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1589Witli proper alidationl,!— .: F this form constitutes an encroachment permit a 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, �bor �`$, Subdivision Improvement Permit— Class III oct1992 DATE: Minor Improvement Permit Class IV - - LOCATION OF CONSTRUCTION Tract 21154 (Street address or Description of Location) 12 y0st * . a+ *At&jA gad • PURPOSE'OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION OR1 ATrAcm DISCR X109 ZA $ � attached �aanditlone ��� ^,At»tat�ecf draw3,aSla DIMENSION OF INSTALLATION OR REMOVAL' k SIZE OF.EXCAVATION, IF NEEDED. APPROXIMATE TIME WHEN WORK WILL BEGIN��12192 APPROXIMATE TIME OF COMPLETION 2/12/93 ESTIMATED CONSTRUCTION COST $ (Including• removal of all obstruction, materials, and debris, backfilling, com- paction-and om-paction•and placing permanent resurfacing and/or replacing improvements) .• '" In consideration of the granting of, this permit, the applicant hereby agrees to: ,e 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. Lx Signature of Applicant or Agentl ftRk`i` 00ADVATOR So•uthorn WifolrnIA, 4^4 Co. '. 300 : i ed Linda. CA 82973 - VA) •335-776 Name of Applicant (please print) Business Address _ Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. . Contractor's License No. ; " y City Business License No. 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 schedule1689 Inspection Fee $ I�r PERMIT VALIDATION Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ Receipt No. Received by Date Recorded by PERMIT NO. 1389 DATE APPROVED 10-29-92 EXPIRATION DATE 2-12--93 DATE IS//SUED10-29-92 By_ 1,22691 �n�wA�✓( l' Administrative Authority TELEPHONE: (619) 564-2246 58440-223 C NOTE: With prover validation City of La Quinta this form constitutes an CITY OF LA OUINTA emoschmen` permit APPLICATION FOR PERMIT OCT 2 z 1991 PUBLIC WORKS CONSTRUCTION (ENCR5I f ffXil _a 0RKS For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other We public works imnprovements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS -4 Cl Subdivision Improvement Permit — Class 111 DATE: October 1992 Minor Improvement Permit Class IV �. LOCATION OF CONSTRUCTION Tract 25154 44treat address or Desw4 tion of Loestion) PURPOSE OF CONSTRUCTION .to overate and maintain Sketch (attach construction plans if appropriate) gas main. DESCRIPTION OF CONSTRUCTION SEE ATTACHED DESCRIPTION G� E v-TTr+ c 1+e17 . Go+v D t"Tr DIJ S DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 11/12/92 APPROXIMATE TIME OF COMPLETION 02 ESTIMATED CONSTRUCTION COST $ (Incuding removal of all obstruction, materials, and debris, backfilling, con• pection and placing permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, the applicant hereby agrees to: Indemnify, defend and taw the City, its authorised agents, officers, representatives and amployaes. harmless from and against any and all penNties. liabilities or loss resulting from cairn or court action and arising out of any accident, loss or damage to persons or property happening or occurring es a proximate result of any work undertaken under Ow permit granted pursnrent to this application. Notify des Administrative Authority at Nest twenty-four (241 hours in advenee of the tint when work will be started. . ssM all applicable City Ordinernoes, the terns and conditions of dna permit and NI' applieabN rules and regulations of the City of Orbs and to pay far any additional n*Maanant aaoaswry M ttte essult of waxk. s,` :r iDhipro of llpPi�orrfe�WASP* PE -MIT :000RD�N Tfl - - ' 71 .. :Narrhe of /lpplioartt (Plein vrMttl - �- r; Business Address Telephone No. Nime of CaerWor and Job Fdre en , •: auainses Address - Teieplhorme No. Coimtractore Liarw No. .Cih WuMrss Eieerw No. Applicants Insuranot Company. Policy Number FEET: Subdivision Improvement Permit — Class 111 Public improvements: 3% of atimeted oonstruction costs , Private improvemermts: 3% of a tiaetsd construction costs Minor Improvement Permit — pas IV: See atteced edwdula : Irhspection Fee i Frrmmit Fee Penalty Cash Deposit -Surety Bond If required TOTAL: "' E Receipt No. RGOGived by Dana Recorded by PERMIT VALIDATION _ PERMIT NO. `J 8 9 DATE APPROVED Z� : Z EXPIRATION DATE y l2 3 DATE ISSUED D y Z q— g 3 B1l Administrative) Authority TELEPHONE: (619) 564-2246 �7 The Gas �Companyem 1981 W. Lugonia Av. P.O. Box 3003 Redlands, CA 92373 (714) 335-7764 (Permits) > PPI A 'I 111 F 'R E /ATI N PE'RMI ' > < »>>' . C 0 O October 20, 1992 City of La Quinta 58440-223 To operate and maintain 1,640' of 2" medium pressure plastic gas main 2' W/EPL of Sagebrush Avenue, beginning 95' SW/CL of Rio Arenoso and proceeding northeast. JOINT TRENCH WITH POWER, TELEPHONE & TV. To operate and maintain 750' of 2" medium pressure plastic gas main 2' N/SPL, of Rio Seco, beginning 5' W/E lot line of lot 25 on Rio Seco and proceeding south for 56' from 2' S/NPL then west. JOINT TRENCH WITH POWER, TELEPHONE & TV. To operate and maintain 730' of 2" medium pressure plastic gas main 2' E/WPL and then 2' W/EPL of Rio Arenoso, beginning 2' N?SPL of Via Melodia and proceeding north. JOINT TRENCH WITH POWER, TELEPHONE & TV. To operate and maintain 470' of 2" medium pressure plastic gas main 2' E/WPL of Rio Arenoso, beginning 2' N/SPL of Via Melodia and proceeding south. JOINT TRENCH WITH POWER, TELEPHONE & TV. To operate and maintain 806' of 2" medium pressure plastic gas main 2' N/SPL of Casa Del Rio, beginning 2" W/EPL of Sagebrush Avenue and proceeding west. JOINT TRENCH WITH POWER, TELEPHONE AND TV. To operate and maintain 615' of 2" medium pressure plastic gas main 2' N/SPL of Via Melodia, beginning 2' NW/SE PL of Sagebrush Avenue and proceeding west. JOINT TRENCH WITH POWER, TELEPHONE AND TV. To operate and maintain 200' of 2" medium pressure plastic gas main 2' S/NPL of Sagebrush Avenue, beginning 2' W/EPL of Sagebrush Avenue and proceeding west. JOINT TRENCH WITH POWER, TELEPHONE AND TV. To install 400' of 2" medium pressure plastic gas main 2' N/SPL of Sagebrush Avenue, beginning 95' SW/CLof Rio Arenoso and proceeding southwest. TGP - 214 E5 CUT - EARTH/JET 45' CONCRETE DRIVE & 35' ASPHALT The following General and Special Provisions are attached to and made a part of Permit No. 1589 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 for his contractors) to secure permission from abutting property owners. Such authorization 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 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 pavement is scarred, spelled, or broken during the term of this contract, or if the pavement is marred, City of La Quinta shall request that these portions of road be resurfaced over their entire width. Resurfacing shall consist of one coat of two inches (2") 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 Quinta City Public Works Inspectors. Suitable detours and detour signs shall be placed and maintained for the duration of the project. The City shall be notified 24 Hrs. 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 eventit 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. 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. DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing water on Cityof La Quinta roads, ii shall be the responsibility 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 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 The follwing shall apply ONLY when indicated: NOTIFICATION: Permittee shall notify the City at 564-2246 at leasto$ 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 b 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 of way authorized by permit, the permittee shall contact all concerned utility companies relative to the location of existing substructures. Damage to existing substructures resulting from operations conducted under this permit shall be the sole responsibility of the permittee. R4 UTILITY CLEARANCE: (Surface structures) No work shall be done under this permit until all utilities are clear of the proposed work site. The permittee shall notify all concerned utility companies of the proposed work. R5 PAVEMENT WIDENING: Area between the proposed concrete gutter line and the existing road pavement shall be 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 Ouinta Road Improvement Standards and Specifications, Ordinance #461. R6 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall begradedtoa slopeof 1/4 inch to one foot 111. R7 GRADES & STAKES: City of La Quinta shall establish grades and stakes for the proposed concrete curb and gutter construction. R8 GRADE CHECKING: City of La Quinta shall check grades upon receipt of plan and pFofile and/or grades as established by 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 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 inches below and in line with the existing flow line. Culvert installation shall conform to the attached drawing. R12 SIGHT CLEARANCE: Sight clearance of 600 feet in either direction shall be assured and maintained. R13 SOIL STERILIZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall comply with the manufacturer's specifications. R14 COORDINATE WORK: The proposed work shall be subordinated to any operation which the State of California or City of La Quinta may conduct in this area during the period of this permit. Work shall be coordinated with the State or City of La Quinta forces to preclude delay or interference with State or City of La Quinta projects. R15 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the centerline 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 shall be furnished to the City Engineer prior to the removal of any monuments. Thisoffice shall K. nnlifiorl - r .1winn nf'renloromnn♦ of .11 e„n,n., ,..nm,,.. 0.....,,...n...,,,....., R16 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments shall be tied ouiby City of La Quinta and suitable payment or guarantee of payment shall be made as reimbursement for all work involved. R17 PAVEMENT CUTTING: Pavement will be mechanically cut to a straight edge prior to excavation. Method of pavement cutting shall be approved through the office of the City Engineer. (Under no circumstances shall excavating equipment be used to excavate prior to cutting of pavement). Excavation material shall be placed in such a position as to best facilitate the general flow of traffic. Prior to final paving operations, any damage to pavement straight edge shall be corrected. R18 PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations, any damage to pavement straight edge shall be corrected. R1 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 forthe protectionof the traveling public. The Public Works inspector shall determinethe suitability of excavation barricading in each case. No excavation shall remain open for a period exceeding five (5) days. No excavation shall be made unless the construction material is actually on the work site. R20 BACKFILL MATERIAL: Backfill shall be free ofbrush, roots or other organic substance cletrimentalto its use for purposes of 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 maybe substituted, but in any case a relative compaction of 95 percent shall be attained within the structural section of the roadway. 22 BACKFILL PLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench before flooding or a maximum of five-foot (5') lifts where trenches are of excessive depths. Care isto be exercised that the backfill material is not subjected to extreme swell by flooding operations. Backfill material shall be placed so that the resulting compaction shall be not less than 90 percent or equivalent to the surrounding ground, whichever 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. ®COMPACTION TESTS: If so required bythe inspector, compaction tests 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. 2OMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line. 4F>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 TEMPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporary patch consisting of 2 inches of SC -800 shall be placed on a prepared subgrade. The SC -800 temporary paving shall be placed 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 PERMANENT PAVEMENT REPAIR: After backfill and compaction operations have been completed, a temporary patch consisting of two inches (2'1 of SC -800 shall be placed immediately. A permanent patch of inches A.C. surfacing placed on a inch class base shall be placed no later than days after completion of temporary road repair. R27 PAVEMENT REPAIR: F.A.S.: Upon completion of backfill andcompaction, a temporary patch consisting oftwo inches (2'1 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 repairto 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 safely without mterferenceor hazardtothe 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 safely 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 anyone 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. f. Pruning shall, in all instances, be at the shoulder of the crotch to insure even, fast healing in all cuts of two inches SPECIAL CONDITIONS --PERMIT NO. 1589 --- The Gas Co. --- In addition to the standard permit conditions, the following shall apply: 1. All work shall be performed in accordance with the the plans submitted by The Gas Co. for tract 25154 . 2. This permit is only for work within the City of La Quinta and it's R/W. Permittee/contractor shall aquire a permit from any other abutting agency. 3. Permittee shall be responsible for providing continuous dust and erosion control. 4. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more frequently if required. 5. Contractor shall comply with the local noise ordinance. Operation and maintenance of equipment within one half mile of human occupancy shall be performed only during the following time periods: October 1st to April 30: Monday -Friday 7:00 a.m. to 5:30 p.m. Saturday 8:00 a.m. to 5:00 p.m. May 1st to September 30: Monday -Friday 6:00 a.m. to 7:00 p.m. Saturday 8:00 a.m. to 5:00 p.m. Work shall be prohibited on legal holidays including Sundays. 6. Permittee shall assume responsibility for repair of any pavement breakdown at the haul road access to any public or private street and for any damage to other City streets or facilities. 7. Advance warning signs and traffic control shall be installed and maintained in accordance with Cal Trans Standards. Permittee shall submit a traffic control/circulation plan for approval by the City Engineer prior to the start of any work. 8. In advance of excavation, Contractor/permittee shall submit to the city for acceptance a detailed plan, in accordance with Labor Code Section 6705, showing the design or shoring, bracing, sloping, or other provisions to be made for worker protection from the hazard of caving ground during the excavation of any trench or trenches five feet or more in depth. If such plan varies from the shoring system standards, the plan shall be prepared by a registered civil or structural engineer. As a part of the plan, a note shall be included stating that the registered civil or structural engineer certified that the plan complies with the Cal OSHA Construction Safety Orders or that the plan is not less effective than the shoring, bracing, sloping, or other provision of the Construction Safety Orders. 9. If the work is to be performed by forces other than the utility company's the contractor shall apply for an encroachment permit and pay the appropriate fee: 10. Permittee shall coordinate work with the contractor performing tract improvements and shall provide a schedule that will not conflict with the improvements. 11. All work shall be completed prior to final pavement improvements to the tract. 12. Replacement pavement section on Date Palm shall be 1" greater than existing. 13. Mailboxes, landscaping, irrigation, driveways, etc. shall be replaced to a condition equal to or greater than the original. Special Conditions - Permit No. 1589 Page 1 of I . ILA" FILE NO. Rwi[ Rw[.cw wwATw, iw[Tew wrR. iROcw • (TZI<t T IN'f• � . CjFL. ., I{NLTT / .., / I f '•_17V 7 .. _ ( _:.... _.. 1 e s::., _.. _.. •t :`_I .So C,GDR�3S'.0S7- - - - Gi __- 17. E \' . -420i - 'r to "-o , V u.0 E 1 � E M t2 V Q40 c /•ures. � � 1 L J - f 15 1 I �J IZ I Io 9 p — _ aTE All.^ D2 f \_ +• � pp " ' •MAT-__ -INS EE a 3ovE _ ..R14t�T" _ .. ' i (jE.CdW '.�P C_ [Ar4fj TFEET - J __ HJT- �.A.T'T✓ ,. _... _ IE o _ Isolation Area Affected Yea --=. �. -. . - Pressure District Affected .Yea ❑ NO Q' •».TALL Y.IN wnN AT LAST �n• CovER {[Low—fyT,L'. TOTAL ►LCT RCTu[o KIVE - _> RETIREMENT IPw"n Ifiu[0 by PERMIT N . DATE MOVED DAT[ MOVED DAT[ OP Business District Affected Yea ❑ NO 0' COUNTY GITY Of= ON Jo. DIP a- . — c _ o P[ R. S SUp Jna Affected Yea ❑ No 3' _F_ REASON ewcw ►oR[~AN DISTRICT Valve(s) Required Yea ❑ NO ETRACT I� COMPANY TNNE NOYEAR C.I. STAKED. C $0. CAL. /ESP.L.S. Reviewed . INSTALLED' COY//NO. IND O REVIEWED w STAKING RIO'D. SMT'IFZV DVSIoM CP. Ravlewed ByLJG cATNoo,uLY OPER MO - ZE Dwc T[f NO AT L[i! THAN 30, DISTRICT SUPERVISOR {TAE[f M[LDLD M. O_ °kh� PROTECTED C_... COO[ l `f . ILA" FILE NO. Rwi[ Rw[.cw wwATw, iw[Tew wrR. iROcw • (TZI<t T IN'f• � . CjFL. ., I{NLTT / .., / I f '•_17V 7 .. _ ( _:.... _.. 1 e s::., _.. _.. •t :`_I .So C,GDR�3S'.0S7- - - - Gi __- 17. E \' . -420i - 'r to "-o , V u.0 E 1 � E M t2 V Q40 c /•ures. � � 1 L J - f 15 1 I �J IZ I Io 9 p — _ aTE All.^ D2 f \_ +• � pp " ' •MAT-__ -INS EE a 3ovE _ ..R14t�T" _ .. ' i (jE.CdW '.�P C_ [Ar4fj TFEET - J __ HJT- �.A.T'T✓ ,. _... _ IE o _ Isolation Area Affected Yea --=. �. -. . - Pressure District Affected .Yea ❑ NO Q' •».TALL Y.IN wnN AT LAST �n• CovER {[Low—fyT,L'. TOTAL ►LCT RCTu[o KIVE - _> RETIREMENT IPw"n Ifiu[0 by PERMIT N . DATE MOVED DAT[ MOVED DAT[ OP Business District Affected Yea ❑ NO 0' COUNTY GITY Of= ON Jo. DIP a- . — c _ o P[ R. S SUp Jna Affected Yea ❑ No 3' _F_ REASON ewcw ►oR[~AN DISTRICT Valve(s) Required Yea ❑ NO ETRACT I� COMPANY TNNE NOYEAR C.I. STAKED. C $0. CAL. /ESP.L.S. Reviewed . INSTALLED' COY//NO. IND O REVIEWED w STAKING RIO'D. SMT'IFZV DVSIoM CP. Ravlewed ByLJG cATNoo,uLY OPER MO - ZE Dwc T[f NO AT L[i! THAN 30, DISTRICT SUPERVISOR {TAE[f M[LDLD M. O_ °kh� PROTECTED C_... COO[ l `f