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2596
e NOTE: With proper validation t this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS DATE: April 1. 1997 Subdivision Improvement Permit — Class I I I Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 51-765 Avenida Navarao/Calla Sinaloa (Street address or Description of Location) PURPOSE OF CONSTRUCTION install 69 ft. of new 2t/ Sketch (attach construction plans if appropriate) plastic laas main DESCRIPTION OF CONSTRUCTION Oven trench cut in earth SEB ATTACHED CONDITIONS DIMENSION OF INSTALLATION OR REMOVAL SEE ATTACHED SIMTCH SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 4/7/97 APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ not available (Including removal of all obstruction,, materials, and debris; backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, the applicant hereby agrees to: Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started. Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of La Quinta and to pay for any additional replacement necessary as the result of this work. Signature of Applicant or Agent Southern California Gas Co. P.O. Box 3003 Redlands, CA 92373 (909) 335-7736 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 .Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ " 0 Receipt No. Received by Date Recorded by PERMIT VALIDATION PERMIT NO. 2596 DATE APPROVED 4/8/97 EXPIRATION DATE 4/30/97 DATE'�ISSSrUED A/IIS/97 By �.(fw o Y Administrative Authority Telephone: (619) 77.7-7075 SPECIAL CONDITIONS --PERMIT NO. 2596 --- Southern California Gas Company --- In addition to the standard permit conditions, the following 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 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. Work is allowed on Saturdays only if special arrangements, including payment of overtime inspection fee, have been made two (2) working days prior to the desired Saturday. 5. Permittee/contractor shall assume responsibility for repair of any pavement damage to any public or private street and for any damage to other City streets or facilities as a result of work performed under this permit. W 6. Advance warning signs and traffic control shall be installed and maintained in accordance with Cal Trans Standards or the Work Area Traffic Control Handbook (WATCH Manual). 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. 8. Prior to excavating, the permittee shall contact Underground Service Alert at 1(800) 422-4133. 9. Should additional work, materials, 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 Quirita. , Special Conditions - Permit No. 2596 Page 1 of 3 SPECIAL CONDITIONS ---PERMIT NO. 2596 (continued) 10. Backfill compaction within improved street rights-of-way shall conform with Section 306-1.3 of the Standard Specifications For Public Works Construction (SSPWC). All backfill soil shall be crushed aggregate base or crushed miscellaneous base, meeting the requirements of Sections 200-2.2 and 200-2.4 of the SSPWC. Native soil shall not be used as backfill material Compaction tests (one per 300 linear feet of trench) shall be provided for areas of excavation large enough to accommodate compaction equipment. For areas of excavation than that which would accommodate compaction equipment, controlled density fill (CDF) or any equivalent sand slurry mixture shall be used. As an alternative CDF or its equivalent may be used for all areas of excavation eliminating the need for compaction tests. Material tickets and compaction test results shall be submitted to the city. 11. All excavations at or near the travel way shall be backfilled and paved at the end of every workday as directed by and to the satisfaction of the City Engineer for the protection of the traveling public. 12. All landscaping, irrigation, decorative rock, decorative concrete, lighting etc. shall be replaced to its original condition. 13. Access and egress to all local properties shall be maintained at all times. 14. Permanent pavement replacement structural section shall be one inch greater than existing, or 4" minimum, which ever is greater. A. C. mix design shall be approved by the city prior to placement. Permanent paving shall be completed within 7 calendar days from completion of the work. 15. Permittee shall notify the City Engineering Department a minimum of 48 hours prior to any work in the street (i.e. paved areas) at (619) 777-7075 when the work involves lane closure(s) in a signalized intersection or within 500 feet of a signalized intersection. Permittee may be required to submit a site- specific traffic control plan for review and approval prior to commencing work at or near a signalized intersection. 16. Work hours at signalized intersections or within 500 feet of a signalized intersection are typically from 9 a.m. - 3 p.m. to avoid peak traffic periods but may vary depending on the location of the intersection. The permittee will be notified by the City of specific work hours (if different) during the 48 hour notice period. 17. All backfill shall be mechanically compacted in lifts of eight (8) inches or less. Jetting or flooding of backfill material will not be allowed unless otherwise specified by the City. 18. Contractor/permittee shall stabilize any soil that was disturbed (shoulder areas etc.) as a result of work performed under this permit. 19. Trenches in the street section shall be permanently paved within seven days after completion of the work unless otherwise approved by the City. Special Conditions - Permit No. 2596 Page 2 of 3 SPECIAL CONDITIONS --- PERNUT NO. 2596 (continued) 20. Where trenching is performed in any P.C.C.. or A. C. improved area the trench shall be saw cut an additional 1' on each side of the excavation area and a butt joint created. The edges shall be saw cut to straight, stable, and unyielding edges. Feather joints are not acceptable. 21. The city has designated by ordinance certain city streets as Truck Routes. The weight limit for restricted streets (i.e. streets not part of the Truck Route network) is three (3) tons; trucks exceeding the weight limit may use the restricted street if making a delivery or pickup on the subject street., or if this permit specifically grants permission to use the street to deliver street construction materials and/or equipment. 22. A traffic control plan shall be prepared in accordance with the Work Area Traffic Control Handbook (WATCH), and submitted to the Engineering Dept. for review prior to starting any construction. 23. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. Special Conditions - Permit No. 2596 Page 3 of 3 0 t .. NOTE: With proper tralidetion this form constitute` an CITY OF LA QUINTA ertexoacitnndnt permit APPLICATION FOR PERMIT CITY OF LA QUINTA APR 0 71997 PUBLIC WORKS PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) v� F, S c�28 For the construction of -public or private curbs, driveways. pavements. sidewalks, parking lots. tawel . water mains and other like public worsts improvements in oonwlection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS 4-1-97 Subdivision Impl'om nent Permit - Class ill DATE: Minor Improvernan Permit Class IV LOCATION OF CONSTRUCTION 51765 Avenida Navarro/Calle Sinaloa . Ukreet sddrea or Or wilydon of LacedoW PURPOSE OF CONSTRUCTION Sk�(atta h construction plans if appropriate) Install 69 of new 2 plastic gas main DESCRIPTION OF CONSTRUCTION Open trench cut in earth SEE ATTACHED SKETCH DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION. IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 4-7-97 APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST S -=I (Including removal of all obstruction, materials, and debris, badtfillifg, tom• paction and placing permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, the applicant hardly agren to: Indernnih, defend and sw the City. its authorized apente, officers. npraergatira and emplovem hamNero from end sgeinst sny end all penalties, liabilities or loo rmatins from daime or own action and or" out of any acident, leer or 1 e to persons or propatlr hq*wd tg or QwurNng a • proxwole rant of any work undertaken under ter permit rented wwroma to this applieetmn. Notify ter Adrminietretim Authority at lint twantyfour 1211 horns in adrortoa of ter tkne when work will be started. Comply wilt all spowaWe City Ordinance. do tonne and conditiona of ter Permit end all appliaWe nda and regulation of dw City of La driers and to psv far any additional raplaamtaett etsaasaery as ter waufl of this went - _ Lynn Young.. -- , >iigfrttrr Appiiognt a Ageftt PERMIT COORDIN&TOR SOOTHERN CALIFORNI'GAS3C0__�" p_d_ anx crena_ gt.nivnc r -n q��7? Nese at Applicant (please printf <-. _ . Busieless Addrdes Telephone Na Now of Contractor and Job Faremerl Business, Addnes Telephone Na Conaaetor s Liaise Na City Business License No. . AppikeeWs Insurance Company Polity Number FEET: Subdivision Improvement Permit - Class 111 Public improvements: 3% of sedmsted construction ousts Private improvenseb: 3% of estimated construction costs Minor Intprovanent Pwmk - Clan IV: Sae attached schedule ifspectim Fee = Permit Fee Penalty Cash Deposit -Surety Bond if fequind all $ fp- p TOTAL:- TOTAL: Receipt Receipt No. Reaiwd by Date Recorded by 17 PERMIT NO. DATE APPRO EXPIRATION DATE ISSUED By Administrative Authority PERMIT VALIDATION TELEPHONE: (819) SIW2416 r:�,/ ATLAS N INSTALLED P.W.D. STAKED COMPANY FACILITY: S0. CAL.Ox P.L.S.O N0. 10112 J. BLACK STAKING REO'D INLAND EMPIRE REGION OPER. 20% OR OVER O ___ C CD ; CATHOOICALLY PROTECTED YESO N00 AT LESS THAN 20% QS.M.Y.S. DISTRICT SUPERVISOR NO STAKES ® W.O. _ _64147-018 ` NEEDED DRG. CODE __ UNDERGROUND SERVICE ALER CALL TOLL FREE ply ,., �►-K�, 1-800-422P'1.. TWO AYSi� ""► WORKING �' >.• s'..� .^ ,,,'.r1 BEFORE YOU DIG ! WR* 25629b TOTALFEET INST'D INSTALL MAIN WITH AT LEAST 30' COVER BELOW GUTTER FLOW TOTAL= FEET RETIRED ; PIPING LEAK TESTED AT P.S.I. COUNTY RIVERSIDE RETIREMENT PERMIT ISSUED BY PERMIT NO. DATE MOVED NOTICE OF ON JOSo OPER.OATEt MPLE ION DATE MOVED COMPLETION - OFF JOBi DATES FOR FOR HRS. AND/OR MIN REASON: (SEE SYS. INS. 6184.0150) DISTRICT DESERT CREW FOREMANCOMPANY BY DATE TRACT N0: YEAR C.P. PLANNED BY . ATLAS N INSTALLED P.W.D. STAKED COMPANY FACILITY: S0. CAL.Ox P.L.S.O N0. 10112 J. BLACK STAKING REO'D INLAND EMPIRE REGION OPER. 20% OR OVER O ___ C CD ; CATHOOICALLY PROTECTED YESO N00 AT LESS THAN 20% QS.M.Y.S. DISTRICT SUPERVISOR NO STAKES ® W.O. _ _64147-018 ` NEEDED DRG. CODE __ UNDERGROUND SERVICE ALER � UPLLt <e L sllvA<.oA i CALL TOLL FREE � . ;ws' r a�++�►, �, z _ Iso 2"P CAP I 59_2 P M i o .,.,. � ►� ' ill�r+wu;.yw� co _ EM O.T.E. WR» 2562910 rL w M r TOTAL FEET INST'0 PIPING LEAK TESTED INSTALL MAIN WITH AT LEAST 30' COVER BELOW GUTTER FLOW TOTAL FEET RETIRED AT P.S.I. 60 RETIREMENT PERMIT ISSUED BY PERMIT N0. DATE MOVED NOTICE OF DATE MOVED COMPLETION FOR HRS. AND/OR MIN 0 0.- N REASON: • :. ON JOBI OPER. DATEI OFF JOBI DATES (SEE SYS. INS. 0184.0150) DISTRICT DESERT 8Y DATE 216 P COUP CREW FOREMAN a z A TRACT NO. YEAR C.P. PLANNED BY N rnMp&my 1 M MAIN COND. �. - CODE EXT o INT .. .. o 8. M • N Q a _ Q Z N O LLf Q N 00 GAS HANDLING 0 , w1r r .. �....•8► Pik N .r M r+a..►j,.►*y.�r�► L INSTALL MAIN & SERVICE AND TEST. 2. PINC� Tlt'V LOCATION �� A �� 1ww+IMuw�.rw 1 60 . 3. PURGE tt-"$t'p.ICE. UNDERGROUND SERVICE ALER CALL TOLL FREE � . ;ws' r a�++�►, �, 1-800-422?? vuq , ' TWO WORKING DAYS BEFORE YOU DIG ! ' .,.,. � ►� ' WR» 2562910 TOTAL FEET INST'0 PIPING LEAK TESTED INSTALL MAIN WITH AT LEAST 30' COVER BELOW GUTTER FLOW TOTAL FEET RETIRED AT P.S.I. COUNTY RIVERSIDE RETIREMENT PERMIT ISSUED BY PERMIT N0. DATE MOVED NOTICE OF DATE MOVED COMPLETION FOR HRS. AND/OR MIN REASON: • ON JOBI OPER. DATEI OFF JOBI DATES (SEE SYS. INS. 0184.0150) DISTRICT DESERT 8Y DATE CREW FOREMAN TRACT NO. YEAR C.P. PLANNED BY rnMp&my t UNDERGROUND SERVICE ALERT ATLAS INSTALLED P.W.D. STAKED Q COMPANY FACILITY: SO. CAL.F-X P.L.S.O NO. IND112 STAKING REO'0 INLAND EMPIRE OPER. 20% OR OVER E J. BLACK E I E REGION CATHODICALLY PROTECTED YESQNOD AT LESS THAN 20% S.M.Y.S. NO NEEDED © ORG. CODE Q DISTRICT SUPERVISOR W.0. _ 54147-018 - UNDERGROUND SERVICE ALERT CALL TOLL FREE 1-800-422{'i.; TWO WORKING (7/AYS BEFORE YOU DIG ! J WR* 256210 TOTALFEET INST'D PIPING LEAK TESTED 1 INSTALL MAIN WITH AT LEAST 30' COVER' BELOW GUTTER FLOW TOTAL' FEET RETIRED AT P.S.I. COUNTY RIVERSIDE RETIREMENT REASON: PERMIT ISSUED BY PERMIT NO. DATE MOVED NOTICE OF ON JOBi OPER.OATEo DATE MOVED COMPLETIUNT OFF JOBt OATEj FOR HRS. AND/OR MIN (SEE SYS. INS. 0184.0150) DISTRICT DESERT CREW FOREMAN BY DATE TRACT N0. YEAR C.P. PLANNED BY COMPANY ATLAS INSTALLED P.W.D. STAKED Q COMPANY FACILITY: SO. CAL.F-X P.L.S.O NO. IND112 STAKING REO'0 INLAND EMPIRE OPER. 20% OR OVER E J. BLACK E I E REGION CATHODICALLY PROTECTED YESQNOD AT LESS THAN 20% S.M.Y.S. NO NEEDED © ORG. CODE Q DISTRICT SUPERVISOR W.0. _ 54147-018 -