0072NOTE: +
,With proper validation 2 `
this form constitutes an
CITY OF LA QUIWTA
encroachment permit , „ 1 '
APPLICATION FOR PERMIT
31245-065 PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OF �y�tiS
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: January 3, 1985 Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV ,
LOCATION OF CONSTRUCTION - ' Install 193' of 3" medium' pressure PA plastic vias main,
5' S/NPL of the Alley south of Calle ' Estado, Beginninq 5' W/EPL Avenida Bermudas Proceeding east
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION ., See Attached Sketch, TGP 214, D-6.
Earth Cut
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 1-11—R5
APPROXIMATE TIME OF COMPLETION 4-11-85
ESTIMATED CONSTRUCTION COST $
(Including removal of all .obstruction, materials, and debris, backfilling, com-
paction
om paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to: y
Indemnify, defend and save the City, itsauthorized -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.
i
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 foranyadditional replacement necessary as the result of this work.
-R.L. Baughman, Disthbution Supe_r*isor
Signature of Applicant or Agent
Southern California Gas -Co. P.O._,Box 2200, Riverside, CA 92516 781-6109'.
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 tr
i
FEES: Subdivision Improvement Permit—Class III
Public. improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule °�'
Inspection Fee $ —0— PERMIT VALIDATION
Permit Fee PERMIT NO. �.
Penalty DATE APPROVED January '3, 1985
Cash Deposit -Surety Bond }
if required EXPIRATION DATE- JulY 3, 1985
TOTAL: $ —0— c'Jarivaiy 3., 1985 '
DATE -ISSUED
Receipt No.
Received by Date Administrative Authority
Recorded by TELEPHONE:, 1
619) 564-2246
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-INSTALL MAIN WITH AT LEAST ' COVER I FLOW
'TOTAL FEET RETIRED
T,:.
r - •y PERMIT, ISSUED BY; ^• PERMIT NO DATE MOVED - DATE MOVED; , • DATE OF `- t'
RIVERSIDE + ` RET}REMENTWM A(� ; ' ' } '-- 1 1 ON JOB ' OFF JOB OPER ' '
COUNTYi Y .. ;_ t- i_ '.y«:oi# f _ t ! t �, I`i +Q'U
DESERT : i fy,f CREW FOREMAN—
r
DISTRICT ' ' : 'REASON+Y
TRACT PLANNED BY • w!. :} } .~ �. ..COMPANY
NO. ;STAKED_ g a. i❑COMPANY FACILITY: • '. SO. CAL. ❑-P.L.S. ❑ ' �-^'..
ATLAS :�: .!�! .YEAR C.P.
_ J... i ` ' •• 1 ; G'-- - - .,r_ '. a 1.=-1
y , }REVI D B i f
NO. Y �,y Q INSTALLED _ j /i/ 'STAKING REQ'D ' _ •-t❑� �_AST>�RN DIVISION
.CATHODICALLY { r Mj
OPER. 20% OR OVER '❑ •Wlt
I r. '-� !��,.�ORG. y +
YES - ❑ �. NO N❑ »! - S.M.Y.S. f 'NO STAKES'NEEDED W.O. J I O
"PROTECTED AT LESS THAN 20% ❑ DISTRICT SUPE
SOUTHERN CALIFORNIA GAS. G0:2956-I-J . ;...,._1 e�{f"}-- ' .. }_ "� i. �.�._,.1.:.`. } •: S r' + ; , -� •-s ,. E,.,
E I, V E
JAN 31984
y OF LA QUINiA
NOTE: _ COMMUNITY DEVELOPMENT DEPT'
With proper validation
•
this form constitutes an
encroachment permit CITY OF LA QUINTA
31245 -065 -
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 III
DATE: Dec. 28, 1984 Minor Improvement Permit Class IV
'LOCATION OF CONSTRUCTION Install 193-' of 2" medium pressure PA'plastic gas main;
5' S/NPL of the Alley south of Calle Estado; Beginning 5' W/EPL Avenida Bermddas, _
(Street address or Description of Location) -proceeding east.
PURPOSE OF CONSTRUCTION. Sketch (attacn s;ruct9n plans i�ppropriate)
DESCRIPTION OF CONSTRUCTION SEE ATTAHCEDc�SKETCH TGP 214, D-6
EARTH CUT
DIM ENSIC": CF !NST.-,L!'_ATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 1_11_gR
APPROXIMATE TIME OF COMPLETION 4-11-8R
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:
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 Appli t or Agent
R.L. BAUGHMAN,-DISTRIBUTION_SUPERVISOR
Name of Applicant (please print) Business Address Telephone No.
SOUTHERN CALIFORNIA GAS CO. P.O. BOX. 2200, RIVERSIDE, CA 92516 '781-6106
Name of Contractor and Job Foreman Business Address Telephone No.
z
Contractor's License No. City Business License No.,
Applicant's Insurance Company:. Policy Number ,
FEES: Subdivision Improvement Permit — Class III
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 VALIDATION `
• r
Permit Fee —
PERMIT NO.
Penalty
Cash Deposit -Surety Bond.
if required --
TOTAL: S
Receipt No.
Received by
Recorded by
Date
DATE APPROVED.
i
' EXPIRATION DATE
DATE ISSUED
By
TELEPHONE: (619) 564-2246
Administrative Author