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0782'+ ` y'.t•�.,}t:•.i7IS:r'�iy'�t,��I�i;t ��?bii% '(�.i%dv�J'�i«�,� '� " .y.5•�.-r �iR{.; ,_ ... ^`�.<-.'"�"',�:,�. t ,y p r r^t+ . 1°. --..Nj«. Y We'v��`�� ."�-arW'� 1'�CttW^atk•es--�,.,..i�•a}�t„uir"sr'�"',;���„`.�e•.i+..}y�•:` }}✓w.. -.r ;'ire-�`+-�•io:.-r-�:v..-e�...-+—'�......� .. a- ... �., � �........� .. �. ......... �....-,.... — .r.....-«.... �. a.. ,.......� — .�.....�.-............�. �...� ....... �..-.,� _ ., a _ r 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 I I I DATE: August 10, 1990 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Avenida Bermudas, Navarro, Villa, Mendoza, Martimiz and Calle Nogales (Street address or Description of Location) PURPOSE OF CONSTRUCTION relocate for proposed catch basins DESCRIPTION OF CONSTRUCTION offset gas lines around proposed catch basins DIMENSION OF INSTALLATION OR REMOVAL install approx. 36' 2" plastic line SIZE OF EXCAVATION, IF NEEDED 401. x 12" trench APPROXIMATE TIME WHEN WORK WILL BEGIN 8/13/90 APPROXIMATE TIME OF COMPLETION 4 days ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) Sketch (attach construction plans if appropriate) 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. Signature of Applicant or Agent So. California Gas Co. 1981 W. Lugonia, Redlands, CA 92373 714/335-7847 Name of Applicant (please print) Business Address Telephone No. George Macco Name of Contractor and Job Foreman Business Address Telephone No. ' 259619.• 566 Contractor's License No. i City -Business License No. Reliance ins. Liability NG1253560 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 Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. $ -0- Received by Date Recorded by - -N2 '0782 PERMIT VALIDATION PERMIT NO. 0782 DATE APPROVED 8/10/90 EXPIRATION DATE DATE ISSU DBy ITIR �/ A ��fA 61122,1" Oel� r` Administrative Authority TELEPHONE: (619) 564-2246 .�s�..�►�.t�-cA".,FC�;+`„+'"�-�,^'•�i.-+Y..aC �?'+�+w+'+w r. �.i. w w r e�+ r ..�.. t.. a r r .r �. n. cw a a r. w .. w N. w u► �f+ •� r r r++.. r .. r w ti. a..�s-rrtr .r + ... r�. w. w «f+ .e �A� 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 August 10, 1990 Subdivision Improvement Permit — Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Avennda Bermudas, Navarro, Villa, Mendoza, Martiniez and Calle Nogales (Street address or Description of Location) PURPOSE OF CONSTRUCTION relocate for Sketch (attach construction plans if appropriate) proposed catch basins DESCRIPTION OF CONSTRUCTION Offset gas lines around proposed catch basins DIMENSION OF INSTALLATION OR REMOVAL install approx. 36' 2" plastic line SIZE OF EXCAVATION, IF NEEDED 401 x 12" trench APPROXIMATE TIME WHEN WORK WILL BEGIN 8/13/90 APPROXIMATE TIME OF COMPLETION 4 days 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. Signature of Applicant or Agent So. California Gas Co. 1981 V1. Lugonia, Redlands, CA 92373 714/335-7847 Name of Applicant (please print) Business Address Telephone No. George Macco Name of Contractor and Job Foreman Business Address Telephone No. 259619 Contractor's License No. 566 City Business License No. Reliance Inas. Liability NG12535.60 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 Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ -0- $ -0- Receipt No. Received by Date vA 0'92 PERMIT VALIDATION 0782 PERMIT NO DATE APPROVED 8/10/90 EXPIRATION DATE DATE ISSUED J C '' By r Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 NOTE. , With. proper validation this form constitutes an encroachment permit CITY OF LA QUINTA. 1, ' APPLICATION FOR 1 PERMIT PUBLIC WORKS CONSTRUCTION: (ENCROACHMENT) - � .. •. - t Y . For the construction •• of public or private curbs= driveways, pavements, sidewalks,_ parking lots, sewers, water mains f ' and other like public works; improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS 1 Subdivision Improvement Permit — Class III k, --i DATE:` f 0 "�1� Minor Improvement Permit'Class IV ' LOCATION OF CONSTRUCTION Old vet) ?AA'6-r-R-RVh " �Air ero I (Street address or Description of Locati6n) f, PURPOSE OF CONSTRUCTION IZEt—g CAME ��, -. Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION -'C?EES—Ak-"- 4-/didE1•' , /42CIt�ND P2anerc_7b. C -g-rM PAQIAIs . DIMENSION OF INSTALLATION OR REMOVAL /A)T-AFL;- APAi20,x,: r-1-nrT 22' �t� cave �tfy.ar, ' SIZE OF EXCAVATION, IF NEEDED 40" X 11" 7"P7vog �•. ' APPROXIMATE TIME'WHEN WORK WILL BEGIN ' Fo&,� h APPROXIMATE TIME OF4OMPLETION' bA�S '• - ESTIMATED' CONSTRUCTION COST $ (including removal of all obstruction, materials, and debris, bad*fillirig, tom- 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, lossor 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 o_ f the permit and all applicable rules and regulations of the City of La Cwinta,and to pay for any additional replacement necessarv.as the result of work. Signature of Applicant or Agent Name of Applicant (please print)' Business Address Telephone o. Name of Contractor and Job Foreman ; Business Address. Telephone No. Contractor's License No. t City Business License No. 4. Applicant's Insurance Company Policy Number A FEES: Subdivision Improvement Pirmit —,Class I II • Public improvements: 3% of estimated construction costs +k Private improvements: 3% of estimated construction costs Mirror Improvement Permit — Class 1)4: See attached schedule Inspection Fee S I PERMIT VALIDATION E Permit Fee PERMIT NO. Penalty N . CashDATE APPROVED . Deposit-Sur'ety.''Bond. �, if required x EXPIRATION DATE ,TOTAL: $ .DATE ISSUED R. Receipt No. , By Received by , Date Administrative Authority Recorded by TELEPHONE: (619) 5642246' so mn Ip N- ffie-rom �:r. y— Sa OMIAI MlfrA41 15 00 L. OF tg ,5'G' 2250F4? OJJW 36 Ro AVEN1�,4' . BERMUDAS ,' UN�ERGi?OUN� TEL . � � ,' ( f `' -_.e_ �. � � :.. , % ' •• � , 79.99' R/ 26 p✓w �J�' soW 77 Gall w 'IY a t/ i. �V IV � W V � .1 . �.1 � r• ' 2fl, 75.33 f W - 91) V-5.5043 F Nd .30C, ,6. N0.3 / �, -q NOGALES e. F. 0-ArAVS rA 66 33 e ..C" O ///.I;rAZ Z 7'� 33 4 Wit' TRA 4LINI t"SER kl 1 V. kMAl F_ YES No �IOIN.T t,:FT OF. P -L -OF `(IN -CASING YES 0 .NO 01 !i+ LOCATED FT. T OF w P.L. •.LAID -4WIDTH KI"n 'LOCATED FT OF P.L. OF ST. OF ST. FT. =FT. P.LVf-MTR.;.�.:.ir.. ""'IFT.TOTAL' "- FT: --"• IL;MD jCe,.'.'BRANCH'SERVICE 0 YES ONO. IFYES,SEE REVERSE 'TIME OF_ OF CREW ,.,WORKED BY -.,ASSIGNMENT -.+ORDER ISSUED -.VDEPARTURE —SIZE ".COMPLETED? ARRIVAL-�­ -AM AM 13 M NO AM 0 *4 --AM VKIND No— a,,v, 41 -7 toft t, 117`i�, _3 W, flig PHONED ol TIME RETURNScCTHM-SEG#A0,rr,! To,-; war: COMPLETE A JT PNQ. 13 Am T jlA Q A - CITY pry- LLCVq"L-Es- u :; . _ - O 4860 59- NAME No.-,. v- Evlm .-I WHE YAF'ISSUEDI DE F0 TIME_��OAM Opm ACCOLIN TOR W.O. — T( M PROJ. OR SUB. 0 DE li [.INV.N INVNPOOR -, l.HA'.NSpE-CTCHA"r;LOCAi FfiMGAS PRUSSUR UARDRA'CVFACMMIW� TION W -IF 4WILCLOWFILL s ---- -- 0�'REPAIR '�4PAVING A;DELIV&R, FBAR-HOLES "i" MATERIALl ­+IHAU ECK TO -CH WELD PAINT -CLEAN TRUCK ARC 7'. -ABD;SFRVICE - %,i OWTOOLA -F `TAP AND" -WRAP OR.: SVC' PIPE 3,OR-MAIN Ftmn;A= vALVi ,,,,[CHECK STOP o� ADELOUTLET -�COG:00VER,t IHSTRUCT.IONSs-' z s+c-. AT AN METE TRA 4LINI t"SER kl 1 V. kMAl F_ YES No �IOIN.T t,:FT OF. P -L -OF `(IN -CASING YES 0 .NO 01 !i+ LOCATED FT. T OF w P.L. •.LAID -4WIDTH KI"n 'LOCATED FT OF P.L. OF ST. OF ST. FT. =FT. P.LVf-MTR.;.�.:.ir.. ""'IFT.TOTAL' "- FT: --"• IL;MD jCe,.'.'BRANCH'SERVICE 0 YES ONO. IFYES,SEE REVERSE 'TIME OF_ OF CREW ,.,WORKED BY -.,ASSIGNMENT -.+ORDER ISSUED -.VDEPARTURE —SIZE ".COMPLETED? ARRIVAL-�­ -AM AM 13 M NO AM 0 *4 --AM VKIND No— a,,v, 41 -7 toft t, PLAN FILE NO. BASE SKETCH CONSTR. SKETCH, COMPL. BKSTCH - "LJ . ■r: BY: ' �" BY: 'SHEET--L—OF . _ :. - � • • '� cam: CAS NAV U.1NG a srALL- +- TF-Sr MAIN PES Cv. nroc. 184.56 CALLS 0GAtEs r 2• &IS7-ALL�`I„Z- 27-_' 2, P� M �c A-13 F1A.)cH. MA 10, wA-r-cN GAUGE _ _ . fl ` . 17' z" PDM . 4,' Loc. A b T ►E iAJ MA 0) L o A ot>cti! PiI��cH'• �q " i D ,y\ '• :. 0 1 PROP. •' PUrGE Loc. .PC.J,.r Iny:- 53 i, LbC a t0PEtiJ f11niC H -� Z.. PDM � :r a ;-1oVE /.;' � PASS' '-'-- 17 C110 T 10AJ 0A) bE-R G go 0A) D TELL= PNoAJE W W oma' ? , - •' H � ~ .� u� ' TOTAL FEET INST'D - "INSTALL MAIN WITH AT LEAST---." COVER BELOW TOTAL FEET RETIRED" r - .e PERMIT ISSUED BY PERMIT NO. DATE MOVED DATE MOVED DATE OF COuNTYh' IVE;.iC.S/DE RETIREMENT `C I Ty O F L A UINT/� ON JOB OFF JOB OPER. DISTRICT / %4L�. � E "-SE "C: T F REASON CREW FOREMAN . TRACT, _ PLANNED BY COMPANY- NO.— OMPANYNO. %� //.y• fA�U=NLS STAKED ❑ COMPANY FACILITY`: SO. CAL. P.L.S. ❑ 'ATLAS LA `-C , .� YEAR G.P. _ REVIEWED BY - - • x NO. "C INSTALLED STAKINGREQ'D p L I/yRND �,M PIKE DIVISION CATHODICALLY- n - OPER. 20% OR OVER ❑ PROTECTED YES - LL p ORG: - ClClNO' AT LESS THAN 20% S.M.Y.S. - NO STAKES NEEDED ❑ A.O. " "� O �� �� CODE - DISTRICT SUPERVISOR - ` �'JARIBUTIONrqiOAM04ElpmADD IL 16 DATE *AtM PROJ.'OR SUB.' CITY,CROS5�9,T NAME IL 16 DATE *AtM DATE *AtM PROJ.'OR SUB.' ,7;� A PRESSURE GUARDRAIL I! -,CHECK TO ASM SERVICE WRAP SVC -OR'MAIN ADP.!RLrnLZT. CSO. COVER oo iA It zy PLAN FILE NO. SKETCH CON6TR. SKETCH COMPL. SKETCH1.111ASE er: fJ'' -Ev:,l er: - I SHEET-/ 'OF - LE GAS,; HAeNDL I FJG r I• INSTA ER Co, PROC: 164-,P5 -,P5 41 �. i�l 4 Z: lI PJSTAC:L IIn 13YPf�SS _ a ' ` ; 2. T 3•. Loc. A + P Pi/yr- M 1A), wA7c14 6k),*C --- ------ --- T r y c� Loc. A r- R3. T /E IA) 4 M A IAJ, • .. .• ►� 5 LdC • A OF'EA) P10CH .. T-2. P ELLS S ,. _ PORGE 'LOC. B+•.r°e.Ic VCTz 1'"q-. 6/.0 .� Loc B :.0PEA) P)MCN� 1.f. I. \\ t .{ a '*REMOVE 1 ;.Cj/f ` _. - N �, . `, ,��•• � rui 1 1 �•?• ^fir • • +• �• '• � ,' .. - f , �` - aP. _ - TOTAL FEET INST'D INSTALL MAIN WITH AT LEAST "COVER BELOW TOTAL FEET RETIRED - ` s - PERMIT ISSUED BY - PERMIT NO. - l DE RETIREMENT" - / :. r• DATE MOVED ' DATE MOVED DATE OF COUNTY .. 1 - - CITY O F [ �U/NT/� . • ON. JOB ,.O_FF JOB „` s , OPER. - DISTRICT ,r AL-M�./E -S t' %%• REASON`CREW FOREMAN' ,TRACT - ' �'a. - .� PLANNED BY - - COMPANY ;"• - ' ' No. N D. ifjAl Cf/E.Z STAKED ❑ - ATLAS 'L YEAR C.P. .COMPANY FACILITY: SO. CAL:-P.L.S. ❑ "NO. r INSTALLED `.REVIEWED BY • CATHODICALLY. OPER. 20% OR OVER ❑ - STAKING REQ�D ❑ ,/NC-AAJ E/�-tf'l.r�'f DIVISION YES ❑ NO ,X SA Y.S. 8 w oGZ r ORG.LIOK ,PROTECTED - `AT - •LESS THAN 20% .DISTRICT SUPERVISOR NO STAKES NEEDED •❑ 0.0. L- CODE SOUTHERN CALIFORNIA GAS CO. 295F.1 -J NE NUMBER R FT WH"ff ISSUED DATE - TIMEO A ACCOUNT OR W.O., PR J. OR 0 k L;".,LJUD� L` MAIN ON' i*p, P. 4 (IN CA SING��lil.ki opm D _O; I NV" il:'N' 0 "ib, INV: POOR 'INSTALL:-, INSPECT- CHANGE CHECKSERV­ FIELD REPORT: S; FT-----�OF. ;'PRESSURE' IC ,Cl!�PACILMES GUARDRAIL ICE LOCATION REPAIR .j FILL O,6a;`-- FILL I MAIN -�P.L­;-�- FT,. P.L. -MTR FT. TOTA --.!--FT. LAID­�•BR CH SERVICE, YES'[3 Ni��,, RSg IF-Y68 SE"qV-E PAR HOLES lZPAVING MATERIAL 4 Aj CREW SIZE '-WORKED BY HPA U I'- -AR WELD: PAINT M!,#� 'CHECKlTO:.,, TRUCK OR TOOLS ."AM 0 4" OIL AB06 SERVICE �SAX-.4f sx , tTAA; -b ' o PM .,,^F!AND ,'-' ATE PIPE • il, WRAP AVC- CHECK FOR" REPLACE VALVE "OR -M .41 4- N - `f" 1 LTA -A 11 S N ADD. OUTLET R 12 , r 4 _,i� 4 'PM y t ',KIND XN v 4�,5 '10rs _y J"I'-A. V. -JI-1 -;N '44'.0% S, tj 14. ­4�, fit- METER Rzwi*llITM Txp Sew ; A jZk­vlm Nei, NE NUMBER R FT OF P.L. OF - - 0- Rviiale -M.P. 0 k L;".,LJUD� L` MAIN ON' i*p, P. 4 (IN CA SING��lil.ki N6`:o)-­ LOCATE D _O; -ADTH SERVICE, SIZE •kllkln� LOCATED- 'pv * 4" FT-----�OF. np qvzrg FT.. YEAR 0 I MAIN -�P.L­;-�- FT,. P.L. -MTR FT. TOTA --.!--FT. LAID­�•BR CH SERVICE, YES'[3 Ni��,, RSg IF-Y68 SE"qV-E DATE TIME -OF 4TIME _ARRIVAL DEPARTURE' OF CREW SIZE '-WORKED BY ASSIGNMENT COMPLET961'1' ."AM 0 AM 01 t �SAX-.4f sx , tTAA; -b ' o PM .41 4- N - `f" 1 'AM 0 Ak/ AM U , r 4 _,i� 'PM PM ❑ ',KIND _y tj Z l� A A 'S.! ` '�� t',,t��'}a :`MISTR{BUT{ONS > PHONED TOS TIME , . RETURN TO s �s > SECTION -SEGMENT COMPLETE TT ORDER" ,i T;' la'3 - i A, s t AM r b t ^ 1-r ❑ P M' ,l J.'wA:� .i TRANSMISSION - 1. 'L�, tl 7"711 .. t, �` �. FT OF r ti.,,:_'S/. ^ i - - ... }; ^. ',_ .�. •,,ic.'•`t '' `��` YES •NO ❑ Y❑ LINE NUMBER .•-' . M.P. .if«+�i-� ^ `°-` P.L. OF _;, ST. --+YES ❑ ❑) ` i r `- L'. i. f} �'�•�r, AD�.''$YLr? ` { t ,Y }": CITY [ e {Yr t `NAME ._ (IN CASING NO � t e S 4 8 6 0.6 1"; CROl38 ETRE T�, ; 3: x ay ,� I.y{ - �4.,�' P ONE NO. - •iS I SERVICEa -SIZE :', - ° I - LOCATED :�.�' FT OF P.L.OF - j ) I y 'a,:. i - t ST... OF ST. .. 1. i � iR •yY . BRANCH SERVICE ❑YES❑ NOI IF YES. SEE REVERSE - Y ,T,•y 1-4, RE 1 SUED * � S DA fi FT: TOTA W TIME ❑ AM ACCOUNT OR W.O. � PROJ. OR SLB. O ODE ,.; TIME OF O CREW j WORKED BY ❑ P M ASSIGNMENT Z3 1. INV: NO"- INV. POOR ' INSTALL IN' TCNANGE CMECICSERV= FIELD REPORT:` - 4 _. - i „• {,_ `GAS 'Q.,,�- PRESSURB,:. GUARDRAIL .Of FACILITIES 'ICU LOCATION . ,:'+= +'r i ^ - «M' �� AM A.. {'�•f+i❑ "pM REPAIR ,. FILL LOW .j'`,•.FILL e � P4 REPAIR `-DELIVER ��t4�F'� ''t•` •� { s �, "' +.r.�.�K t: C.M,:B.i^ -'3"!CUT-?-? f#ARHOLES ��,PA VING' _. MATERIAL �_tl - i ,.. - :.,.. HAUL. ;. .-r7;`..-,j..., .d .., (CHECK TOS, ARC WELD yPAINT MSA` SPOIL. ABD-SERVICE ..cLewNTRUCK 'OR TOOLS S .' 11 _ V .i✓ �, r,. r D RAP SVC.* CHBCKFOR `c LOCATE PIPE t'"OR MAIN ADD. OUTLET REPLACE VALVE CSG. COVER ;-•• - , - �.•.»` - ,•,STOP NO ,.;j ,1NSTRUCTIONSt, ;,f'�z-fit• _ e, _, ,; ..,. a"'7 _ ',F:T` jam' � ,��;� '� # - ' - ;h,• .`t�„' .'..rrt., � 4V� T( J. J�`�« .. yl, ' - �'/. �' f • �:. ��` �.,'�Y •�'S. t F• � .' ' .Api. iV ! � �a METER • 0 ,l J.'wA:� .i TRANSMISSION - 1. 'L�, tl 7"711 .. t, �` �. FT OF - ..('.� rq, " ' f'+ .•.: i - - ... }; ^. ',_ .�. •,,ic.'•`t '' `��` YES •NO ❑ Y❑ LINE NUMBER .•-' . M.P. .if«+�i-� ^ `°-` P.L. OF _;, ST. --+YES ❑ ❑) JOINT SERVICE'S YEAR -P. L.P. MAIN 4- ,.v H.P.• ON ._ (IN CASING NO � LOCATED—- FT.OF' " L. . LAID WIDTHw•t, r. t ,}. "RT. I SERVICEa -SIZE :', - ° I • RIND - LOCATED :�.�' FT OF P.L.OF - j ) I y 'a,:. i - t ST... OF ST. .. 1. i � iR •yY . BRANCH SERVICE ❑YES❑ NOI IF YES. SEE REVERSE -MAI N P.L. " RT: P L" MTR'xt' FT: TOTA W - FT. • , 't`LAID " •` - •— ' DATE TIME OF " TIM6 OF` � CREW j WORKED BY ASSIGNMENT 10. 'ORDER ISSUED *! ARRIVAL' DEPARTURE SIZE COMPLETED? C=- Al / AM ❑ AM A.. {'�•f+i❑ "pM .. i:.ls r± %' r t .- •' +11 - ,. :.K, f c - �•.' � PM ❑ ❑: 11 AM 13 PM.❑ PM,❑ KIND NO • 0 - PLAN FILE NO. OASE SKETCHT��/R.SKETCH CONS COMP L. SKETCH Ni t�J -�� ._ .. !li.� I 1 r) �• '. I p� ay:— er:_ —I Er: SHEET pp TC3G u- tj _-7 p '' i `\. NOGAL.. E. - GAs HANDL•IIJG ._ _._.............. --- -I I• I uSTALL i- TEST Mgly .PEF CD, �9 - - -- --- PRoC• . � 14-, Z. I til STALL I %�YPf1 SS 3• Loc. A + PhJc H MA1.U,W,4701 vAU.S`� __.........._ .,.......'.:...... ..._� - `f, Loc. A ( T!E IA) M�4I AJ, E -17 \ �-Z" P ELLS 5. Loc- A oFEA) PhOcH aw 6• .PuRGE toe• B F,t-ie c._Tz 134-, 1-,L0I - - --- ..: Loc.. 73 orE:A :l Pir.icN• REMOVE I" BYPASS -1. . u� { � ' N � •• .• r-z��PEtLS - ' - TOTAL FEET INST•D INSTALL MAIN WITH AT LEAST-----!--" COVER BELOW TOTAL FEET RETIRED _ �% l V E. D� RETIREMENT PERMIT ISSUED BY PERMIT NO. DATE MOVED DATE MOVED DATE OF COUNTY � ` �--'- - CITY OF LA Illy ON JOB OFF JOB OPER. i �/ j� DISTRICT " PALM l `.JE. S L: /LT r REASON �Q CREW FOREMAN TRACT - _ - PLANNED BY '! .. b. �6N C86z i COMPANY STAKED ❑ COMPANY FACILITY: CpAL.A 'P.L.S. ❑ ' ATLAS L �•� YEAR C.P. - + REVIEWED NO. INSTALLED BY STAKING REQ•D, ❑ [SO. IA.) /J L�/ I!� DIVISION' CATHOOICALLY YES ❑ NO PROTECTED OPER. 2O% OR OVER -. ❑ S.M.Y.S. = ((_Q���� ORG. 164 ` AT LESS THAN 20% DISTRICT SUPERVISOR NO STAKES NEEDED 0 jI0 .O. ' a CODE 'IE NUMBER FT 0 F ---lSTA?j• P.L. 0 WORKED BY -YES NO RvicE 13,.� .. 13 lf- DEPARTURE * . ­ SIZE DISTA 'PHONEDURN YP,,,,�tt, TIME TO ON- IET Spr" -SEGMENT, COMPLETE '7-' NP '2-2-(� - 2- I R -AM •bAM .4VICEI, ­­'KINfi- LOCATED AT: 13 F�m •KIND >NO CITY )f.b,6 - j A'J vsk - q - C) o A86060 TOSS STREET.�SPL NAME. -, - - PHONE NO; '?, � - W�, . ,cis S E By" WHEjkE.ISSUED DATE ME 0 A.'rA CCQUN T OR W.O.,.11 PROJ. 'OR SUB. OR 3. C DE INV. NO.tl ANV:POOR INSTALL mwEcrcmANGECHECKSERV- FIELD REPORT: GAS "PRESSURE" GUARDRAIL OF-FAOLMES,ICF-LOCAMN REPAIR ��tLt�c.uow_ FILL-" 1_�;:>MrUT EPAIR ,,'DELIVER ;V -BAR 'HOLES -AVING MATERIALi. HAULSvRum k^RC WELD -PAINTMSA 'CHECK TO,,:ax" ABD. SERVICE OR TOOLS SPOIL 'AP-A"D 4W RAP SVC.! 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