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NOTE: -
{With proper validation
this form constitutes an ,
F; - . CITY,OF LA QUINTA.'
' encroachment permit :� ,
} ' ' APPLICATION'' FOR PERMIT.
°PUBLIC WORKS" CONSTRUCTION''(ENCROACHMENT) w�
I. »n
For the construction of, public or private • curbs;,-drivevvays;-pavements; sidewalks; parking, lot
s, water,mains
other like public works improvements in connection with'MINOR,IMPROVEMENTS and APPROVED SUBDIVISIONS
• .4 \-y •.-rte - .'.. `, : r '••. • k` 's. � - � r.•"• ' - .S •.
.' 3 + • >' ' Subdivision Improvement Permit — Class III +'
DATE: 'OCtobe .19,4:1990 '" �y. Minor. s
_ Improvement Permit Class IV
LOCATIONOF'CONSTRUCTION Avenida 'E1 Nido
- �.' ✓ is x'4 .. "- f .. '- �
(Street address or Description of Location)
a PURPOSEbF-CONSTRUCTION 'to ixl_i-a11• npra!µctaR' main 1 ' Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 99' of
mediummoressure :ctas':ma'in''l5'
E1•'Niclo '']: eairinir a ' 329'_ W/WPL of 'Coachella Dr, proceeding west -
DIMENSION•OF INSTALLATION "OR REMOVAL w
/ SEE`ATTACHED SKETCH
, W4. .58440'222 -
4"1SIZE,OF EXCAVATION, IF NEEDED
j, APPROXIMATE TIME WHENVORK WILL BEGIN 10/1.5/9'0
;. APPROXIMATE'TIME;OF COMPLETION
`-; STIMATED'CONSTRUCTION COST $
(Including' removal of all'obst'ruction, materials, and debris, backfilling, com
pa on and placing permanent; resurfacing and/' - replacing'improvements)•
III consideration -of the granting .of this'permit„the applicant hereby agrees'to: `
Indemr ify;•defend and save the City, its authorized agents, •officers,` representatives and employees, harmles0rom and against`'any and _all
penalties; .liabilities or. loss resulting from claims or court action and arising out of,any'accident,aoss 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.
r Notrfy the Administrative Authority_ at least twenty-four,(24) hours •in• advance of the time when work will be started.
Co ply with all applicable .CityjOrdinances;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.MG Snyder, 'Distribution Supervisor
Signature of Applicant or Agent
y
-Southern California Gas'"Co PO Box 3003 'RddlandS,'. CA 92373 714/335/7742
Name of Applicant (please print) '4Business'Address Telephone No.
Name of Contractor and Job Foreman Business Address r Telephone No.
Contractors License No. City Business License
• Applicant's Insurance CompanyPolicy Number•
1 -
FEES: Subdivision Improvement Permit - Class] I I
Public improvements: 3% of estimated construction costs
'Private improvements: 3% of estimated construction'ccsts '
.� 4. � :0873
Minor Improvement Perrriit ='Class' IV': See attached schedule, ,•
Inspection Fee $ , —D— PERMIT' VALIDATION
Permit Fee
-,,PERMIT NO.
Penalty ,- — DATE'APPROVED 1019/•90.
Cash Deposit -Surety Bond
if required - 1131191
'� • EXPIRATION DATE '
TOTAL: $ L
DATE ISSUED.' /.710/19%90'
Receipt No.
By
.Received by 1 Date ' J Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
^��.+,.7:..;,.�(I.-y wp�a- '^'.i°� ��}�•�rv.14%Y �w„^.•�.,irY _'� "°vim, Y'�:.� � � y�.nw��f..+`�..' T"�•�+ j.�:e�. .. 4. .._ .0 �U
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NOTE:
With proper validation
this form constitutes an
encroachment permit'
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit - Class I I I
DATE: October 19, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Avenida E1 Nido '
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 11-0 install npw aa.q main Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 99' of 2" nlartic
mediummoressure ctas main 15' N/SPL of Ave.
El Tidos heainni.na 329' W/WPL.of Coachella Dr, proceeding west
DIMENSION OF INSTALLATION OR REMOVAL
SEE ATTACHED SKETCH
W0. 58440-222
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN10/15/90
APPROXIMATE TIME OF COMPLETION 1/15/91
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 300.3 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
FEES: Subdivision Improvement Permit — Class I I I
'Public;improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule 1lvA 0873
Inspection Fee $ —D—
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
PERMIT VALIDATION
PERMIT NO. 0873
DATE APPROVED 10/19/90
EXPIRATION DATE 1/31/91
L DATE ISSUED-. /•10/19/90
By /if.✓f L .
.-/Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
The following General and Special Provisions are attached to and made a parrof Permit No:
GENERAL PROVISIONS • '
.tf
$
The following shall always apply: I ; -
.
='ENCROACHMENT
:.
ON PRIVATE PROPERTY: This permit authorizes work lobe 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.
Y' ye
+-t *8
TRACKLAYING.CONSTRUCTIONEQUIPMENT: Cleated tracklaying construct'ion equipment shall not be perm'ittedtooperitoon any
paved surface unless fitted with smooth -faced street pads. All mech an icai outriggers sh ai I be fitted with rubber street shoes to protect `
thepaving. during, excavations. Rubber-ired 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 '
q -
that these portions of road be resurfaced, over their entire width'- Resurfacing shall consist of one coat of two inches (2") of A.C.
..�"v .�.
surfacing plus appropriate seahcoat as.specifiedabove
PROTECTION OF TRAFFIC: All excavations and work areas shall be properly lighted and barricaded as deemed necessary by the City
t
Engineer or La Quinta City Public Workslnspectors. Suitable detoursanddetour signs shall beplaced and maintained for the duration '
rc `.
w
of the project. -The 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 be replaced in kind. In the'evenuit 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 '
+�.
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.
f
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.
CLOSINGSTREETS: 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 isfelt bythe permittee that he mustclose a street for
.,
any length of time. permittee shall contact this office to'obtain the necessary permission.
=SPECIAL
•
` PROVISIONS = ° "
r ,
The follwing shall apply'ONLY when indicated: ,
t
4 '
RolPermittee shall notify tiie City 564-2246 leasi 4B hours in
at at advance of starting construction.
• R2 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 Quinta to cover all work involved in the restoration of the various La Quinta
r
roads avid 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 .
3 TILITYCLEARANCE:(Substructures) Prior to making any excavation within the City of La Quinta right of way authorized
R03
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.
/ R 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"value of not less than and in conformance with City of La Quinta Road Improvement Standards
and Specifications, Ordinance #461. '
C,F ✓`:' - '
R6 PARKWAY GRADING: Are a betwee n t h e p rope rty I i ne a nd top of the proposed concrete cur b sh a I I be graded to a slope of ,
1 /4 inch to one foot (1'). .- r
.� •
R7 GRADES & STAKES: City of La Quinta shall establish grades and stakes for the proposed concrete curb and gutter
construction.
f
Rg 'GRADE CHECKING: City of La Quinta shall check grades upon receipt of plan and profile and/or grades as established by
licensed 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 end gutter shall be saw cut prior to removal. Depressed curb, matching concrete gutter and
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.
R11 CULVERTS: A inch diameter(—) culvert shall be installed with the -invert approximately 1-1 /2
,}
below and in line with the existing flow line. Culvert installation shall conform to the attached drawing. -
r
/inches
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
`M
anufacturer's specifications. "
l/` R141,WORK: The proposed work shall be subordinated to any operation which the State of California or
-OORDINATE
City of La Quinta may conduct in this area during the period of this permit. Work shall be coordinated with the State or
} l
City of La Quinta forces to preclude delay or interference with State or City of La. Quinta projects.
E115 URVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the
i
enterline of ail 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 setof notes showing the
. ties to these monuments 'shall -be furnished to the City Engineer prior to the removal of any monuments. This office shall
f be notified upon completion of replacemenrof all survey monuments for proper project clearance.
�..
RD -31
R16 SL 'MONUMENTS: Prior to excavation or beginning of cons n, all survey monuments shall be tiedout by City
of La Quinta and suitable payment or guarantee of payment st,,.,. „. 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.
�R1 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 �MITOFEXCAVATIONS:Excavationsshallbelimitedto1,000linealfeetofopentrenchbeforebackfilloperationsmust
�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.
®R20ACKFILLMATERIAL:Backfillshallbefreeofbrush,rootsorotherorganicsubstancedetrimentaltoitsuseforpurposes
f producing an adequately consolidated backfill. Any material which the City of La Quinta 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.
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')1ifts where trenches are of excessive depths. Care is to ba axe rcised 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, compactiontests shall be made at intervalsof 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
Standard Specifications, Division of Highways. State of California, dated January 1973.
i� R24 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line.
�vOne (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
f California, dated January 1973.
R25 T MPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporary patch
t `-__¢insisting 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
// placement of the temporary Pieffsafk trxt:aeU d fi%a iu) day limit.
(R26 PE MANENT 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�f inches A. C.
surfacing placed on a inch class base shall be placed no laterthan days after completion of
temporary road repair.W f j kis
R27 PAVEMENT REPAIR: F.A.S.: Upon completion of backilland/ 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.
928 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 interference or 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 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.
-4
ADDITION----ENCROACHMENT PERMIT,_NO.0 . .... CONDITIONS'
�R31,
Survey -shall-be in
monists-; protected
.-#pace-or,-
re-established •pursuant. to, standards and -the :State,of
California Land' Surveyor-Is Act.
.Work shall be-coordinated,with the. City of,La-Quinta_s-�..
forces to preclude, delay 6r''interference with'.the City.of,-La-
Quintals projects.
R35-__'
Contractor shall comply with the localnoise'o rdinance and.1
construction operations and maintenance of equipmentviithin'
one half mile of human occupandy-phall be perfd-rmed.only
during,,the' time periods as.fc;lYows:
October 1st'to April 30: 'Monday-Friday 7:00a.m.;-5:30p.m.,,:-
Saturday 8:00a.m.-.5:00p.m.
May 1st to September'.30: Monday-Friday 6:'00a.m:-T:00p.m.
Saturday 8:00a.m.75:00p'm:
.,-Work
shall be prohibited anytim'e,on Sunday and Fe'deral,
holiday.
R36
Traffic control shall be as per Cal Trans Traffic Mdhual.-,-,,
.•Field adjustments in-detouring shall be accomplished cis,
4.
°..directed in order to adjust` to actual field-coriditioiis. -It
'Shall be the'contractor's responsibility t6,ade'quately
barricade and detbur'.this'sitd. A Tiaffic ' control plan shall•
be,submitted :for approval by the City Engineer."
R31
'hall
Alli�xdav'atio'ri At travel way-s be' backf illed
at -the, end-of the work day;.-for the protection of the
traveling public.'
R381
, street closures shalK not be 'allowed At any*time.
R39
A,minimum-of one travel. lane shall be maintained at all',,,.,*
times with flagmenduring"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,
of ter' completion of the temporary road repair.
R41
egress for local: properties shall be maintained-,
Ingress and eg a
at all times.
R42',
Prior to. work starting, 'Underground service Ale'rt '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.
Additional
Conditions:- Encroachment,•Permit No. 0873
• Page
2
tLR44 .' All. backfill subgrade soil shall, be -compacted to nothing -
ti.
y
less than 90% relative dry density, all backfill soil within`
the top 2' of finish pavement surf ace shall be compacted to. ;, : !
'-nothing less than '95 0 'relative 'dry density, all base'`
material shall,be compacted.,to nothing less, than 95 0
dry density. F
R45
Replacement .pavement sections shall be 3 " 'AC over ~'4"• Class
II aggregate base.
R46
'If the,work�is to be performed by forces other than that of
r,:
^ the • .utility company, the contracting company, will..'be
required to apply for an additional encroachment: permit �.
`
and pay the' appropriate fee.
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INSTALL MAIN WITH AT LEAST [D "COVER BELOW y/c.S7' -5// TOTAL -FEET RETIRED
PERMIT ISSUED BY PERMIT NO. DATE MOVED DATE MOVED DATE OF
COUNTY R VER S149Gm' RETIREMENT ON JOB OFF JOB OPER.
DISTRICT Of S —I—R / REASON CREW FOREMAN -
TRACT PLANNED BY .". COMPANY
NO.
STAKED ❑ COMPANY FACILITY: •SO. CAL. ❑ P.L.S. ❑
ATLAS /jt,/O %2 YEAR C.P. REVIE V '
NO. INSTALLED �/ - STAKING REO'D ❑ /NL'4 fM.o/�4 .E DIVISION
CATHODICALLY OPER. 20%OROVER ❑ �ij - s8 ,`f f� -- ZZZ ORG"
" PROTECTED YES ❑ NO ❑ AT LESS THAN 20% ❑ S.M.Y.S. DISTRICT SUPERVISOR NO STAKES NEEDED • �. . W.O. CODE
i
58440-222
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 corutection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class 111
GATE: OCT. 5, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION - AVP.nI da F1 Nido
l6tra atierase or OMaiption of Location)
To install new as =main:�. ,;:� c:
PURPOSE OF CONSTRUCTION g Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION To install 99' of 2" plastic medium pressure gas main 15' N/SPL of
Avenida El Nido. beginning 32q, W/WPL of Coachella Dr., proceeding west.
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 10-15-90
APPROXIMATE TIME OF COMPLETION 1-15-91
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 loss resulting from claims or court action and wising out of any accident, loss or damage to persons or property
happening or Occurring as a proximate result of env work undertake under the permit granted pursuant to this application.
Notify the Administrative Authwity at least twenty-four 1241 haus in advance of the time when work will be started.
Comply olds all applicable City Ordinances, the terms and conditions of the permit and MI applicable rules end regulations of the City of
!, Q and t0 pay for any additiOrrM replaoanent rte0eeeary as.the t this wwk. _
: .M. SNYDER "D 3' b r"SUPERVISOR
woo
of APplie�nf: or Agrrlt
°SOUTHERN CAL FURNIA''dA! CQ'.>..P_�_• IRbt 1ni .R� T.AUTIGr rA - 9�'t7''t (71' )-.3�5�7742
.Nmr of Applicant (per grind OusirAss Address Telephone No.
Nerrw of Contractor and Job Foreman Business. Address . Telephone No.
Contractor's License No. City 8ueirnse Lioiraa No. .
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III
FAAAjc improvements: 3% of "noted construction costs
Private improvements: 3% of a d mated construction costs
Minor Improvement Permit — Class IV: Sea attached schedule
Inspection Fee $
Permit Fee
Pendty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Reces!rad by ate
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (6191564-2246