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1838NOTE: 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 II DATE: 8/16/93 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Jefferson Ave A .300' Worth of AV* 49th La Quint& (Street address or Description of Location) PURPOSE OF CONSTRUCTION IID Hlettrical. Conduit Crossing DESCRIPTION OF CONSTRUCTION 109tAll 3-611 Ce"d"It ACROSS Jefferson — Slurry Backfill DIMENSION OF INSTALLATION OR REMOVAL 62x30" Slide by 48' Depth SIZE OF EXCAVATION, IF NEEDED 62'x30"148" APPROXIMATE TIME WHEN WORK WILL BEGIN 8/17/93 Sketch (attach construction plans if appropriate) SES ATTACHED CONDITIONS SEK ATTACHED DRAWING SEE ATTACHED TRAFFIC CONTROL PLAN APPROXIMATE TIME OF COMPLETION 8/17/93 1 day ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, com- paction, and placing permanent resurfacing and/or replacing improvements) 1 ' In consideration of the granting of this permit, the applicant hereby agrees to:, D Q 0 AUG 16 1993 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 per_m-itland all applicable rules and regulations of the City of La Quinta and to pay for any additional replacement necessary as the resu„t66f tWs work. Indio Name of Applicant (please print) ature of Applicant or Agent Business Address Telephone No. F -W, Developwnt Jack Burry (Ssmie As Above) Name of Contractor and Job Foreman "�''jA°� Business Address Telephone No. 367841 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 Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ 19' ,90 Permit Fee /,ep • 0449 Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No $ 7U. d0 Received by Date PERMIT VALIDATION PERMIT NO. 18.38 DATE APPROVED 8/16/93 EXPIRATION DATE 8/20/93 DATE ISSUED 8/16/93 By -W rt Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 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 lou, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS i - � DATE:-- /�� /�� Subdivision Improvement Permit — Class 111 � T_! Minor Improvement Permit Class IV `LOCATION OF CONSTRUCTION 100 �VP47-114 of - (Street �S (Street address or Oescnption of Location) �C PURPOSE OF CONSTRUCTION + Sketch (attach construction lana if C011J014iT C,2DSS/� p appropriate) DESCRIPTION OF CONSTRUCTION T.U.S%AGL L11-irnSc ,TaGG17ln., ci:. 0._ i .� ,,(,DIMENSION OF INSTALLATION OR REMOVAL - ° X 30"cm(de A %J , Ld d' A 1='_.� %k SIZE OF EXCAVATION, IF NEEDED G e- ` X' 30 APPROXIMATE TIME WHEN WORK WILL BEGIN S 'APPROXIMATE TIME OF COMPLETION 3 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: Sff- /�%7✓frf/ co.�l� �Tio�S Indemnifv, defend and saw 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 happening or occurring a a proximate result of any work undertaken under the permit granted Pursuant to ��application. to Persons« 0 ropery Notify the Administrative Authority at Isar twenty-four 124) hours in advance of the time when work will be stared. Comply with all apOliCable 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 replaoertent neee:esry as the result of this work. X -fir/-OHO G�1�5j %' Name of Applicant (please print) 2`7 Gv, DF 11670, MQ v - L;;�ce-e Name of Contractor and Job Foreman Y-3-62 6 L// Contractor's License No. r Signature of Applicant or Agent /ri= 3y/$= vs';- 6zz arnTPe1 ccaB be ply SzZi/ Business Address BUAI1 ` 774 2 > i Business Address Telephone No. C�/� Pte. /D• gzzii 3 y3 =�lSS"� Telephone No. City Business License No. Applicant's Insurance Company Policy Number "y FEES: $ubolvlslon 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. PERMIT VALIDATION PERMIT NO. X838 DATE APPROVED V —1GO ^ 9 EXPIRATION DATE e - 20 - 93 DATE ISSUED Received by Date BY Administrative Authority Recorded by TELEPHONE: (619) 564-2246 LN:3-8'CND.165'W - R T17295-75' PROPOSED RISER POLE y I. i �yl CORS: UN580', n a a 4 a � n A i a A . Wo �W ii i. o X 12'-O'FACE 0 C i 15 . 20, UN5 08P Ll i w N. A. P. . a 'Q INST. NO. , D' w 32044 9 J O.R. ►- x o .,..0- The following General and Special Provisions are attached to and made a part of Permn No. �$3$ GENERAL PROVISIONS The following shall always apply: ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within Citv of La Quints right of way ONLY. Whenever construction extends within private properly. it Shall be the responsibility of the perrhmas for his contractors, l0 secure permission from abutting properly owners. Such authorization must be Secured by the permittee prior to starting WOM. TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated tradtleving construction equipmem shall not be permmedtooperate anany Paved surface unless fined with smooth -faced street Peds. All mechanical outriggers Shall be fitted wnh 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 contraeL 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 cost of two mates all of A.C. surfaging plus appropriate seal coat as specified above. PROTECTION OF TRAFFIC: All excavationsand work areas shall be -properly lighted and barricaded as deemed necvegn pt the City Engineer or La Quints City Public Wrxfislnspeeors. Suitable detours and detoursignsshallbeplaeedand msintairtedfaMedurauon of the proism The City $hall be notified 24 Ha. in advance of any traffic detours or delineations, CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete lv concrete structures encountered during excavation which necessrats rama event -it stert and eel cculvbecomes necessary to remove cut skirtovsl shall Pope.pe,ay De replaced in kind. In the existing drainage structures. City of La Quintsshall be notified prior to commencement of this work. Drainage structures and open drains shall be kept free of debris et all Ames for proper drainage, RIGHT OF WAY CLEANUP: Any surplus matenal resulting from excavation and backfill operations shall be removed from the right of way. All paved surfaces shall be broomed dean of earth and other objectionable materials immediately after backfill and compaction. Existing gutter line and drainage ditches snail be replaced to their original standard or better. All excess material shall be removed prior to paving. Water tanker Shall be used, as required. to sprinkle the job site to keep down dust conditions anti shag be used immediately after backfill. OE -WATER OPERATIONS: If de -watering operations are required and pumps aro forcing wateron City of La Quints roads, it shall be the responsibility of the permittee Icontractorl to control this water and to Provide off-street barricades when nepssary. CLOSING STREETS: No street shall be dosed. A minimum of one lane of traffic shall be maintained at all times to provide limned access for the adjoining property owners and emergency vehicles. In the event it i s fe It by the perlhmee that he mustclose a street for any length Of time, permittee shall contact this office to obtain the necessary permission. SPECIAL PROVISIONS The follwing shall apply ONLY when indicated: V NOTIFICATION: Pernimee shall notify the City at 664-2246 at least0hours in advance of Starting R2 CASH DEPOSITS OR BONDS: A casts bond Oran a eontxruetion n an amount of not less than$ _ shall be furnished in the name of City of La Quints o cover surety 1work involved in the restoration of the w rNM La roads and survey monuments. This bond shell be continuous until cancelled by the City Engineer. This bad MustQuinta be �posted prior to commencement of any work on this project. LfTY CLEARANCE: (Substructures) Priorto making any excavation within thsCitV of La Quints right of by perms. the Permmee shall comet all concerned utility companies relative to the location of existingSubstructures. Damage Damage to existing substructures resufting from operations conducted under this $ubatntetures. of the Permmee. Permit R4 UTILITY CLEARANCE: (Surface atructuresl No work shall be dons under this permit until all utilities are dear of the Proposed work site. The perntmes shall notify all concerned utility companies r the proposed work, R5 PAVEMENT WIDENING: Area between the proposed concrete gutter fine and the existing road pavement shell be surfaced with inches of A.C. Paving placed on inches of class having an"R"valueofnot less than and in conformance with City of La Quints Road Improvement entStandards and Specifications, Ordinance 0481, rhProvementStandards R6 PARKWAY GRADING: Area between the property line and top of the proposed concrete eurbshallbegradedtoaalopeof 1/4 inch to one foot (11. R7 GRADES & STAKES: City of La Quints shall establish grades and stakes for the proposed comerete curb and goner construction. R8 GRADE CHECKING: City OfL.aQuintashall check grades up -on recerptofplanandprofileand/ a or gradeseseatabfiahedpy lirensed engineer. R9 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( fast)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 Quints Standard 0207. RIO DRIVEWAYS. A.C.: Driveways shall be constructed as not to after 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 (_ 1 of class aggregate base. Driveway construction shall conform to attached drawing. R11 CULVERTS: A:nchdiameterl-)culvertsha11beinstalledwiththeinvenapproximatelyI.1/2 inches below and in line with the existing flow line. Culvert installation Shall conform tO the attached drawing, 6) 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 Citv of La Quints forces to preclude delay or interference with State or City of La Quints projects. R15 SURVEY MONUMENTS: Prior o excavauon or beginning of construction, all survey monuments which exist on the centerline of all streets or propertyfines when involved shall bscompletety tied out so they maybe readily and correctly be reolaced by a licensed civil engineer or surveyor at the expense of the permittee. A complete set Of notes showing the cies to thaw monuments $hall be furnished to the City Engineer prior to the►emovai of any monuments. Thisoft ceshall be notified upon completion at. cement Of all survey monuments tar braider Project clearance. c, - .F _ a..- : --.rot - : „r�-,•.+�: G..c�n� ..r ,-a•. _ .. _ - , . r - of La Quints ano Suitable payment or guarantee Of payment snail `be'made as eimoursememsforla I warout ilvCed. R17 PAVEMENT CUTTING: Pavement will be macnanica iv cut to a stratght edge prior to excavation. Method of cutting shall be approved through the office Of the City Engineer. (Under no circumstances shall excavatio (pavement+ be used to excavate prior to Cuttin0 of pavameml. Excavation material shall be placed to such a g equipment facilitate the general flow of tratfic. Prior to final paving operations. any carnage to pavement straghtien as to best C edge shall be R1 PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paying Operations. any damage to Pavement straight edge shall be corrected. R19 LIMIT OF EXCAVATIONS: Excavations shall be limited to 1.000 lineal feet of open trench before backfill operations must begin. All excavations snail be oronertv barricaded with lights overnight, on weekends ano holidays torthe protection of the traveling public. The Public Works inspector snail determine the suitability of excavation barricading in each case. No excavation shall remain open for a perioa exceeding five 15) days. No excavation snail be made unless the construction material is actually On the work site. BACKFILL MATERIAL Backfill shall be free of brush. roomor other organic substance detriments, :..ks use for purposes Of producing an adequately consolidated backhll. Any material which the City of La Quints deems unswtable (spongyor saturated material) which is encountered during excavation shall not be used for backfill. but shall be supplementetl or replaced by an approved sand or gravel. R21 BACKFILL SAND: Baddill shall be approved transit-mix sand or equivalent and shall be placed in lifts of not greater than three feet (3') and vibrated using vibrotamperorequivatemequipment. Alternate methodsmaybesubsthuted but in any case a relative compaction of 95 Percent shall be attained within the structural section of the roadway, R22 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 (51 lifts where trenches are of excessive depth& Care is to be exercised that the backfill material is not subjected to extreme swell by flooding operations. Backfill material shall be placed 90 that the resulting compaction shall be not less than 90trercem or equivalent to the surrounding ground. whichever is the greeter compaction. Where ponding or flooding is used for a maximum settlement, adequate dikes will be constructed to retain the water. Where letting is used. the jets shall be of sufficient length to reach the bottom of each :aver and the water Supply shall be continuous. Q0 COMPACTION TESTS: If so required bythe inspector, compaction tests shall be made at intervals of not more than 1.000 feet and a minimum of one (1) test on each road. One it) 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 of California, dated January 1973, 24 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing g� service line. Convection tests shall be made as outlined in Section 6.3.01 of the Standard g Permanent repairs. of California. dated January 1973. SpeelficatlOns. Division of Highways. State R25 TEMPORARY PAVEMENT REPAIRS: Atter 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") of SC-800 shall be placed Immediately. A permanent patch of inches A.C. surfacing placed Ona inch class baseshall be placed no later than temporary road repair. days ahercompletionof R27 PAVEMENT REPAIR: F.AS.: Upon completion of backtill and compaction. a temporary patch consisting OftWO inches (2-) Of cold mix Paving (SC-800) shall be placed immedistely.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 0 5) days after completion Of temporary Paving. Concrete base shall be of five-sack mix and shall conform to the City of La Quints Road Improvement Standards and Specifications. Ordinance 0461. 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 seat coats existed prior to issuance of this permit. Seal or armor coats shall be applied as stuecified in Section 37. Standard Specifications. State of California. Divisionof Highways. dated January 1973. Work of pavement repair to be accomplished by a licensed contractor engaged in the business of pavement repair. R STREET RESTRIPING: Where street Striping isstill visibleonstreets tobeexcavated.suchstripingshallbereplacedupon Completion of permanent repairs. R31 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quints road right Of way shall be accomplished by a licensed. bonded and insured tree service. and handled safely without mterference or hazard to the traveling public. It shall be the responsibility of the permittee to maintain the tree in a vigorous growing condition at is new location. Tracts to be removed shall be removed in sectipnswhich can be handled Safely without interference or hazard to highway traffic. The entire width of the tree stump snail be removed and disposed Of so that no debris remains in view of the hignway. The stump hole shall be backfilled and thoroughly compacted as specified inthe 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 backfilledand 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 Semon 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. p. 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. 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 oarmn. d. Aft tree trimming on EVERGREEN TREES. PALM TREES. and other ORNAMENTAL TREES shall be accomplished to Me satisfaction of the City Public Works Instimar. e. Abutting property owners shall be contacted in all instances. prior to trimming or topping trees. f. Pruning shall. in all instance& be at the shoulder of the crotch to insure even. fast healing in all cuts of two Inches 12"1 and above in size. Sealant shell be applied to as cut sections as directed by the City Public Works Instie inr •_ - ... r; •... . .. � 1 x , �X..-p... _ : � ._.�mr4...^G.- Y.-..- «-]fir. .. .�.si. ,. . .. .. - • ,,.h ... ,. C � . : _ •. -> :PEC I AL CONDITIONS --PERMIT NO. 1838 --- Electrical Crossing --- In addition to the standard permit conditions, the fallowing shall apply: 1. All work: shall be performed in accordance with the latest edition of the Standard Specifications For Public Works Construction. 2. Permittee shall be responsible for providing continuous dust and erosion control. 3. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more frequently if required. 4. 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 fallowing time periods: October 1st, to April 30: Monday -Friday 7:00 a.m. to 5:30p.m. Saturday ewo a.m. to 5:00p.m. May 1st to September iii: Monday -Friday 6:00 a.m. to 7:00p.m. Saturday 8wo a.m. to 5:00p.m. Mork: shall be prohibited on .legal holidays including Sundays. 5. 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. 6. Advance warning signs and traffic control shall be installed and maintained in accordance with Cal Trans Standards. It shall be the permittee's responsibility to detour and barricade this site. 7. Street closures shall not be permitted. A minimum of one travel lane on paved surface shall be maintained with flagmen at all times. B. If the work: is to be performed by forces other than that of the utility company the contracting company shall apply for an additional encroachment permit and pay the appropriate fee. - 9. Prior to excavating; the permittee shall contact Underground Service Alert at 1(800) 422-4133. 10. Should additional work, material=_., or modifications of the work be required in order to meet city standards, safety requirements, signage requirements, or to fit actual field conditions, the work: shall be performed by the permittee as directed by and to the satisfaction of the City Engineer at no cost to the City of La Ouinta. Special Conditions - Permit No. i838 Page 1 of 2 2 10 2 abe,q BEB I ''std _i T'L 'a,:j - SU,] t 4 T PU03 I e T. Dadg 7 -AIa4k-tpa11JuJT JTL-da-t iie4s aa+4Tw jad iDilgnd buTIane -tq a(4:} ,DI 9:)L1 STi1!-( a saw,:)aaq 4D}ed f._!e-!odwa4 a+lq+ JI f3UTr+STXa Ue44 -!a4ea_!b 4Du.T aL.!-:) e aq iieL45 UC)14Oas '4Uaf1J1aZ)eIda_t '4UawaAed 4uau"LL"•a,:l I '/,4'rSUap f,._!p ant-}},ia-! %�6 o4 pa4Dadw,» aq i ie4s tit-!aqew aseq iii f.a.tsoap A. t.p anTDeIa-'• ':S6 04 pagDTdw-» aq ii"' -{S aDe -ti-IS 4atut� 10 :2 d,:).l a4D. UTL14TM ITOSiiT�°f=�?G ti" iA4Tsuap A'p ant'4eIa-! %C)6 IDD, pa?»dw-» aq i i"4s I-Tos app tbgns PUL' i i T� 1�"q t IH •+�i ':y k,:)M bu-14_!t'4s ,]:.-got-!d s_!(4 8+7 I') 1JJl-1UJ1U'C11J e aqet Ad'»dde S" 84789-889 (6 T 9) 4" -!I daQ i eL!b TS SUeA4 i'-'3 -!47689-SG2 (47IG} I -F -4daQ IeubtS aPTs_AaAl,� AITIOU Iieys aa44Tw_!ad a4-4 �U:)T4::)as -Aa-4Ut paZTisLAbTS s p:) cf Ut44TM ST ::1 -k -:)M a4.1 Ua4M 'ET a'1� �I PLAe f q pa4Da-!TP Se ea -ke a41 !!t4,4TM buT:-i_!,7ti S-'•a44'� PUe-1'34>»-!a.U0Z) S,/,,4T3 a44 44 T^^ Paj)PUTP-100D aq ii'a4s :iJ-:)M iid '2I •.AOT?TP!-!'» I?L!tbt-!':) Sa.T aq pa:)slda_! aq IIeLIS •a}a :i:)0-! aAT4e-k0:3ap U0T4)P5T-! Jt buTdpdspueI iiti 'IT , GEORGE H. CHANEY CO. Inspection Services TO: 4-111� THE FOLLOWING WAS NOTED: 6f/Ir v 6593 DATE 4?' JOB NO. PROJECT DESCRIPTION eWPIJ? %— LOCATIOJN�`�� N CORACT)OR ,rpm WEATHER FROM TO HRS °Bd9 : 30 Q . TOTAL 72777 IW C , - � FFIX- COPIES TO: MI RD SIGNED WHITE - CLIENT, YELLOW - FIELD FILE, PINK - OFFICE FILE ,. .�,., _ l y _ r i y •' a 1 ` �. ° i _ • ° � ` t � \"`. � .\F t._ '\ �..\` 1 .�_ �� � � is � � . ' � �•. i'-:z;�x���Mil�8w�t���1n'°i:-°...ia�:T�"�r.�<�@:?:�'r:*���t��,r��..a., an +�+�'"�:j3;:^�r�+;fz` 'a � ♦r. /A1Er+ii..iet GEORGE H. CHANEY CO. Inspection Services TO: / ./1_ THE FOLLOWING WAS NOTED: _G� ��6��� Cf�/✓t7r� c � '�/ S�/i>�� � .jamrZ AP T-- /-� /, P - 9 IPA- 4) 44 elm DATE / 17 -% 100, ol TIL- JOB NO. PROJECT DESCRIPTION r /� LOCATIONp \J'�l� 6 4-13�' of L CONTRACTOR WEATHER FROM TO HRS ;moo Ls�v l-� TOTAL ,� �� /�-�Q %._?����� ����-�v�� S6� ���a✓� !tel COPIES TO: SIGNED WHITE -CLIENT, YELLOW- FIELD FILE, PINK - OFFICE FILE VI F r _ +e :% ... +� Via'...- �:_"� x.. ''N .. Y'i•2Rf�- '!k an -7 .��•+� ...� . "[u.'C, .