0146 (2)4
*• 0. 0•
r validation
m constitutes an CITY OF LA QUINTA
roachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS .CONSTRUCTION (ENCROACHMENT)
59
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
. Au st 9, 1985 Subdivision Improvement Permit - Class III
DATE: Minor Improvement Permit Class IV X
LOCATION OF CONSTRUCTION Avenida Navarro
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Gas Main Installation
DESCRIPTION OF CONSTRUCTION Install 220' of 2"
PA medium pressure gas main
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN August 16, 85
APPROXIMATE TIME OF COMPLETION Oct.. 12, 85
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent .resurfacing and/or replacing improvements)
Sketch (attach construction plans if appropriate)
In consideration of, the granting of this permit, the applicant hereby agrees to:
NOTE: All conditions applicable to
Permit # 136, issued to
So. Ca. Gas Co. apply to this
permit.
So. Ca. Gas Co. W/O #31245-650
CONRETED
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 leasti 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 his work.
Signature of Agp1 cant q�Xgen
blacco Const. Inc. P.O. Box 783 Palm Desert, CA 92262 343-1180
Name of Applicant (please print) Business Address Telephone No.
sam
Name of Contractor and Job Foreman Business Address Telephone No.
259619 A & B
Contractor's License No. City Business License No.
Travelers Ins. Co. TRSLG 173T 795—A-85
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III ENTERED NOV 2 5 1985
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
$ 17.60
10.00
$ 27.60
Date
N 146
PERMIT VALIDATION
PERMIT NO. 146
DATE APPROVED 8-9-85
EXPIRATION DATE —3 1-85
C
DATE SSUE o
LEj:4
By
Administrative Authority
TELEPHONE: (619).564-2246 -