
Ea'st' side of Calle Rosarita
N
222' W/14PL of Ca 11°e Mazatlan
PERMIT -NUMBER
°
WORK ORDER
PROD. OR
ORG.
'-
OR ACCOUNT
'SUB. ACCT.
CODE
DATE 9'30-86 EXECUTION
G=90°52
31218
KA
,PREPARED ORDER NO.
.9.96•
,
SIZE OF,CUT
-
KIND'-
EXCAVATION'REPORT - SOUTHERN CALIFORNIA GAS CO.
9*?30-86 'EXECUTION G--90952 :3ORDER NO.
SIZE OF CUT
j=THER',N CALIFORNIA GAS CO. 2865-26
CalleRosarita Pool
2221 W/WPL ofCalle Mazatlan
9*?30-86 'EXECUTION G--90952 :3ORDER NO.
SIZE OF CUT
j=THER',N CALIFORNIA GAS CO. 2865-26
SOUTHERN CALIFORNIA gqS. COMPANY
3700 CENTRAL AVENUE • RIVERSIDE, CALIFORNIA
Mailing Address: P.O. BOX 2200, RIVERSIDE, CALIFORNIA 92516-2200
September. 30, 1986.
City of La Quinta
P. 0. BOX 1504
781.05 Calle Estado
La Quinta, CA 92252. R ly
coMMu Vo LA6PMENT[Ir'
ATTN: PAM NIETO'
Blanket permits processed during the month of September 1986,,•
are enclosed..
Sincerely t
5JIM. SNYDER
DISTRIBUTION SUPERVISOR
JMS/smt
enclosures