0517'J4o-+.�-w•s=.o•.•a.L+:+-a.a;a••r-•-�.o • �,<^-,^y3'-•!-'•?'^.•'is'•�'^a!"'•�,.-+..•••,.•— ,...y,.._... K..�,�,.. ....r.t.�..-..y..�,.—�.....,..,,..-..w.r--..--.�....,••-.r,.�,.�7.. .;,,,.�., �..
NOTE:
With proper validation' "' t Q•
_ .b ,� y , , { ' • . ` ., :�' � �,.' O�
this form constitutes an
CITY O
encroachment permit F. LAQUINTA
.
53440=225 '
APPLICATION,FORT PERMIT.
PUBLIC WORKS CONSTRUCTIOWIENCROACHMENT)
• " f . . , ,.• Y• i� "t't fir . r _ � .:, rJ. F , � �y'r" s y j t`�•'i' y, f �OF Y
For the construction of ,public or. private •curbs,- driveways' pavements,.tsidevvalks' parking lots; sewers,water,main
;and other like public woks improvements. in'"connection with MINOR.IMPROVEMENTS•and APPROVED SUBDIVISIONS',
' a ' Subdivision Improveinent.Permit = Class III
DATE: ,. March "6 ,1 , 1990 r r `- ' Minor Improvement Permit Classy ,
r LOCATION OF CONSTRUCTION" J• YAty'ean 4.Aa �Rth4 i; arr'•iUfr►rn•�.n•9r,s�` zaff aM11 R! i + a' ` l
. ' . ,. _' ••� !� rl•1 1 - •mow A 1
x.' r (Street address or'Description of, Location)
;.to `install new gas : main.; , '' • '' . • �� ; . ,..
`.� PURPOSE OF CONSTRUCTION ` `' Sketch (attach construction plans if appropriate)
DESCRIPTION OF.'CONSTRUCTION ' '' _; ~ to. in&s'j&11 " x.17 ' .'o'f 2" medium
pressure pl`astiC gas main.' 15 -
W/EPL off` -Avenida Rubio, '
DIMENSION OF INSTALLATION OR REMOVAL beginrining 15!:. S/NPL of '..
Montezuma AVe. , 'proceedli g' north'
'~ SIZE.OF EXCAVATION, IF NEEDED -
'See .SKETCH .TGP .214 'C6 ;Cut Earth
APPROXIMATE TIME WHEN WORK WILL BEGIN •! /1 -7 �QM ' r. �'•• r. `• 1
APPROXIMATE TIME OF COMPLETION 115/7/00
ESTIMATED CONSTRUCTION COST
Aincludtru
ing removal, of.all,obsction; materials, and debris, backfilling; corn-
' paction and, placing permanent resurfacing, and/or replacing improvements). -
In'consideration-of'the granting of this permit, 'the applicant hereby agrees to: Y - - ,• k, ' _
a�r• •. il,ndemnify,•defend and save the City, its authorised agents, officers, representatives,and employees; harmless from and against•any'a, all
'penalties,` liabilities or loss resulting from claims or .court action. and arising out,of any accident,,loss or damage to persons -or,
j ; • happening orccurring as.a proximate result of any work Undertaken'under•the,pe�mit'gransed-pursuant to this application. k' ,•
�' • Notify the Administrative Authority at least•twenty-four (24) hours in 'advance.' f' the time when work will be started.-','
't i Comply-with,all a applicable Cit • Ordinances, the terms and conditions of .the ermit and'all a r licable rules and re •ulations, of. the!Cif of • '+
PP. Y P PP 9 Y
La Quinta and to. pay for any additional replacement necessary as tit a result of .this, work.. ` •. ! a`, , ' ,'
J M: Snyd r.; DI i
e istributizon ; Sug®rvsor``
-,.<`
Signature of,,Applicant ir•Agent
Southexn Cali£o"rn3-a Caa C`!� , PO Rnx 1R(1� 6-4 'CA (a�'t�a' `j'�id\
NarTe'of Applicant (please print) Business Address } . �• i. 4;,Telephone No:
W
Name of Contractor'and Job'Foreman _ �y. BusinessAddress Telephone+No.*.. _
Contractor's License,No: r + .' City Business License No: - ; A. `
1 "Applicant's Insurance Company Policy Number '
FEES: ' Subdivision Improvement Permit — Class I II
Public„improvements.' 3% of'estimafed construction costs
Private improvements:: 3% of estimated construction costs }�� *� -
Minor Improvement Permit — Class IV: See attached schedule . _ HN2 0 `
Inspection,Fee'PERMIT VALIDATION
Permit Fee ' 4•'' PERMIT NO. J 0517 ,.
♦. 4r
Penalty. rr _ 3/6/90'
Cash Deposit -Surety Bond
�.. DATE APPROVED
if required EXPIRATION DATE.- 9/30/90 • - :
1
TOTAL: $ —0 - DATE ISSUED 3/6/90
Receipt -No. By—
Received by Date l 'Administrative,Authority
Recorded by TELEPHONE: (619) 564-2246
3
0..e i4 ir` .� .ai.4i, F" i ..-.-:
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•�
I
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
53440-225 PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
F'
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: March 6, 1990
;.g .. ` Y .
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION -- A1rpni dA Riahi n AnA Mny►+•ro*,„na il,ycay,,,rc
(Street address or Description of Location)
to install new gas main
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
to infja&ll 117' of 2" medium
pressure plastic gars main 15,
W/EPL of Avenida Rubio,
DIMENSION OF INSTALLATION OR REMOVAL beginnning 151 S/NPL ofMontezuma AVe.., proceeding north
SIZE OF EXCAVATION, IF NEEDED See SKETCH TGP 214 C6 Cut Earth
APPROXIMATE TIME WHEN WORK WILL BEGIN 1117140
APPROXIMATE TIME OF COMPLETION
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.
J.M. Snyder, Distribution Supervisor
Signature of. Applicant or Agent
Southern California Gas Co PO Box 3003 Rpolardg . C.A. (0173 .171 41 334-77x2
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.
r
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 y C
r Minor Improvement Permit — Class IV: See attached schedule
�� J
Inspection Fee $ —�—
PERMIT VALIDATION
Permit Fee PERMIT N0. 0517
Penalty 1 3/6/90 t
Cash Deposit -Surety Bond DATE APPROVED
if required EXPIRATION DATE 9/30/90
TOTAL: $ _0 DATE ISSUED � 3/6/90
Receipt No.
Received by Date Administrative Authority
Recorded by
TELEPHONE: (619) 564-2246
The following General and Special Provisions are attached to and made a part.of Permit No. v -
s 4 d GENERAL PROVISIONS „
' The following shall always apply:. + }
ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within City of La Quinta rightof way
ONLY. Whenever, construction extends within private property, it shall be the responsibility of the permittee (or his contractors)to
secure permission from abutting property owners. Such authorization must be secured by the permittee prior to starting work.
`" ' ' TRACKLAYINGCONSTRUCTIONEQUIPMENT: Cleated tracklaying constiucti 6n equipment shall not be permittedtd operateonany
paved surface unless fitted with smooth-faced street pads. All mechanical outriggers shall be fitted with rubber street shoes to protect
i . the paving during excavations.' Rubber-tired equipment only shall be used in backfill operations in paved areas. If the existing
pavement is scarred, spalled, or broken during the term of this contract, or if the pavement is marred, City of La Quinta shall request
y that these portions of road be resurfaced over their entire width. Resurfacing shall consist of one coat of two inches (2") of A.C.
Y surfacing plus appropriate seal coat as specified above.•
y ' t PROTECTION OF TRAFFIC: All excavations and work areas shall be properly lighted and barricaded as deemed necessary by the City
'Engineer or La Quinta City Public Works Inspectors: Suitable detours and detour signs shall be placed and maintained for the duration
of the project. The City shall be notified 24 Hrs. iri advance of any traffic detours or delineations.
CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete pipe, steel culvert and
�y'' • • ` t,r concrete structures encountered during excavation which necessitate removal shall be replaced in'kind. In the event.it becomes
• t- necessary to remove or cut existing drainage structures, City of La'Quin ta shall be notified prior to commencement of this work.
' Drainage structures and open drains shall be kept free of debris at all times for proper drainage.
RIGHT OF WAY CLEANUP: Any surplus material resulting from excavation.and backfill operations shall be removed from the rightof
+� way.'All paved surfaces shall be broomed clean of earth and other objectionable materials immediately after backfill and compaction.
Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shall be removed
prior to paving. Water.tanker shall be used,.as required, to sprinkle the job site to keep down dust conditions and shall be used
immediately after backfill.
< DE-WATER OPERATIONS: If de-watering operations are required and pumps are forcing water on City of La Quinta roads, it shall be
the responsibility of the permittee (contractor) to control this water and to provide off-street barricades when necessary.
xCLOSING STREETS: No street shall be closed. A minimum of one lane of traffic shall be maintained at all times to provide limited
* access for the adjoining property owners and emergency' vehicles. In the event it is felt by the permittee that he must close a streetfor
any length of time, permittee shall contact this office to obtain the necessary permission.
s SPECIAL PROVISIONS
The follwing shall apply ONLY when indicated:
R1 OTIFICATION: Permittee shall notify the City at 564-2246-0at least 48 hours in advance of starting construction.
• R2 CASH DEPOSITS OR BONDS: A cash bond or an approved surety bond in an amount of not less than $
shall be furnished in the name of City of La Quinta to cover all work involved in the restoration of the various La Quinta
L roads and survey monuments. This bond shall be continuous until cancelled by the City Engineer. This bond must be
posted prior to commencement of any work on this project .
• .�, I �
i R3 ILITY CLEARANCE:ISubstructures) Prior to making any excavation within the City of La Quinfa right of way authorized
by permit, the permittee shall contact all concerned utility companies relative to the location of existing substructures.
" Damage to existing substructures resulting from operations conducted under this permit shall be the sole responsibility
of the permittee.
R4 UTILITY CLEARANCE: (Surface structures) No work shall be done under this permit until all utilities are clear of the
proposed work site. The permittee shall notify all concerned utility companies of the proposed work.
R5 ,PAVEMENT WIDENING: Area between the proposed concrete gutter line and the existing road pavement shall be
's `surfaced with inches of A.C. paving placed on inches of class aggregate subbase course
t' having an"R"valueofnot less than and inconformancewith City ofLaQuinta Road Improvement Standards
" and Specifications, Ordinance #461. r
R6 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of
1 /4 inch to one foot (1').
R7 .GRADES & STAKES 'City of La Quinta shall establish grades and stakes for the proposed concrete curb and gutter
~' construction.
R8 GRADE CHECKING: City of La Quinta shall check grades upon receiptof plan and profile and/or grades asestablished by
• a licensed engineer. ' A. - I ' •
R9 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( feet)shall be
removed. Curb and/or curb and gutter shall be saw cut prior to removal. Depressed curb, matching concrete gutter and
-t concrete driveway approach shall be constructed in conformance with City of La Quinta Standard #207.
R10 DRIVEWAYS; A:C.: Driveways shall be-constructed as not to alter existing drainage pattern. Surfacing between the
property line and the'existing road paving shall be 2-1/2 inches of A. C: paving placed on ( "! of class _
aggregate base. Driveway construction shall conform to attached drawing. 1
a
'R11CULVERTS:A inch diameter( )culvert shall beinstalled lwith the invert approximately 1-1/2
inches below and in line with the existing flow line. Culvert installation shall'conform to the attached drawing.,
R12 SIGHT CLEARANCE: Sight clearance of 600 feet in either direction shall be assured and maintained..
R13 'SOIL STERILIZER:.The area to be surfaced shall be Treated with soil sterilizer. Rate of application shall comply with the
j manufacturer's specifications. r
a R1 COORDINATE WORK: The proposed work shall be subordinated to any operation which the State of California or
City of La Quintamayconduct in this area during the period of thi's permit. Work shall be coordinated with the State or
e-',r•' „ k City of La Quinta forces to preclude delay or.iriterference with State or City of La Quinta projects.
SURVEY-MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the
R15
v. centerline of all streets or property lines when involved shall be completely tied out so they may be readily and correctly
• • be replaced by a licensed civil engineer or surveyor at the expense of the permittee. A complete set of notes showing the
. r ties to these monuments shall be furnished to the City Engineer prior tothe removal of any monuments. This office shall
:. be notified upon completion of replacement of,all survey monuments for proper project clearance.
RD-31 ,
R16 VEY MONUMENTS: Prior to excavation or beginning of a ction, all survey monuments shall be tied out by,City
3 Quinta and suitable payment or guarantee of paymen. _.. .. be made as reimbursement for all work involved.
R17 PAVEMENT CUTTING: Pavement will be mechanically cut to a straight edge prior to excavation. Method of pavement
cutting shall be approved through the office of the City Engineer. (Under no circumstances shall excavating equipment
be used to excavate prior to cutting of pavement). Excavation material shall be placed in such a position as to best
facilitate the general flow of traffic. Prior to final paving operations, any damage to pavement straight edge shall be
corrected.
R18 PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations, any damage tc
pavement straight edge shall be corrected.
n19IMITOF EXCAVATIONS: Excavations shall be limitedto 1,000lineal feet of open trench before backfill operations must
egin. All excavations shall be properly barricaded with lights overnight, on weekends and holidays for the protection of
the traveling public. The Public Works inspector shall determine the suitability of excavation barricading in each case. No
excavation shall remain open for a period exceeding five (5) days. No excavation shall be made unless the construction
material is actually on the work site.
R20 BACKFILL MATERIAL: Backfill shall be free of brush, roots or other organic substance detrimental to its use for purposes
of producing an adequately consolidated backfill. Any material which the City of La Quinta deems unsuitable (spongy or
saturated material) which is encountered during excavation shall not be used for backfill, but shall be supplemented or
replaced by an approved sand or gravel.
R21 BACKFILL SAND: Backfill shall be approved transit -mix sand or equivalent and shall be placed in lifts of notgreaterthan
three feet (3') and vibrated using vibrotamper or equivalent equipment. Alternate methods may be substituted, but in any
case a relative compaction of 95 percent shall be attained within the structural section of the roadway.
R22 ACKFILL PLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench
—before flooding or a maximum of five-foot (5') lifts where trenches are of excessive depths. Care is to be exercised that the
backfill material is not subjected to extreme swell by flooding operations. Backfill material shall be placed so that the
resulting compaction shall be not less than 90 percent or equivalent to the surrounding ground, whichever isthe greater
compaction. Where ponding or flooding is used for a maximum settlement, adequate dikes will be constructed to retain
the water. Where jetting is used, the jets shall be of sufficient length to reach the bottom of each layer and the water
supply shall be continuous.
R23 COMPACTION TESTS: If so required bythe inspector, compaction tests shall be made at intervalsof not more than 1,000
eet and a minimum of one (1) test on each road. One (1) copy of each test shall be forwarded to the City Engineer for
approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Section 6.3.01 of the
Standard Specifications, Division of Highways. State of California, dated January 1973.
R24 OMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line.
ne (1) copy of each test shall be forwarded to the City Engineer for approval and filed prior to making permanent repairs.
Compaction tests shall be made asoutlined in Section 6.3.01 of the Standard Specifications, Division of Highways, State
of California, dated January 1973.
R25 TEMPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporary patch
consisting of 2 inches of SC -800 shall be placed on a prepared subgrade. The SC -800 temporary paving shall be placed
atter a maximum of 3,000 lineal feet of trench has been excavated and backfill operations completed, but in no case shall
the placement of the temporary pavement exceed a five (5) day limit.
R2 ERMANENT PAVEMENT REPAIR: After backfill and compaction operations have been completed, a temporary patch
consisting of two inches (2") of SC -800 shall be placed immediately. A permanent patch of inches A.C.
surfacing placed on a inch class base shall be placed no later than days after completion of
temporary road repair. D � � i J
R27 PAVEMENT REPAIR: F.A.S.: Upon completion of backfill and compaction, a temporary patch consisting of two inches (2")
of cold mix paving (SC -800) shall be placed immediately. A permanent patch of three inches (3") of A.C. surfacing shall
be placed on six inches (6") concrete base as directed, but not later than fifteen (15) days after completion of temporary
paving. Concrete base shall be of five -sack mix and shall conform to the City of La Quinta Road Improvement Standards
and Specifications, Ordinance #461.
R28 FOG SEAL: A fog seal coat consisting of an application of asphaltic emulsion shall be applied over all patch areas as
determined by the City Engineer.
R29 SEAL ARMOR COAT: A seal coat consisting of an application binder and screenings shall be applied on all patch areas
where such seal coats existed prior to issuance of this permit. Seal or armor coats shall be applied as specified in Section
37, Standard Specifications, State of California, Division of Highways, dated January 1973. Work of pavement repair to
be accomplished by a licensed contractor engaged in the business of pavement repair.
R30 STREET RESTRIPING: Where street striping is still visible on streetsto be excavated, such striping shall be replaced upon
completion of permanent repairs.
R31 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quinta road right of way shall be accomplished
by a licensed, bonded and insured tree service, and handled safelywithout interference or hazard to the traveling public.
It shall be the responsibility of the permittee to maintain the tree in a vigorous growing condition at its new location.
Trees to be removed shall be removed in sections which can be handled safelywithout interference or hazard to highway
traffic. The entire width of the tree stump shall be removed and disposed of so that no debris remains in view of the
highway. The stump hole shall be backfilled and thoroughly compacted as specified in the following paragraph. Where it
becomes necessary to restrict traffic, the work shall be restricted to a maximum of 500 feet at any one time. Adequate
signs, flagmen and/or barricades shall be provided to protect the traveling public at all times.
Large holes resulting from tree removal shall be backfilled and compacted to not less than 90 percent or equivalent to the
surrounding ground, whichever is the greater compaction as determined by the impact or field method. Compaction
tests shall comply with Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated
January 1973.
R32 TREE TRIMMING:
a. Only the necessary trimming shall be accomplished to provide clearance of the facility for one calendar year.
All broken or weak sections within the trimming shall be removed.
b. Where it becomes necessary to restrict traffic, the work shall be restricted to a maximum of 500 feet at anyone time.
Adequate signs, flagmen, and/or barricades shall be provided to protect the traveling public at all times.
c. If tree trunks are partially outside of the City of La Quinta road right of way, permittee shall make his own
arrangements with adjoining property owners for consent to the trimming in addition to the authorization provided
by this permit.
d. All tree trimming on EVERGREEN TREES, PALM TREES, and other ORNAMENTAL TREES shall be accomplished to
the satisfaction of the City Public Works Inspector.
e. Abutting property owners shall be contacted, in all instances, prior to trimming or topping trees.
I. Pruning shall, in all instances, be at the shoulder of the crotch to insure even, fast healing in all cuts of two inches
(2") and above in size. Sealant shall be applied to all cut sections as directed by the City Public Works Inspector.
r`
= ;`ADDITION -Y= -ENCROACHMENT PERMIT NO.0517-=.--CONDITIONS'• Y
R33--
Survey 'shall' be i or jr
morium s protected . n Pp e
F
`re-established' pursuant',to City standards- and the, State' of r
-California Land' Surveyor's Act. ;
R34
Work shall` be coordinated 'with the `City of La _Quinta's
forces: ,to --preclude delay, or interference with 'the City of La ..
'
Quinta's projects.
Contractor shall comply with the local noise ordinance and
_R35
f---
construction-operations.and maintenance•of:equipment within
' :.
,
one half mile of. human occupancy sh'al'l 'bei.performed only
during the time'periods,-as follows: 4 "'
October 1st to April 30. Monday -Friday 7:00a.m.r5:30p.m.
Saturday - 8:00a.m.-5:00p.m.`
May'lst to September 30. Monday -Friday 6.�60a:m:-7:00p m..
`.
Saturday',.- ,8:00a.m.-5:00p:m.
Work `shall be -prohibited" anytime 'on', Sunday and' Federal
ho l iday. a �•:^r-
• R36 �;
Traffic control:.shall be as per Cal.rTrans .'.Traffic'. Manual::
; :
.
Field: adjustments -in detouring'•shall be accomplished as,
directed" in .order to adjust to actual field !conditions. • ,It
shall -be the •contractor's, responsibility. to., adequate `
barricade ,and detour this site.` A' Traffic, control wplan shall '
be,submitted for approval by the City..Engineer'. `
R37j
•"•A11 excavation -ata or near the '-travel way shall '.be backfilled
.at, the,�end of .the work. day, fo'r,.the*` rotbction * of the,
traveling 'public. ' :v
R38`
Street; ,closures shall not be allowed 'at .ariy time.
• R39
A minimum of, one travel lane shall be'maintained 'at'•all'--
r
times~with flagmen during working hours. `
-- R40
�
;. �; .
All -'work .to be performed' within -the existing paved section
`
shall.be temporary paved and maintained"�tby the Permittee;
permanent pavement shall be,placed no later than 15 days'
' _ r
after completion of, -the temporary road repair.
R41
Ingress and egress for•local properties`shall be maintained
at all times.
R42
Prior , to ',I,work r starting;, Underground -Service Alert shall be"
contacted at''l-800-422-41'33 and`•an ."inqui'ry number"', shall` be
provided to the City Pub.lic�Works Inspector.
R43
Pavement "shall be sawcut.prior to removal.
y
" R44
All backfill ,'subgrade soil .shall be .compacted to` nothing,
less than 900 relative dry density; all backfill soil within
`"the ,top 2! -'.of .finish -pavement, surface shall be- compacted to ,
,nothing -less• than` 95 0 •relative dry density, all base rt
r
material -shall be coin acted to nothing 'less:,than. 95 0
P g -
t
- relative dry density.
R45
Replacement pavement sections - shall- be. 3" AC over 4" Class
'
II,aggregate,,base: ".
....
,n.
r
1
SOUTHERN CALIFORNIA GAS CO. -2956.3J.
TOTAL .F E ET I N ST' D.
INSTALL MAIN WITH AT LEAST �� . COVER BELOW �- X iST S%�. TOTAL FEET RETIRED
PERMIT ISSUED BY*,
PERMIT NO.
DATE MOVED- DATE MOVED •DATE OF '
'
_RETIREMENT•
r"
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ONJOe OFF JOB OPER.
COUNTY
••
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-
`-CREW
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ILam/11_ �U I i•.�.,�
l"
-
..
�
FOREMAN
-
DISTRICT
REASON
- ,
; TRACT .. ��-�
rr ..
PLANNED BY -
, ,.
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COMPANY --
STAKED ❑
COMPANY FACILITY: SpO.C.A�L!.' P.L.S. ❑..
�.
NO.
F.
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./ CKI n�So �./A
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ATLAS rJD 0 -
NO.-
FEAR C.P:
INSTALLED
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STAKING REQ'D. ❑
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�•>� �' DIVISION
..
REVIEWED •.
opER. lox oR oVER ❑
- S.M.Y.s'
CATHODICALY
YES ❑ • N6'-0 •.
. r��(%�
+- - - •
Cl
ORG. -
W.O. ��O � CODE
'DISTRICT -SUPERVISOR
PROTECTED i
AT- LESS THAN toy. ❑.
NO.STAKES NEEDED
1
SOUTHERN CALIFORNIA GAS CO. -2956.3J.
53440-225
NOTE:
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 111
DATE: 03/02/90 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Avenida Rubio and Montezuma Ave.
(Street ad0rsss or Description of Location)
PURPOSE OF CONSTRUCTION To install new gas main.
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 03/17/90
APPROXIMATE TIME OF COMPLETION 06/02/90
ESTIMATED. CONSTRUCTION COST S
(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:
Sketch (attach construction plans if appropriate)
To install 117' of 2".medium pressure
plastic gas main 15' W/EPL of Avenida.'
Rubio, beginning 15' S/NPL of
Montezuma Ave.,.proceeding north.
SEE SKETCH TGP 214 C6 CUT EARTH
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities or lou resulting from claims or court action and arising out of any accident, lou 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 (241 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 appticable rules and regulations of the City of
Le Quina and to pay for any additional replacement necesaery u the not of work.
J:M: SNYDER DISTRIBUTION SUPERVISOR
_
'. Signature of Aphl'1 cant'or Agsnt.
SOUTHERN` CAL FORMA; dAS � .0 P _ 0 _ gnx lone ' RrnT.ANIIS � rA 9217-1 (710- 335-77.42- -- .
Name of Applicant (please print( :. _.... Business Address Telephone No.
Name of Contractor and Job Foreman Burliness Address Telephone No.
Contractors Lioanse No. City Business License No.
Applicant's Insurance Company Policy Number -
FEES: Subdivision Improvement Permit —Clan 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 S
Permit Fee `
Penalty
Cash DepotitSurety Bond
if required
TOTAL: W. S
Receipt No. .
Received by ate
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246