0196 (2)�s s
;;,NOTE:-
Will
OTE: With proper validation 04
this form constitutes an
encroachment permit CITY OF � -LA QUINTA-
' APPLICATION FOR PERMIT
` PUBLIC WORKS :CONSTRUCTION (ENCROACHMENT)
OF 'r
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 -
•,
Maj(. 20l¢ 19$6 Subdivision Improvement Permit. Class III
DATE: Minor Improvement Permit Class IV
'LOCATION -OF CONSTRUCTION To •install,"$01 of 2" PA redium pressure plastic qas mein, 10`
14". W/EPL of Avenida Obrec on„' beginning 30' S/SPL of . Calle aisenada, proceeding North.
_ (Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction tans if
• � p appropriate)
DESCRIPTIOMOF CONSTRUCTION See Sketch Cut—Earth and Mac' `
Work No. 31246-536
DIMENSION OF INSTALLATION OR REMOVAL•
SIZE OF EXCAVATION', IF NEEDED `
APPROXIMATE TIME WHEN WORK WILL BEGIN 5-23-86
APPROXIMATE TIME OF COMPLETION 8-'23-86 ,
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials; and debris, backfilling, come '
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 Ord inances,`,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, Distribution Supmbisor..
• - Signature of Applicant or Agent
Southern California Gas Ccn=ny P.O. Box 2200 Riverside, CA 92516,(714) 389-4512
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. g
t
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 $ NSA PERMIT VALIDATION
Permit,Fee PERMIT NO. 196. ,
Penalty ”
Cash Deposit -Surety Bond •
DATE APPROVED - 5-20-86 -
if required EXPIRATION DATE, 9-23-86
TOTAL: $ 5-20-66 '
DATE ISSUED
Receipt,No.
By
Received by Date Administrative Authority
Recorded'by' TELEPHONE: (619) 564-2246
31246-536
•
MAO 1985 .
CITY OF LA pUINTA
NOTE: -COMMUNITY DEVELOPMENT DEPT
.
With,p roper validation
this form constitutes an
encroachment permit 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 II I
DATE. MAY 16, 1986 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION To install 80' of 2" PA medium pressure plastic gas main, 10' & 14'
W/EPL of Avenida Obregon,.beginning 30' S/SPL of Calle Ensenada, proceeding North.,
(Street address or Description of Location) TGP 224, C-1 SEE SKETCH CUT -Earth ' & MAC
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSIC OF !NS?:.LLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 5-23-86' '
APPROXIMATE TIME OF COMPLETION_ 8-23-86
ESTIMATED CONSTRUCTION COSTS
(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 Ouinta and to pay for any additional replacement necessary as the result of this work.
Name of Appiicant (please print) Business Address
�4)369E45120R
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: 390 of estimated construction costs
Private -improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee S _ _ PERMIT VALIDATION
Permit Fee — . PERMIT NO.
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
--
S
Receipt No.
Rer-ived by
Date
Recorded by
DATE APPROVED
EXPIRATION DATE
DATE ISSUED 5 mad -8�2
By
Administrative Autho:
TELEPHONE: (619) 564.2246
PLAN FILE NO. I BABE SKETCH I CONSTR. SKETCH I COMPL. SKETCH I ♦'k
er, ' en er: SHEET / OF
/_<z T 1 14,17�E J GUT r_ �/E_T •33�4� >� G
zz
!TGA.
E+ • i • L�,. '._ � i 1 i lii j, 4 1 � : ' i .� r t I^
L.
,
3 x
f—` i .' i i.—� ! �� ` f i { ?-1 1 .• ,—S 3 '__ ' i IT -/; A ; f^t '
' � 1 � . i '. I 1 •. ` �.'._f ' -� t. f 't� } I y � � \ ! .` �- .1. � - `� �f - ,.. �...t_ i t � I � l � � �/% G� � k i ' .1.. -..
J- aDi ' -� - i _•f ' 1 r 1 _�.,�0.
i f I ; r i- ., _, r� L t, _.I-_; ' _ o - \ 1 - . I ._.;. i•. ... }. :... , � i '_ 7 .S-..1LF _..
41,
7- -I t _ :� F'l• I '1 I � � � i- ( F i � ._. .. i ., - f •' ... i_, Y� 7
_ 3/249 -924' 2 'o.✓�> 8=79 3/2 49 - 7/9
x
_� i k ! '/1°A/y
T 5 ' } Q f -. ` f• r..�, ., _ } .J _.i ; 7• f {, �_,.' s . fi +�. } - (1 { I ` ' - ,Q - I j
. :- � � '� l�,c�it!/Uig, � k .i � ' . �''_ � k 1 •�I t ._ �f '•-.'�: IF�i . •' - • O•� �ZEG.DN � � ; 1 �t .
•
, .
•:
r
7 T S
1. J..*_.�. {
• _.y � { ... _, � 1 j ! er � a _. f. `1 ._ , 'i .7 T'i f�O/4 L -O �-� !•/�/7// '�D /�'', �/�� �'
- r -F r , + ! , - ��,-� � � 1 1 } � 1 , � •- :v ! � - ,Tt� ' .�vo/O .�XsT. �•ot��: T.��ES
= ',. ., ` i r-. ._IY .moi...: y _ . }• F .. , Ed
.. ' I .7._; - - • .I.. i ,�' 7 i �-..F�' i ` � '`. � f '/� V 1. -sLI .1 .j .,c 1 +
� L � l � i . l I i i- r'' _ 1 � - � O I 1. ._ � ' � .... :•-.>�:..1 : - - _.r .—• r . - •
! j -1 ' j ,� .�� •±' ' �/' . `` y� [C• ' _. t �. TOTAL FEET-,INST'D
INSTALL MAIN WITH AT •LEAST + 3 COVER BELOW �^ ' i' TOTAL FEET RETIRED
PERMIT ISSUED BY 1 7 PERMIT,NO. I - i DATE MOVED, f DATE MOVED DATE OF
xiWM �.�RETIREMENT. A G L /tI I t l
COUNTY /••� /tl III' -� ! { �� /Yjiry r ? j _ - lON JOB OFF JOB OPER;
DISTRICT 17E' S'.h /-lf �f' �• tREASON` •� I i ' !CREW FOREMAN
TRACT; PLANNED BY:^ {. .. ".l _! ; I F tCOMPANY
NO -I-'+ t STAKED:i ;--' �{ i ❑ !C_OMPA_NY FACILITY: SO. CAL. [,� IP.L.S.
• < y ,� r < y .. A
ATLAS.' .2�� T /.^a - -{- YEARCP r-; 1 REVIE BY - �' -' S..TE�Q�1/
NO. `f' INSTALLED , c T
,._,STAKING REO'D' •, ;"❑' j DIVISION �`" i''"
-,..'NO.
, ! .OPER:,,;120$ OR OVER , ' . ;,❑ ORG.
PROTECTED ° 'YES Cl- . NO ❑ AT : 'LESSTHAN209e! ❑ S.M.Y.S.• o15T T SUPE oR ' ,S3G� '
NO STAKES NEEDED W.O. CODE
mm
co ci
- �/ TOTAL FEET INST'D
INSTALL MAIN WITH AT LEAST_,_, '" "COVER BELOW �^/f� Is� TOTAL FEET RETIRED
-PERMIT
. •COUNTY
DISTRICT
TRACT
NO.
RETIREMENT A `
- �
REASON
-
ISSUED BY
L /Y //7
PERMIT NO.
�
DATE MOVED DATE MOVED DATE OF
ON JOB OFF JOB OPER.
..
CREW•FOREMAN
_ - -
COMPANY
PLANNED BY
ro�Vy.•
STAKED ❑. -
STAKING REO'D ❑
NO STAKES NEEDED
-
COMPANY FACILITY: SO. CAL. I� P.L.S. ❑
E/¢ S.TE/Q/V -DIVISION
// DRG.
W.O. �1 ? A t, r '' 3 CODE
ATLAS ,f
NO. L-~ - /
YEAR C.P.
INSTALLED •__
OPER. 20% OR OVER _ ❑
AT LESS THAN 20y. ❑ S.M.Y.S.
REVIE BY
/d�L M�
" CATHODICALLY
PROTECTED YES ❑ NO Cl
DIST T SUPE OR�
SOIITHiRN F:Al I-PNIA rAG (. rf