0238NOTE:..
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
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: December 4, 1986 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Within the paved and earth sections of various Ta Quinta streets
within the dies of S.. Ca. Gas Ccopany operating areas.
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION BL'r PERMIT Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Maw• and recairs of
,exi sty i nQ 11T) ex_ rotmd emAr me nt and installation
DIMENSION OF INSTALLATION OR REMOVAL Not more than 80
I in_ feet .excavated under blanket permit..
SIZE OF EXCAVATION, IF NEEDED 4 x 4 bellholes and installation
of r mo .re"ri c
APPROXIMATE TIME WHEN WORK WILL BEGIN NOT'IF'Y CITY 24
hnnr%% in ATA ANrP [)F' MTY kr
APPROXIMATE TIME OF COMPLETION Permit expires December 1987
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
In corisideration 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.
9
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. •aye ..
y t�=
��. .T.M. Snvder- (Sian. on file)
Signature of Applicant or Agent
Southern California Gas Company P:O. Eox.2200 Riverside, CA 92516 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 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 $ n/a
Permit Fee
Penalty
Cash Deposit -Surety Bond.
if required
TOTAL: $
Receipt No.
Received by Date
PERMIT VALIDATION
PERMIT NO. 238
DATE APPROVED 12-4-86
EXPIRATION DATE December .87
DATE ISSUED 12-446
By
Administrative Authority
Recorded by II TELEPHONE: (619) 564-2246
BLANKET PERMIT FOR 1987
NOTE:
. With proper validation
this form constitutes an
encroachment permit
Np • ���
_. .. COMM�Nr � pfVEDEPT
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 publicworks improvements in, connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class III
DATE: -NOVEMBER 21, 1986 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION VARIOUS STREETS IN THE CIYT OF -LA QUINTA `
(Street,address or Description of Location)
• PURPOSE of CONSTRUCTIONTO MAINTAIN AND REPAIR GAS LINES. Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION TO CUT 4 X 4 BFLIHOIU AS
NEEDED.
DIMENSIC OF !:"'ST,,Ll:ATtON OR REMOVAL •
SIZE OF EXCAVATION, IF NEEDED t
APPROXIMATE TIME WHEN WORK WILL BEGIN•IANIIARY 19R7
APPROXIMATE TIME.OF COMPLETION DECEMBER 1987
ESTIMATED CONSTRUCTION COST S
(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 applicant. hereby agrees to: .
Indemnify, defend and save the City, its authorized agents, officers, representatives and ertiployees,'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 personsyor orooerty
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 124) 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...
Si nature of Applicant orOAgent
�DISTRIB.UTION. SUPERVISOR
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°b of estimated construction costs
Private improvements: 3% of esiimated construction costs
Minor Improvement Permit'— Class IV: See attached schedule!! _
Inspection Fee S_ _ PERMIT VALIDATION
Permit Fee —
Penalty
Cash Deposit -Surety Bond
if required --
TOTAL: S
Receipt No.
PERMIT NO.
-DATE APPROVED '
EXPIRATION DATE
DATE ISSUED
By
Rec-ived by Date Administrative Autho:
Recorded by TELEPHONE: (619) 5642246