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0669NOTE: With proper validation • this form constitutes an� encroachment permit 53440-704 CITY OF LA QUINTA 'APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) 7 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 I I DATE: May 29, 1990 Minor Improvement Permit Class IV, LOCATION OF CONSTRUCTION Avenida Carranza (Street address or Description of Location) PURPOSE OF CONSTRUCTION to inatAl T" nA�k� !aAe main Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION ? na.tal l ).R5' . of 1" „l,ac+-ie,: me e9l4iim nrarxcitrAa iaa mAib I A WilyPT. f �veaniA.x rArran7A: hoCtinln;in y' r,n M/MDT. of C'a11e Sinola Cut earth, jet 61' Of DIMENSION OF INSTALLATION OR REMOVAL oil and gravel .SIZE OF EXCAVATION, IF NEEDED see sketch TGP. -22,4-C-1 APPROXIMATE TIME WHEN WORK WILL BEGIN Juni± 1; 199Q APPROXIMATE TIME OF COMPLETION A174/9D 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 Supervisro • Signature of Applicant or Agent •Southern'Californid•Gas Co PCS Box 30.03 Redlands,.CA 92373 714 335-7742 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 J FEES: Subdivision improvement Permit --'Class III M! Public improvements: 3% of estimated construction costs Private improvements: 3%_of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule 0669 Inspection Fee $ :4 Permit Fee —0— Penal;.ty Cash Deposit -Surety Bond if required TOTAL: $ —�— Receipt No. Received by Recorded by Date ` PERMIT VALIDATION ..PERMIT NO. 0669 DATE APPROVED 5/29/90 EXPIRATION DATE 12/31/90 DATE ISSUED- X5/29090. By Administrative Authority TELEPHONE: (619) 564-2246 - . �-t EX Air' TION REPORT - SOUTHERN CALIFORNIA GAS CO. 669 J t f I N CITY OF LA QUINTA LL Inter®eceion Avenida Carranza & Calle Sinaloa T PROD. OR I O PERMIT NUMBER 1 r I C 45'x3' SOU-i�HERN CALIFORNIA GAS CO. 2865-26 3"MAC WORK ORDER PROD. OR ORG. ORACCOUNT SUB. ACCT. CODE DATE 8-31_90 EXECUTION PREPAREM ORDER NO. 53440 / •7 O4 �p KA i F SIZE OF CUT KIND i C 45'x3' SOU-i�HERN CALIFORNIA GAS CO. 2865-26 3"MAC ��-. ".. �.; ...�•i`.i.^�!. ....,. y'� _};�r`.l!` '`:..'4{Iwy: ;?.._ --.. r" ......"` -.. ..�,,. .� .. •.�. ��..: ,�.. + -.1: `;r� ..F �. :.._�! C�^�°„rL .+� . •...+.-.�..;-rti-Y.e«:- ' rii.�r�-^...r ,.. en .�. «, w: e.. .�.F� on ....w •.o.'.s a. -w .3.. m. «.. w •s. a. .� ,► �... w. w .�.. 'r.• w .�..�...+ w. .�.. �..� a. -.a. w... e .....a.-.:..+ .;.w-a+-rr o NOTE: With proper validation this form constitutes am CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) 53440-704 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 I I DATE: Mav 29, 1990 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Avenida Carranza (Street addressor Description of Location) PURPOSE OF CONSTRUCTION; f=n ;natal i new crac main Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION i nclinl 1 II of a" f-4nava train 1 A I W1V..PT. e,f �-ttmp 4 rla1�ocrri nni ncr An I M 41NIAT, of Palle Sinola Cut earth, jet 611 Of DIMENSION OF INSTALLATION OR REMOVAL oil and gravel SIZE OF, EXCAVATION, I F NEEDED See , sketch TGP 224 -C -l' APPROXIMATE TIME WHEN WORK WILL BEGIN Jiang? ]_ 3,940 APPROXIMATE TIME OF COMPLETION R ?Q /QQ ESTI MATED' CONSTR. UCT.ION COST $ (Including remoyal 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 ernployees, 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 SuRervisro Signature of Applicant or Agent Southern California Gas Co PO Box 3003 Redlands„ CA 92373 714 335-7742 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 ' E FEES: Subdivision Improvement Permit — Class III Public improvements: 3% of.e'stimated construction costs Private improvements: 3%of.estimated construction costs r ,r ` •- 0669 Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ PERMIT VALIDATION Y_ i rPer (fit Fee "0"' PERMIT NO. 0669 Penahy 5/29/90 Cash Deposit -Surety Bond DATE APPROVED if required 12/31/90 EXPIRATION DATE TOTAL: $ —0- 5/2.9090 DATE ISSUED Receipt No. By f .4 A-1. Received by Date Administrative Authority Recorded by TELEPHONE: (619) 564-2246 (0 The following General and Special Provisions are attached to and made a part.of.Permit No. •h -'R « GENERAL PROVISIONS . The following shall always apply: ' ' f-0 ENCROACHMENT ON PRIVATE'PROPERTY: Iis,permit authorizes work to be accomplished within City of La Quinta right of way ONLY. Whenever construction extends within private property, it shall be the responsibility of the permittee (or his contractors) to - . i• .• secure permission from abutting property owners. Such authorization must be secured by the permittee prior to starting work. • f TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated tracklaying construction equipment shall not be permitted to operate on any paved surface unless fitted with smooth -faced streetads. All mechanical outriggers ggersshallbefittedwithrubberstreetshoestoprotect 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 t ' that these portions of road be resurfaced over their entire width. Resurfacing shall consist of one coat of two inches IV) of A.C. surfacing plus appropriate seal coat as specified above.' ' PROTECTION OF TRAFFIC: All excavations and'wo' areas shall lie properly lighted and barricaded as deemed necessary by the City • .•; Engineer or La Quinta City Public Works Inspectors. Suitable detours and detour signs sha 11 be placed and maintained for the duration « 1• .K of the project. The City shall be notified 24 Hrs7in advance of any traffic detours or delineations. CARE OF DRAINAGE STRUCTURES: Any drainage. structure including corrugated metal pipe, concrete pipe, steel culvert and•; S s«. ` concrete structures encountered during excavation which necessita' to removal shall be replaced in kindIn the event.it becomes ,•'•- necessary to remove or cut existing drainage structures, City of La_ Quinta 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. r RIGHT OF WAY CLEANUP: Any surplus material resulting from excavation and backfill operations shall be removed from the right of r� 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. c 1prior 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-NVATER OPERATIONS: If de -watering operations a`re 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. JCLOSING STREETS: No street shall be closed. A minimum of one lane of traffic shall be maintained at all times to provide limited „ accessfor the adjoining property "Pers and emergency vehicles. In the event it isiellbyffiepermilleeihaihe mustcl ose a str6ellfor any length of time, permittee shall contact this office to obtain the necessary permission. y t, SPECIAL PROVISIONS s The follwing shall apply ONLY when indicated:. OTIFICATION: Permittee shall notify the City at,564-2246 at 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 , 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 . , �UTILITY CLEARANCE:(Substructures) Prior to making any excavation within the City of La Quinta right ofwayauthorized 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 surfaced with inches of A.C. paving placed on inches of class aggregate subbase course having an "R"valuaof not lessthan and in conformance with City of La Quinta Road Improvement Standards *• and Specifications; Ordinance 17461. ; ,`• 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. RS GRADE CHECKING: City of La Quinta shall check grades_ upon receipt of plan and pFofile and/or grades as established by t a lirensed engineer. ` 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 - concrete driveway approach shall be constructed in conform a nce,6th' C i ty of La Quinta Standard #207. r ». Rio 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. , R11 CULVERTS: A ' inch diameter ( )culvert shall be installed with 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. SOIL STERILIZER The area to be' surfaced shall be treated with soil sterilizer. Rate of application shall comply with the 4 rnanufacturf;r's' specifications. 14 COORDINATE WORK: The proposed work shall be subordinated to any operation which the State of California or City of Ca Quinta may conduct in this area during the period of this permit. Work shall be coordinated with the State or 'A City of La Quinta forces to preclude delay or interference with State or City of La Quinta projects. R15 URVEY MONUMENTS: Prior to.excavation or beginning of construction,- all survey monuments which exist on the 11_�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 ties io these monuments shall be furnished tothe City Engineer prior to the removal of any monuments. This office shall be•notified upon completion of replacement of all survey, monuments for proper project clearance. - R16 =Y MONUMENTS: Prior to excavation or beginning of cor ion, all survey monuments shall be tied out by City _. __ Quinta and suitable payment or guarantee of payment snaii oe 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. GR� PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations, any damage to pavement straight edge shall be corrected. R19 LIMIT OF EXCAVATIONS: Excavations shall be limited to 1,000 lineal feet of open trench before backfill operations must begin. 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 suitabilityof 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. l 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 maybe substituted, but in any ase a relative compaction of 95 percent shall be attained within the structural section of the roadway. R2>1ACKFILL PLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench efore flooding or a maximum of five-foot (5') lifts where trenches are of excessive depths. Care is to be exercised thatthe 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 is the 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. 823 COMPACTION TESTS: If so required bythe inspector, compaction tests shall be made at intervals of not more than 1,000 feet 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 ER24 Standard Specifications,Division of Highways, State of California, dated January 1973. COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line. 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. R25 EMPORARY 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 after 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. R26 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 mqh class base shall be placed no laterthan days aftercompletion of temporary road repair. 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 streets to 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 interferenceor hazard tothe 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 sectionswhich 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 tothe 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 accgmplished 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. f. 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. ' ADDITION=---ENCROACHMENT PERMIT'NO_.00 9 ---- CONDITIONS, - R33' -Surv'ey.,monuments shall'be,,-protected,in= place 'or re-established-pursuant to.City standards and'the State of California•lLand' 'Surveyor!s Act:. ' R34. -Work shall xbe- coordinated with the City of, La. Quinta''s :forces to preclude .delay or,interference witY'`the City. of La Quintals projects + •; ` R35-1Contractor 41 ' is ... ♦it, 5 _ shall ' comply,. with `the local • noise ordinance and . ;. construction operations and,maintenance"of. equipment•within` h. one',half.'mile of human:occupancy shall-lbe performed only during. the time •.periods as.: follows:. " October 1st tol-April 30 Monday-Friday.'7:00.a.m.-5:30,p.m. • ;,- Saturday '4. ` - 8:60d.m-. -5: 00p.m. 4 ' May. 1st to September_.'�30: Monday-Friday.6:00a:m.-7:00p.m.•. •,: ' Saturday 8:00a:m.-5.00p.m. -.Work-,shall be -prohibitedanytime on Sunday. •..and-, Federal -_ r " holiday. R36" Traffic control shall be as.per 'Cal Trans'Traffic Manual. Field adjustments.'in,detouring�shall be accomplished as, ' directed iri.order to adjust to-actual field conditions. •It shall be the'contractor's responsibility_to adequately • barricade `and detour this site .. "A Traffic control plan-:shall , ;' be. submitted for' a y y ` g .• pproval.. b .the.. Cit Engineer. Y. ,:' R37 All excavation at ' or. near,�the• travel way shall be backfilled,' -at the end. of, the work day, •for 'the protection of•, the -c 'f• traveling public. R38 Street closures shall not" be yallowed at any'';time., ' ' ►. R39. A minimum-of one travel 1`ane 'shall be". maintained at all' • times with flagmen during working hours. . R40All work ,to be performed w thin,the existing paved section, � .rshall be 'temporary';paved,`and maintained by the. Permittee, . permanent pavement shall} I be, pilaced rib, later- than 15 days , , after completion Of,, the temporary road repair.: 4- R41 Ingress and egress for'local properties shall-be.maintained at all times . { i •ti R42 '.,Prior- .'to ' . work. •starting; Underground Service Alert shall be' -` contacted,at' 1-800=422-41.33 and'an.-','inquiry number"-shall _ be provided to the City Public}Works Inspector. - ,R43 Pavement,'shall be. sawcut prior, to removal-. • ,; .. Additional Conditions - Encroachment Permit No' 0669 f Page 2 .• ti: s R44 .. All backfill- subgrade. soil',shall be ;compacted to nothing> :less than 90%�relative -dry-.density,, all, backfill soil within f ;, • tthe top 2 ! .• of finish 'pavement surface shall- be ..compacted to ' nothing less than. 95,%,., relative,, dry density;, all base„ ' material shall be ,compacted •ta nothing less ahan 95% relative' dry density. +, R45 Replacement`.; pavement sections shall be 3 `"'AC overi4" Class I I . 'aggregate base.,.,. 46 _; Rthe-work: If •is •to be 'performed by forces., other "than-that-of.. • the -`utility, company, the•.contracting• company _will"be'r' required to-apply for. an additional encroachment, -permit 4' nand pay the',appropriate.fee. h't n lqjj!AN FILE NO. BASE SKETCH CON STR, SKETCH I TI GI ►�1T I L J G By:. I 9Y: 1 =i COMPL. SKETCM er: SHEET ' OF , 1 I NOTE 53440-704 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 I II DATE: MAY 23, 1990 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Avenida Carranza (Street address or Description of Location) PURPOSE OF CONSTRUCTION To instal 1 new gas main Sketch (attach construction plans if appropriate) QAESCRIQTI?N OF CONSTRUCTION To install 155' of Z plastic medium pressure gas main 14' W/EPL of veni. arranza, beginning 50' N NPL of Calle Sinal4a, proceeding south. TGP 224, C-1 DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN June 1, 1990 CUT EARTH AND JET 61' OIL AND GRAVEL APPROXIMATE TIME OF COMPLETION 8-24-90 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: 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, 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 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 a rules and regulations of the City of La Quina and to pay for any additional replacement necessary as the result of this work J.M.-SNYDER, D I'4 -SUPERVISOR . ' .. . •- � • • - � Signature of Appl s •an . or Agent, SOUTHERN -CAL FQRNTti"GAS • Q- P_Q_• RON '10nl' RFnT,ANnS, ra 73 (714), 335-7742 .. 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': Insurance Company Policy Number FEES:. Subdivision Improvement -Permit —Class I11 - Public•improvements: 3% of-asti.:atev construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee S Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: W. $ Receipt No. Raceived by Date Recorded by PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: (619) 564.2246