0184NOTE:
�P
With pp per validation
•
A
this fem constitutes an CITY OF LA QUINTAv'�
encroachment permit
' APPLICATION FOR PERMIT -
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)��
SOF fE189
y `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
April 23, 1986 Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF,CONSTRUCTION • FMd Tk1 . inq I)r•
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Tb install 124' Of 319 PA med. Sketch (attach construction plans if ap r`opriate)
nrPsstzre plastic aas main. 22' N/SPL of Fred Waring Eir. be inning approx 3, Dim Wfflm•Of. `
DESCRIPTION OF CONSTRUCTION Chapelton, proceeding West.
DIMENSION OF INSTALLATION OR REMOVAL SEE SKMICii 7117:1 204, !G--6 cur — EAInH•
SIZE OF EXCAVATION; IF NEEDED
APPROXIMATE TIME WHEN,WORK WILL BEGIN 4-18-86
• Y �
APPROXIMATE TIME OF COMPLETION 7-1€3-86
ESTIMATED CONSTRUCTION COST $
Y(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.
R.L. BaughMan, , Dist. S%Ve visor
Signature of Applicant or Agent
Southern California Gas Company P.O. Box 2200 Riverside, CA 92516 (714) 369-4512
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 III '
Public improvements: 3% of estimated construction costs
Private improvements: 3%of.estimated construction costs C.
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee- $ n/a R' PERMIT VALIDATION
Permit Fee, PERMIT NO. 184
Penalty 4-23-86 '
Cash Deposit -Surety Bond DATE APPROVED
11
if required EXPIRATION DATE ' 8-13-86
TOTAL: $ n/a t4-23-86
DATE ISSUED `
Receipt No.
BY '
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form constitutes an ,
encrc. c6inent permit CITY OF' LA QUIN.TA .
APPLICATION ' FOR PERMIT
PUBLIC WORKS CONSTRUCTION .(ENCROACHMENT)
t
Im
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.
pzil 23 1y86 Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION FYed blarlr?n. Gr.
t
(Street address or Description'of Location)
PURPOSE OF CONSTRUCTION 7b install 124' Of 3" PA Ited. Sketch (attach constructionLlans if appr prate)
pressures plasticr..�ts ►rain. 1'
22' IE,l L ;� Its Fred Waring .ginning approx 3T DQ1� W%WPL of
DESCRIPTION OF CONSTRUCTION ^> Chapelton, proceeding IA-st.
_ x
DIMENSION OF INSTALLATION OR REMOVAL SEE SK= IKT 204, 6-6 Ci7r — EAFM3
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN d
APPROXIMATE TIME OF COMPLETION��F0�v. J�
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing •peimanent 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 fromand against any and all
penalties, liabilities or loss resulting frum claims or court action and arising rout of'any—aceident, 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. �x
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 terms7 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.
-V
Signature of Applicant or Agent
c,�;� ,'Amt' P. t3or, 2?_(?0 iZly r.;i,:ie, CIS 92516 (714) 36� 1 -c..-;1.'
Name of Applicant (please print) Business Address Telephone No.
r
Name of Contractor and Job Foreman Business Address Telephone No.
r
Contractor's License No. City Business. License No.'- .
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
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' Date
Recorded by
- . 2 law,
��T��' ®�iAT
4� .L
PERMIT VALIDATION
PERMIT NO. 184
DATE APPROVED 4 23-6
EXPIRATION DATE 5-1J—iiE
DATE ISSUED
By M.
Administrative Authbrity
t
TELEPHONE: (619) 5,64-2246
0
IS
o d , Mll
7
PLAN FILE NO. MA116 SKIlTr"
CONSTR. *XrTCN CONIL. SKETcH
orSHEBT
—
�619
7,q.1w
IFX1267-
C?� ¢ �"Zr 9 IPWIR
40'
4JKr —9Z3;o
I? ow
r- 3-
^0* Ar,
TOTAL FEET INST'D
I L MAIN WITH AT LEAST -----`3 46
COVER BELOW TOTAL FEET RETIRED
low
COUNTY Alil" 5 111-PlIe- WAN RETIREMENT. c PERMIT ISSUED By PERMIT NO. DATE MOVED DATE MOVED DATE OF
ON JOB— OFF JOB OPER
.5 Agr.-Ar
DIST!RIC'rf--:— RE CREW FOREMA
TRACT PLANNED By
NO. COMPANY
..STAKED 0*, -t4YFACfLrrY:.. --SO.CAL.jm P.L-S. 0
A YEAR QF�- - _�qOMPA.
. I ... . REVIE AKING RE
PROTECTED YES 0 NO Cl M.Y.S. VIE d%o- G.
bISTRICT SU'�'C STAKES NEEDED W.O.
ATLAS
- —/w A INSTALLED
CRTHODICALLY OPER.. 1.0%'Oft OVF-R. 0 S� DIVISION
AT LESS THAN 20% WPIRVAGO CLOD
1,77
77; .P:LAN F LE
{' s. t'T C"bNC7~R.'EKEYCH co
PL',.�RH7CM.. yv
1a �t. t, �er=rev. ire S SPIFFY"� Ot`
}f X - a rsr :i iA - _ ".-. .. - .r " r t w t :'... ;..a • T. tn•••a w
Ni Y y
I
79 /r 0
>'..
,y• S fI. -,,..., bs S � �,t � r .r Vii._ _ � •c � ;•.«° -"•� _ "•w
r
k� '� O!.x 1 _ �t � - \ ;:3. � � "t.. - - a F ...r ,i fi.,E a `y v. ., •1d ..
`.. t• . h v. r .AAe- do
F
f ► -.9 d 3 P.ft 6 3%
3
.(� . - ! :{ ^+.f. I a •,rtt _ y'. cit �, �3.
4 .'+,*; >+
kj . -•tr. -�,I,. 4,
'.. �%^.i�f�/� `4 ��,� F I G "• �{/1 I ;" .i :.,f.:
.lam ,t. i � " L`i—• � �-* ` `- '
� + i' * y `' ; a x r+,cy 1 x. • ry' i • w
" _ z
71,
FEET--':INST D
-INSTAL L MAIN WITH AT LEAST , r
TOIi FEET
A r _
COVER BELOW i�'", •RETfRED-
a
3 � �''. -'':. ..::.•y' �::; 1 , - -; >..sa.. .:r• ?PERMIT
-ISSUED BY,` 'PERMIT 3.'
WM - `.RETIREMENT Ci PER - DATE M01/ED h bATE MOVED PATE OF
couniTv, f ; •� , j/..'.: `'y: r x: ' �-
r ' �/ GAJ`
REASON
PLANNED
�. ult*'•�wz•E:ila* r-2 "'� ii 21���'�i� �`i' 4 a l .'
:'t/ -/Y �/t ./�, J i s :'t' YEAR,G,P�
s'�_ LNSTAL.L.ED
IDICAL.LY ,, zdX'ott.
CTED '.YES �:.❑: s' 'NO;" ❑
_ ,. .. 'AT,Y. LHSS THA
SOUTHERN CALIFORNIA' GAS CO: 2956 -IJ
tREV
IE
OVER ❑ ' '/C
N 2o6, F p SMYS.
DIST 'ICT S
< r 7r y0N JOB AFF JOB._,_.,_ . OPER
.p ... t ¢ CREW FOREMAN -
z •tiT I COMPANY
fYt,
COMPANFACILITY „ r 35a; CAL PLS, ❑
TAKLNG REQ`D', [J"' 4 DIVISION ��
� NO STAKES NEEDED W.O. �`-^, CODE
APR
.NTA
I this form constitutes an - 'CITY OF LA QU
encroachment permit
CITY OF LA QU I NTA COMMUNITY DEVELOPMENT DEPT
APPLICATION FOR„PERMIT _
PUBLIC , WORKS CONSTRUCTION (ENCROACHMENT)
For the construction W 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 I11
DATE: - APRI`L 11; 1986 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Fred Waring Dr.
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION TO install 124' of 3” PA medium Sketch (attach construction plans if ap ropriate)
pressure plastic gas main, 22' N tSPL of -Fred .Waring. Dr.., i�fining approx. 331' W/W�L Of
DESCRIPTION OF CONSTRUCTIONChapelton; Proceeding West.
See Sketch, TG.P 20% F=6 CUT -EARTH
DIMENSIC": CF !!`.'ST:,LLATION OR REMOVAL
MIRECEIVED
SIZE OF EXCAVATION,.IF NEEDED APR 1 196
APPROXIMATE TIME WHEN WORK WILL BEGIN 4-1$'86
COMMUNITY DEVELOUINTA
PMENT DEPT
APPROXIMATE TIME OF COMPLETION 7-18-86
ESTIMATED CONSTRUCTION COSTS.
(Including removal of all obstruction, materials, and defiris, backfilling, com- .
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the .appiicani. 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 gramed pursuant to this appl:cation.
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...
$igna)tureBO AV' fffiBUTION SUPERVISOR
SOUTHERN CALIFORNIA GAS COMPANY, P 0 BOX 2200. RIVERSInF, CA 92516 714-369-4512
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 111
Public improvements: 3% of estimated construction costs, :
Prit,et_ imprcvernents: 3%.uf estimated ccnstruction costs
Minor Improvement. Permit — Class IV: See attached schedule
Inspection Fee S_ _ H PERMIT VALIDATION
Permit Fee —
Penalty
Cash Deposit -Surety Bond
if required --
TOTAL: S
Receipt No.
Rec-ived by Date .
Recorded by
PERMIT NO
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
BY..
Administrative Autho:
TELEPHONE: (619) 5642246