0813^
With pr.oPe-r-'valiaatiori-."ikis for, im"cionstitutes anencroachment permit.APPLICATION FOR, PERMIT,MO, 545-31342-IPUBLIC woks 'CONSTRUCTION (ENCROACHMENT)'F 0 �Ahe conwi1ction',. of public or 'private curbs, driveways,'p�vemenis: sidewalks, .'park in"' 'I otA an public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONSSubdivision. Improve.Fnent PerFnit'— Class IIIAugust. '990DATE: Minor Improvemen't Pe'r'mit Class IVMiles Avenue n./s W/o AdamsLOCAT;ON OF "CONSTRUCTION(Stre6t'address'or Description of.Location) 3.4UCT16N to .,place, c a7b16 iii Hite) --'PURPOSE OFCONSTR Sketch (attach construction plans if approp aDESCRIPTION OF CONSTliUCTION.3, splice with one -"DIMLNSIQN OF INSTALLATION OR REMOVAL. 3 -?-5*X,5,_"x8',APPR XIMATE TIME, WHEN WORK WI CIL BEGIN'
ESTIMATED CONSTRUCTION COST 1,500'.
p�ction ar�d placing permanent resui facing. and/or replacing. improvements`)
I n *consideration of the� granting of this - perm it, the appl icant hereby agrees to:
-cl�fend and save,!he 'City, its authorized agents, officers, mpresentatives and employees, fiarmle;s frorn and'agiiihst a6y and all
penaiiies,' liatWities ;or',"ioss',resulti�g from claims or cobrt action and arising out of a*�y accident, loss or. clamage� to persons or property
happening or occurring,a.s a proximate result of ainy v�ork un�6rtaken -under the permit'granted pursuint,to this - alPolication.
Notify the,Aclminisirati�� Authority'at least twenty-f6ur (24) ho6rs in advance of,the time whein work 'will, be* -'started.
Comply''with 'all ii'pficable City Orclihinces, theterms and conditions of the permit. and all applicible rules- and'regulations of 'the City of
re
Signature of Applicant'orAgent IA
Business Address *-Jelephone, N
Name of Cont�actor and Job,Foreman Busin�Lss Address., Telephone No.
Contract6r's License No. City Business Licehse No.
Public impr�vemehtg: 3%of estimated construct i on, costs,"',
Private improvements: 3% of estimated 6onstrdction costs
Minor Improvement Permit— Class IV:,,See attached schedule—
Inspection Fee PERMIT VALIDATION, -
Permit F6e .0813 -
DATE APPROVED
Cash Deposit -Surety Bond
Receipt No.
By—
Received by Date Administrative Authority
Recorded by
TELEPHONE: (81Q)5G4-2246 ^
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49. ,
NOTE:
.With proper valid
"='this form constitutes an
t . - CITY OF LA QUINTA
1 :`:encroachment "permit
APPLICATION FOR PERMIT
GTE". WO 549-31342-I 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
August31, 1.990 Subdivision Improvement -Permit'— Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Males Avenue n/s w/o Adams
(Street address or Description'of Location)
PURPOSE OF CONSTRUCTION to place cable in.
conduit'
DESCRIPTION OF CONSTRUCTION 3 splice pits with one
7' trench
DIMENSION OF INSTALLATION OR REMOVAL 3 - 51x511x3'
SIZE OF EXCAVATION, IF NEEDED 3 .5'5'8' pits
APPROXIMATE TIME.WHEN WORICWILL BEGIN 9/7/90
Sketch (attach construction plans if appropriate)
see attached drawing
reference GTE ;1549---31342-I
APPROXIMATE TIME OF COMPLETION 11/7/90
ESTIMATED. CONSTRUCTION, COST $ 1 500
(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
r ' 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. ! «r
Signature of Applicant or Agent
GTE.California incorporated 83-739 Dr. Carreon Blvd, Indio, CA 342-0535
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 1II
„'tom r Public "improvements: 3% of estimated construction costs 1
Private improvements: 3% of estimated construction costs
Q Q
81
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ —0—
PERMIT VALIDATION
"�
Permit Fee 'N
PERMITO. 0813
Penalty
!
APPROVED 8/31/90
Cash Deposit -Surety Bond DATE
if required EXPIRATION DATE 12/31/90
TOTAL: $ —0"' 8/31/90
DATE ISSUED
Receipt No. r� '
By
Received by Date Administrative Authority
Recorded by TELEPHONE:.(619) 564-2246
y C14 ® t 6 199
��®� • ~; GI.E CALJ F ORN I A
Mentone`.OPCF-N Bldg #123
1500 Ci•-axf`toi i A'i
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(714), 794 -97,26,.
City of La" L?6 nta . •: A : _ _ . ,
787-'105 Cal lc E tido
'La QL(inta, CFS 9y25;_
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PieaSe iaSUe a, RIDER to 6xtbnd the'e,,,pir-ation dates for' -:the fallowi'nq
pe�rmi L , i#081 =
AT ADDRESS: MILES AVE N/a W%O ADAMS 'ST:•
WOFik; ORDERNO,. 549, -3134
NEW'^FXPIRATION DOTE- )3,/3U/91 /
' GTE CALIFORNIA,Ar
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° PLEASE B I'LL TidE • FOLL•,OW I NG EMG I NEER-I NG --,DE_ PARTMEN1" ,
GTE CALIFORNIA
, ,Engine Lr.i ng Departfnent
8379;3 Dr- a" Carre (:)n. Eel vd a'
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92201
°Indio; Co �".
PERM 17- NO. 081
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WORK, ORDER:5.4.9,--L3 1'342
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PERMIT
NO. 08'13.'„
WORK ORDER-
549:: —31.342
Ci tv of L_a ,'Q ai.i tcx
78-105 Call e, Estado
La ;.ui nta o ,.CA 92253 � •
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02 28/91 .
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{' NOTICE
OF"WORK ORDER'
STARTF
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WORK Of PERMIT 'NO n i i81 ".
HAS . JUST BEGUN.
1�1AT ADDRESS- MILES. AVE':N/S -W/0 ADAMS°lST
14
PERMITTEE REPRESENT(�T I VE oA GTECAL_
I FORN I A
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?he following General and Special Provisions are attached to and made a part of Permit'No. D ,
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„ GENERAL PROVISIONS"
The following shall always apply:
ENCROACHMENT ON PRIVATE PROPERTY: This 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
secure permission from abutting property owners. Such authorizatiori must be secured by the permittee prior to starting work.
, TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated tracklaying construction equipment shall not be permitted to operate on any
j.
paved surface unless fitted with smooth-faced street pads. All mechanical outriggers shall be fitted with rubber street shoes to protect
the paving during excavations:' Rubber-tired equipment only,shall be used in backfill operations in paved areas-If the existing
pavementis scarred. spalled, or broken during the term of this contract. or if the pavement is marred, City of La Quints shall request
that these, portions of road be resurfaced over their,entire width- Resurfacing shall consist of one coat of two inches (2"1 of A.C.
surfacing plus appropriate: seal coat as-specified above:- `
PROTECTION OF TRAFFIC: All excavations and work areas shall be properly lighted and barricaded as deemed necessary by the City
Engineer or La Quints City Public Works Inspectors. Suitable detours and detour signs shall be placed and maintained fortheduration
of the project: Th"e City shall be notified 24 Hrs. in advance of any traffic detours or delineations:
CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete pipe, steel.culvert and
concrete, structures encountered during, excavation which necessitate removal shall'bWreplaced in kind. In 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 avall times for proper drainage. `
j
RIGHT OF WAY CLEANUP: Any surplus material resulting from excavation and backfill operations shall be removed from the right of
- •i
way. All paved surfaces shall be broomed clean of earth and other objectionable materials immediately after backfill and compaction.
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•'Existing'gut{er line and drainage ditches shall be repiaced to their original standard or better. AII•excess,materiaLshall'beremoveds.
prior to paving. Water tanker shall be used, as required, to sprinkle the-job,site to.keep down, dust•conditions andlshalkbe%used-,
1
immediately :..
DE-WATER OPERATIONS: If dewatering operations are required and pumps are forcing water on City of La Quints roads, it shall be
'
the responsioility of the permittee (contractor) to control this water and to provide off-street barricades when necessary.
CLOSING STREETS: No street shall be closed. A minimum of one lane of traffic shall be maintained at all times to provide limited
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access for the adjoining property owners and emergency vehicles. In the event it is felt bythe permittee that he must close a street for
.,any length of time. permittee shall contact this office to obtain the necessary permission.
SPECIAL PROVISIONS
,The follwing, shall apply iiNLY when indicated:
I,
e`Ri OTIFICATION: Permittee shall notify the City at 564=2246 at least 48 hours in.advance of starting construction.
CASH DEPOSITS OR BONDS: A cash bond or an approved surety bond in an amount of not less than s
" shall be furnished in the name of City of La Quints to cover all work involved in the restoration of the various La Quints
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 ..
M
a, U ILITYCLEARANCE:(SubstructureslPriortomakinganyexcavationwithintheCityofLaQuintsrightofwayauthorized
t •; '
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
fthe permittee.
DCILITYCLEARANCE: (Surface'structuresI No work shall tiedone under this permit until all utilities are clear of the
�.
posed 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"valueof not less than and in conformance with City of La Quints Road Improvement Standards
and Specifications. Ordinance #461. }
R6 'PARKWAY GRADING: Area between the propene line and top of the proposed concrete curb shall be graded to a slope of
1,14 inch to one foot (11.
y R7 GRADES & STAKES: City of La Quints shall establish grades and stakes for the proposed concrete curb and gutter
I
cbnsiruction. ,
R8" GRADE CHECKING: City of La Quints shall check grades upon receipt of plan and profile and/or grades as established by
'..:• ' a lirensed engineer. ^
'
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R9 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter( feet)shall be
r
removed. Curb and/or curbiand gutter shall be saw cut prior to removal. Depressed curb, matching concrete gutter and !
w concrete driveway approach shall be constructed in conformance with City of La Quints Standard #207.
~ 810 :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 inchdiameter( •I 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.
2 SIGHT CLEARANCE: Sight clearance of 600 feet in either direction shall be assured and maintained.
'The
`R 13 `SOIL STERILIZER: area to be surfaced shall be treated with soil sterilizer. Rate of application shall complywith the '
-m`anufacturer's specifications. `r '
R14 COORDINATE WORK: The proposed work shall be subordinated to any operation which the State of California or
'---City of La Quints may conduct in this area during the period of this permit. Work shall be coordinated with the State or
of La Quints forces to preclude delay or interference witti State or City of La Quints projects.
I •915 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the
._:..ednterline of all streets or property lines when involved shall be completely tied out so they maybe 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 to these monuments shalt be furnished to the 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.
r.
.Rn-31
S16 SL MONUMENTS: Prior to excavation or begtnninq of const n, all survey monOments shall be tiedlaut by City
of linta and suitable payment or guarantee of payment shall be made as reimbursement for all work involved.
R 1 7 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 to
pavement straight edge shall be corrected.
( R19 LIMIT OF EXCAVATIONS: Excavations shall be limited tot,000lineal feet ofopen trench before backfill operations must
l\�• ; 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 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 PACKFILL 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 Quints deems unsuitable (spongyor
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.
821 BACKFILL SAND: Backfill shall be approved transit -mix sand or equivalent and shall be placed in lifts of notgreaterthan
three feet (31 and vibrated using vibrotamper or equivalent equipment. Alternate methods may be substituted, but in any
E\,f�ase a relative compaction of 95 percent shall be attained within the structural section of the roadway.
bef-re
ACKFILL PLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench floodingdramazimumoffive-footl5')liftswheretrenchesareofexcessivedepths.Careistobeexercisedthatthe
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 isthegreater
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 i ntervals of not morethent1:000
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
standard Specifications, Division of Highways" State of California, dated January 1973.
/ 1
ZR24 CJDMPACTION 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 as outlined in Section 6.3.01 of the Standard Specifications" Division of Highways, State
�-9f California, dated January 1973.
R25 lTEMPORARY 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 temporar, f ielfie ii exceeu d ii,;a ;3j day iimit.
R26 PERMANENT 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 LS days after completion of
temporary road repair. /' !(D
R27 PAVEMENT REPAIR: F.A.S.: Upon cam ptetion of backfili and compaction. a temporary patch consisting of twdinches(2"I
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 9461.
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 1s 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 insurea tree service. and handled safely without 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 safelv without 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 500feet at any one 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.
f. Pruning shall, in all instances, be at the shoulder of the crotch to insure even, fast healing in all cuts of two inches
(21 and above in size. Sealant shall be applied to all cut sections as directed by the City Public Works Inspector.
ADDITION --==ENCROACHMENT PERMIT N0:0813----C0NDITI6NS-
r
' R33
Survey monuments.,shall be protected in place,or
'
re-established) pursuant to' City 'standards' and the"State of
r
California Land Surveyor's'Act. t•
R34.;
Work shall be,coordinated with the City of"La•,Quinta's.
^t
forces, to preclude delay. or interference with the City of ,La'
Quintals•projects. F .'
R35'
Contractor',.shall comply with the'local noise'ordinance and ,
construction, operations . and maintenance' of equipment . within , .
one half mile of,human occupancy shall,be performed only
during the -.,time periods asi follows:.,
october'-1st to April 30: Monday -Friday 7:OOa.m.-5':30p.m.
` Saturday. 8:00a:m.-5:00p.m.
- May 1st'•to September.30: -Monday-Friday 6:00a m..-;7s0Op. t. „
.Saturday • 8:00a.m.-5:0Op.m.
Work•Shall-be prohibited anytime on Sunday and Federal
holiday: <: F.�.
R36
Traffic.control shall be -as per Cal Trans•Traffic'.Manual.
'
Field adjustments i:n' detoiiring-'shall be accomplished.'as }.
"directed in order to'adjust,.'to actual field conditions. It.
sha-l-l'be the"contractor's responsibility to adequately `
. barricade and detour this site. A Traffic control plan'•shall�, M
`
be submitted.for approval by the City:Engineer._
R37
..All -excavation at or near the travel way shall. be backfilled
-,at the, end 'of the work day, .for the protection . of the
traveling•public.
R38:
Street closures shall not_:be-allowed at any, time.
t R39.
'A minimum of 'one travel lane shall be maintained'at all. p. ,
'
times with flagmen during working hours.' -
• R40
All work to be performed within -.the existing paved -section.
shall' be. temporary, paved and. maintained .by the Permittee,
permanent-pavement'shall be placed no later•than 15 days,-,,
'
<,af ter ,completion of the temporary road repair .
R41
Ingress and egress for local properties shall be maintained.
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at all times., r
- ..' R42
Prior to�. work starting' Underground- 'Service. Alert shall" be
;.
contacted -at • 1-800-422-4133 and an "inquiry number"_ _shall' be
provided 'to the City. Public Works Inspector. ..
R43' Pavement shall be'sawcut prior to,removal.',
l
Additional•_Co
., No.` 0813. -
Page
2nditions,-'Encroachment,Permit
F'
R44
ALL backf ill :sub4rade.; soil, shall be:. compact' -a' tonothings
:less than 90%* relative` dry. density, a ally backfill soil within
the top, 211 of finish. pavement' surface shall '•be --compacted -to. ;
nothing, less than 95o relative -:dry density,,- 'all•base' x`
material. shall ''be° ,compacted to, nothing less. than ` 95 0.
relative. dry density: -
R45
Replacement: pavement:* sections shall be 4'°"," .AC -.-over .8" Class.
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I I. :base . '
aggregate
R46
-If -the • work � is to be performed by' forces other •than that• of
,.,
the utlit .: f
y ,company; the contracting company xwll. be'
required to.apply-for an additional.e_ncroachment permit, and -r
_pay ' the, appropriate .fee.. r
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REFERENCE. - GTE -W.O9-31342-I
NOTE: - h
With proper validation • ,
this form constitutes an i
CITY, OF. LA QUINTA .
encroachment permit v
APPLICATION FOR .,PERMIT'
t 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
DATEi- Auguet 30,E 1990 r! Minor Improvement Permit Class IV
•`Mi les: Ave N/S W/O Adams f
• LOCATION ;OF CONSTRUCTION •' •
(Street address or Description of Location) . +'
PURPOSE OF CONSTRUCTION t0 pl ace` Cabl e'An.-con dul t : Sketch (attach construction plans if appropriate)
y.
DESCRIPTION OF CONSTRUCTION 3 SPI. ce pits wi "_one SEE ATTACHED DRAWING
7' trench = ;REFERENCE GTE,#549-31342-I ,
DIMENSION OF INS T.-.LLATION OR REMOVAL -3 - 5"x5' x8'.
SIZE OF EXCAVATION, IF NEEDED 3- - 5' x5' X8' pits
APPROXIMATE TIME WHEN WORK WILL BEGIN 9-7-90 a r
APPROXIMATE TIME OF COMPLETION - -
ESTIMATED CONSTRUCTION COST $ • 1500.00
J '
(Including removal of all obstruction, -materials, and debris, backfilling, tom=
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant. hereby agrees to: t `
Indemnify, defend and. save •ihe City„its authorized agents, officers, representatives and employees, harmless'fiom and against any arid 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.
a Notify the Administrative Authority at least twenty -tour (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 appli able rules and regulations of the City'of
La. Quints and to pay for any additional replacement necessary•as.the result of this
Sig t re of Applicant or A"gent .
GTE CALIFORNIA'INCORPORATED -83=739 Dr,'Carreo Vd, YIndio, CA',, 922 619/342=0535
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% of estimated construction costs ,
4 Private improvements: 3%6f estimated construction costs
Minor. Improvement Permit - Class IV: See attached schedule
Inspection Fee S
Permit Fee
Penalty
Cash Deposit -Surety Bond
.a if required
TOTAL: $
Receipt No.
Received by Date
Recorded by
A
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
• By ' _
Administrative Authority,
TELEPHONE: 1619) 5642246 '