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2742 (2)_With proper -'validation 0 `"r thls;fo�in constitute t s an CITY OF 'LA QUINTA i encroa6hment`permit"-3*---ti y'"",� • K� ':`APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) OF For the construction of public or private curbs, driveways,, pavements, sidewalks, parking `lots, sewers, water, mains" 's and otiier•like public works improvements in connection with MINOR IMPROVEMENTS and'APPROVED SUBDIVISIONS . ' Subdivision ., .: Improve,ment Permit — Class Ill ,DATEx90$•Minor .; Improvement Permit IVB- '�• } - 51 •360 Avenida: Rubie It Avenida •Montezuma LOCATION;OF CONSTRUCTION ' • t�J „,(Street address or bescription'of Location) PURPOSE -OF CONSTRUCTION Provide 06i sex'viee; Sketch (attach construction plans if app ophate)' DESCRIPTION OF„CONSTRUCTION ' '” � -•`. •, V:, plastic Raft# wain. SWATTAC CONDi7< 6' c �. DIMENSION OF INSTALLATION OR REMOVAL Bora. 23 -ft. S' AWAC�'ARAW1N6 4%$#.0. 9 r t x.; ;; ilzitar at�eis:`'trench earth 'bar' others; r:' 54_�k8µU7Q: .SIZE OFEXCAVATION;.IF NEEDED 48HOL °M, ADVANCE NOTiCS � OUTM. . PWSE CAU (760).,777 -767$- -TO.. APPROXIMATE,wTIME WHEN WORK WILL BEGIN unktowd SG i> OUB. INGVE'CT10N.; • I .� � . , v, 1, y_• ''APPROXIMATE TIME OF COMPLETION' ESTIMATED'CONSTRUCTION COST $ N/A'. 4(Including removal of, all.obstructiori,materials, and debris, backfilling, con' ' pactionfand 'placirig permanent resurfacing and/or replacing improvements)'+ �= t '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 fromand agai4st`a'y and all , +• penalties,rliabilities or loss resulting from claims or,court action and arising -out of any, accident, loss or damage to Persons -or property i' happening or,oceurring 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 Cityof ' fLa Quinta and to pay for any additional replacement necessary'as the result of this work. t _ -Signature of Applicant or %Agent. L Y10 -1 a' Southern California - Gas Co. P.0# Pox 3003 Redia ide; CA 0909)"335-7756 Name of Applicant (please print) Business Address Telephone No. "14 .Name of Contractor and Job Foreman Business Address a,-• Telephone No. mac, • '• -_ - .'J r`.�• r' - w •. •_ • . Contractor's License No. r • • r �' a • '. City Business License No. -', " . '• ' .- . ' ` .. C .r •3 '• Applicant's -Insurance Company r :� • •Policy Number.' - 3 "ImprovementrPermit FEES: Subdivision —Class III Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated constructio"Wcosts Minor Improvement Permit — Class IV: See attached schedule • : ' .Inspection°Fee $ U " PERMIT, VALIDATION •Permit'Fee PERMIT NO: 2742 x Penaltyf " 4%27/98 A-. Cash Deposit -Surety Bond, .' DATE APPROVED: ' ' if required . • EXPIRATION'DATE' . +��3'�$..��,: TOTAL: $ Receipt No: DATE ISSUED Y r Received by Date V Administrative Authority Recorded by Telephone: (619) 777-7075{t 4 - NOTES WMib loom t+didstion d* (boll oulotiil" M alnoadlma0t panrlrt gjr.-q OF57 t CITY OF LA QUINTA APPLICATION FOR PERMIT Punic WORKS CONSTRUCTION (ENCROACHMENT) For On mntauetion of 'public or pritrats cato, drit+awavn. prmnerm sidtMMq. perking low wmn. wotw nteine and oda► Wo public works Impioverawn In connection wide MINOR IMPROVEMENTS and APPROVED SUSOIVISIONS q Stabdirition Ilnotot.nrlrtt DAM12 - 4 �,,, Minor Iawwomm" Ptnnit Claw IV LOCATION OP CONSTRUCTION 5 I b O f���Nl Dfl VRIO/aJEN I.DA MO/�TFZI�M T mk . Summer otortlltiew d Laudem - n PURPOSE OF.CONSTR.UCTION ipyLd(e aa,; S-cr j,( Gu. g �ttiah�oa ion pim if approprimo : DECRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION ON REMOVAL Or l=V6TION. IF -04,5,1-ALL b f or- NE \2" P L-,4s?)c GA' M A i APPROXIMATE TIME OF COMPLETION T-6 ESTIMATED CONSTRUCTION COSTSV (Indudnq nfnorM of W obunaedm nmwimlt. and debris, bmkfibina o�- pai dm and tdeeiq pornnnem Iaturfadn� www npleoirN i,o mel (o — c) -D SGHaDuu� In consideration of tllo Wmtkq of dais permit d» epp(iMt harobv acres to: IW►' c, -n ON . f N. deface NO taro dw Chw. is ardente/ seen. ofti mmorale a hm w d ■noigraat� hwwdar naw ad doom ow ane me PwWtiK Ilabditiat. w Ices rater" haw aMiwrt a aorw MOM WA SHWIS ort of aft aomdw4 for or dam p to paracme or proprty hoow q or aumnae at a weamme noes at awr ww% wwwaaM www tale Oarwrit •Mete amwr w ow apptwwow MmAr eM Adwi Ww tiro Aw s tr of Met mow~ 1241 Aorro in @*A~ d tAe time wAaw "a ww be ttaetut. Carwab u*ft all amphsdb Civ Oreirr nm% *e "r and osrmtbft d "ON" a w dl m/iaaf o ndas ase rwrldlar of ow Civ M V driste and to sofl ler my ea ftim" mommosorw aaeottrr as as mores of His "wow LVXVAA SWAUM W AMMON w APP ERMiT COORMATOR SooTAERN rar- L : •GAS _ -9-a- BOX 3004 • &CO nn r,Q Nmaas d Appliearst (Placa pa+wo` Masiwss Addraw- Tdephom Na Ntnta d Coalarsetw and Job Fwafwafs . wines Adflnes> Tdeplala Na CMOwm% L 0sm Nec Clq Ylatifw Lit>tlws Na ApOicenCt lydww oa Con*mv NWnba►' FEEit Subdivision Inlprownlent Prrnlit -Claes 111 Pubik inlprovetnenta: 3N of eednlsts0 aonetrvetion aslaa. Prlvata imm cow w -- 3% of adwaud construction coat Minor Inlprovewwlt PwwAt - Clew IV: Sts ottaNM I to o&" Inspection Fee _ Perelit Fat PERMIT NO. Pa wtv -' 1:Yi1 17eO�utSurfitr Wra`al - - it roouirt0 TOTAL. "' S Rataeipt Na Roomed b1► Dow Rawrded b1► DATE. AM"O' EXPIRATION PERMIT VALIDATION DATE ISSUED By Administntive Audwitr TELEPHONE: (6191566-2246 .?� ' , .• ,t_ + The following General and Special Provisions aze attached to and made a part of Permit No.� 2" 1, r t « ` { - r t .. * • GENERAL PROVISIONS . , y ' e The following shall always apply:' tENROACEIMEN'ftON PRIVATE PROPERTY: This.permit authorizes work to be accomplished within City -of La Quinta right of, ~ gay ONLY., WWhenever'coostrucuonextends within private property, it is the responsibility of the permittee for his contractors to ,acure permission rrom abutting property owners. Such authorization mus[ be secured, by the permittee prior to starting work. : r l . _TRACKLAYING,CONSRUCTONEQUIPMENT: Cleated acklaying construction equipment shall ot r be. permitted to operate on w y,' ! , 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 is paved areas.' If the existing a ` yf' -1 y pavement is scarred: spailed, or broken during the term of this contract,', or if the pavement is marred; Cit f La y of shall request t ',that'its ' portions of road be resurfaced over their enure width. Resurfacing shall consist or one coat of two inches (2') of A.C. surfacing plus appropriate seal cost as specified above.. PROTECTION OF TRAFFIC: Allexcavations and work areas shall be properly lighted and barricaded as deemed necessary by the • t 7 x f. City Engineer or La Quints City Public .Works, inspectors: Suitable detours and detour signs shall be placed and maintained for the . .. durationof the project. The City shall be notified 24 hours in advance of any traffic detours or delineations, ` CARE OF DRAINAGE S'T'RUCTURES: Any drainage structure including corrugated metal pipe, concrete pipe; steel culvert and r + y _concrete structures encountered during excavation which necessitate removal shall be replaced in kind. In the event it becomes necessary:to remove or cut existing drainage structures, City of La Quinta shall be -notified prior to'cammencement of this work. Y Drainage structures and open.draias shall be kept free of debris at all times for. proper' drainage. ` ARIGHT OF WAY CLEANUP: Any surplus material resulting from excavation and backfill operations shall be removed from the right ' [ of way. All paved gurfaces shall be broomed clean of earth and other objectionable materials immediately after backfill and compaction. ' r r Existing user line and d t g B rarnego ditches shaii be replaced to their original standard or better: - All excess material shall be removed + prion to paving. Water,tanker shall be used, as required, to sprinkle the job site to keep dowa dust conditions and shall be used immediately after. backfill. F - DE -WATER OPERATIONS: If de watering operauoas are required and pumps are forcing water on City of La•Quinta roads, it shall s,t be the responsibility of the permittee: (contractor) to control this water end to provide off-street barricades, when s neussery. x r rw• �` CLOSING STREETS: No street shall be closed. A" minimum of one lane of traffic shall be in ad at all times to provide limited ' y +t access for the adjoining property owners and emergency vehicles. 'In the event it is felt by the permittee [hat he mast close a street for. any length of time, permittee shall contact this office toobtain,the necessary permission. r ' c r i K• , '. 'c . E SPECIAL PROVISIONS 4 The following shall ipply when indicated • Rl , ` NOTIFICATION: Permittee shall notify the City at (619.)77/-7075. at least 49 hours in advance of afarting construction. a� R2 tiUlih1 ,.CLEARANCE:- (Substructures) Prior to. making any excavation within the City oftLa Quinta righof way authorized by permit, the permittee shall contact all concerned utility companies relative to the location of existing ' subswctures. Damage to existing substructures resulting from operations conducted under this permit shall be the sole'' t responsibility of the per*ttee. R3 r UTTIIdI'Y CLEARANCE: (Surface Structures) No worn shall be done under this 'permit until all utilities F' a y Js, P are clear of the - Proposed work Bite. The •permittee shall notify all concerned utility companiea.of the proposed work.:. R4' PAVII1ffiVf WIDENING:: Area between the proposed concrete gutter line and the existing road pavement shell be surfaced with inches of A C , paving placed on- , . -inches of class <.., . t r• aggregate wbbase course having an 'R' z ' value of not less than sad in conformance with Cityof_Ia Quints Road Improvement Standards and Specifications. Ordinance #461. RS PARKWAY GRADING:' Area between the property line and top of the proposed concrete curb.shall be graded to a slo i, r+ ; �'•ri } 1/4 inch to one foot (1'). pe of " R6 • GRADE CCIlECCKIIVG: City of L,:Quinta `shall }ch a licensed engineer. eck grades upon receipt of plan and profile and/or grades as established by ''.:` i :� t *'•'- w- t 'R7t. CURB. REMOVAL FOR DRIVEWAYS: , A'portion of the existing concrete curb and/or curb and gutter (_feet) shall be P , removed. Curb aad/or'curb add gutter shall. be saw cut prior to removal: Depressed curb; matching concrete guttter and concrete driveway approach shall be constructed in conformancewith Cit o Quinta S „r • y f La Quin tandard N207. { RS DRIVEWAYS: A.C. driveways shall be constructed as not to alter existing drainage pattern. Surfacing between the.properry • �• yL Y = line and thee road paving shall -be 2 1/2,inchea of A.0 paving placed on of close hall co _� • aggregate base. ri , ``Driveway constructions conform to attached drawing. 'R9 ' SIGHT CLEARANCE: Sight clearance of 600 feet in all dtrecttons shall be assured and maintained at all times. t RIO, SOIL ST'ERILUEFL,-ThCarea to be surfaced shall be treated with soil sterilizer. Rate of application shall commply with the ' manufacturer's specifications.` r RII 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 of City of La Quinta projects. R12 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 may readily and correctly be replaced by a licensed civil eneineer 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. This office shall be notified upon completion or replacement of all'survey monuments for proper project clearance. R13 PAVEMENT CUTTING: Pavement will be mechanically saw cut to a straight 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 traffic. Prior to final paving operations, any damage to pavement straight edges shall be corrected. R14 LIM[T OF EXCAVATIONS: Excavations shall be limited to 1000 linear feet of open trench before backfill operations must begin. All excavations shall be properly barricaded with lights overnight, on weekends and holidays for the protection of the traveling public. The Public Works Inspector shall determine the suitability of excavation barricading in each case. No excavation shall remain open for a period exceeding five (5) days. No excavation shall be made unless the construction material is actually on the work site. R15 BACKFILL MATERIAL: Backfill shall be free of brush, roots or other organic substance detrimental to its use for purposes of producing an adequately consolidated backfill. Any material which the City of La Quinta deems unsuitable (spongy or 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. R16 BACKFILL SAND- Backfill shali'be approved transit -mix sand or equivalent and shall be placed in lifts of not greater than 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 with the structural section of the roadway. R17 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 depths. Care is to be exercised that the backfill material is not subjected to extreme swell by flooding operations. Backfill material shall- be.plaied so that the resulting compaction shall be not less than 90 percent or equivalent to the surrounding ground, whichever is(the grtater 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. RIB COMPACTION TESTS: If so required by the inspector, compaction tests shall be made at intervals of not more than 1000 feet and a minimum of one (l) 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. R19 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line. One (1) copy of each test shall be forwarded to' o 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. R20 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 3000 linear feet of trench his been excavated and backfill operations completed, but in no case shall the placement of the temporary pavement exceed a five (5) day limit. R21 PERMANENT PAVEMENT REPAIR: After backfill and compaction have been completed, a temporary patch consisting of two inches (2') of SC -800 shall be placed immediately. A permanent patch of inches A.C. surfacing placed on a inch class base shall be placed no later than days after completion of temporary road repair. R22 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. R23 S173MT RFSIRIPING: Where street striping is still visible on streets to be excavated, such striping shall be replaced upon completion of permanent repairs. R24 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 interference or hazard to the traveling public. It shall be the responsibility of the permittee to maintain the tree in a vigorous growing condition at its new location. Trees to be removed shall be 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 is 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. SPECIAL- CONDITIONS--PERMIT NO. 2742. " Southern-California Gas Co. --- In addition to the standard permit conditions, the following shall apply: 1. Pursuant to Section 14.16.320 of the"La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), all" work shall be performed in accordance With the latest edition of the Standard Specifications For Public Works Construction (SSPWC) and as directed by and to the satisfaction of the City Engineer. 2. Southern California Gas .Co., hereinafter referred. to as "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. Pursuant to Section 6.08..050 of the La Quinta Municipal Code (Ordinance 18 § 1, 1982), throughout the ' work site, the Permittee shall. comply • with City regulated work hours. Operation and maintenance of equipment within one-half mile of human occupancy shall be performed only during the following tim' e'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 1 st 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 and Sundays. 5. Work performed within 500 feet of a major and/or signalized intersection is restricted between the hours of 9 a.m. - 3 p.m.. Traffic control shall be set up after 9 a.m. and removed before '3 p.m. The Permittee shall contact the Riverside Country Traffic Signal Maintenance Departmentat (909)275= 6894 if signal operation at the intersection is to be altered in any way. 6. Pursuant to Section 14.16.110 of the La -Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), Permittee 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. 7. Pursuant to Section 14.16.250 of the. La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), advance warning signs and traff c control shall be in and maintained in accordance with Cal Trans Standards or the Work Area Traffic Control Handbook (WATCH Manual). A traffic control plan, if required, shall be prepared in, accordance with the, WATCH Manual and submitted to the City for review and approval, one (1) week prior to starting any construction. It shall be the Permittee's responsibility to appropriately detour'and barricade all construction sites. Special Conditions,- Perri it No. 2742 Page I of 3 SPECIAL CONDITIONS --PERMIT NO. 2742 ' --- Southern California'Gas Co. --- 8. Pursuant to Section 14.16.290 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1.982), Street closures shall not be permitted. A minimum of one travel lane of paved surface shall be . maintained with flagmen at all -times. 9. Prior to excavating, if required, the Permittee shall contact Underground Service Alert at 1400-422- 4133. It shall be the Permittee's responsibility .to notify the'Public Works Department of anticipated excavation which impact City facilities, including but not limited to.traffic signal conduits and loops, irrigation lines; electrical conduits, and storm drain facilities: r 10. 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 Quinta. 11. , Pursuant to Section 14.16.370 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), backfill compaction within .street rights-of-way shall.conform with Section 306-1.3 of the latest edition of the Standard Specifications For Public Works Construction (SSPWC), and as required by the Public Works Department. -Backfill shall be completed in lifts, not to. exceed 1', compacted to 90%o minimum relative compaction. Native material may, be used, provided the material is suitable for use as backfill after construction operations. Controlled Density Fill (C.F.) may be used as an Alternative. ' 12. All excavations within City of La Quinta right-of-way shall be backfilled, and temporarily paved if within the existing travel way, at the end of every workday as directed by and to the satisfaction of the City Engineer for the protection of the public. 'Lengths of open trench shall not greatly exceed that which can not. be backfilled in the same day. Excavated trenches shall not be allowed open overnight, however, Permittee may leave a length of,excavated trench, not to exceed twenty (20) flet 'in length, .open overnight•at a point where'construction will begin the next day, provided that this length of trench is completely covered by steel plating. 13.1 All landscaping; imgation; decorative rock, decoratiye.concrete, lighting, etc., shall be replaced to its original condition. 14. ' Access and egress to all local properties shall:be maintained at all times. 15. Pursuant to Section 14.16.375' of the La Quirita Municipal Code (Ordinance 10,§:l (part), 1982), permanent pavement replacement shall. be completed 'no later than seven (7) days after. the completion of the work. Permanent pavement shall be replaced as.follows: ; (a) Existing a.c. pavement shall be removed a minimum of F outside of all,'reviously cut edges; straight, vertical, sawcut edges shall be provided: (b) ` -Base a.c. pavement; meeting the requirements of Greenbook B -AR -4000 (3/4" max. medium), or other City`approved mix design, shall.be installed in.one.lift, not to exceed 3". Special Conditions - Permit No. 2742' Page 2 of 3 f Page 2 of 3 SPECIAL CONDITIONS--PERMITNO.`2742 --- Southern California Gas Co. - - (c) Finish a.c. pavement, meeting the requirements of Greenbook C2 -AR -4000 ('/z" max. medium); or other approved mix design, shall be installed in one lift of 0.10' depth. (d) Permanent pavement depth shall be.a minimum of 1" greater than the existing section. All pavement edges,shall be flush.with the existing a.c. surfaces adjacent to it. Additional finish pavement requirements may be required by the Public Works Department, including grinding and capping overlays. .16.. Permittee shall notify the City of La Quinta Public Works Department a minimum of 48 hours prior to commencement of any construction at (760) 777-7075. 17.' Permittee shall stabilize. any soil that was disturbed (shoulder areas, etc.) as a result -of work, performed under this permit withan approved dust control treatment. 18. Pursuant to Chapter 12.56 of the La QuintaMunicipal Code (Ordinance 10 § 1. (part), 1982) the City has designated 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 a restricted street if making a delivery, or pickup on the subject street, or if this permit specifically grants permission to. use the streetto deliver street construction materials and/or equipment. 19. The City of La Quinta reserves the right to•revoke, suspend or void this permit at any time: 20. :This permit authorizes the installation of a new residential gas. service to 51-560 Avenida Rubio. All installation shall be performed behind existing curb and gutter, and no street excavation shall be authorized. Special Conditions - Permit No. 2742. Page 3 of 3 MAIN COND. CODE EXT INT j RP�N � N,P GAS HANDLING N�tiw M� o �0 RM 1. 1- MAIN & SERV. TEST PER FCD 184.0150 S -- > 2.PINCH & TIE c LOC 'A' J a 3.PURGE THRU SERV. PER FCD 182.0160 � r_ pVEN\O A ., m 60, N - 6' ..+ ..+ N W C N • Cr QCm- lo' W SL Q ./t o ZcoW W >' W > > Q A Q a0 v N 60 a a I - , N � U DERGROUND SERVICE ALERT - CAL TOLL OLL FR EE -800-422-4133 T40 KING W R 0 DAYS I BEFORE YOU DIG ! ! lsolotlo� Area Affected Yes ❑ No ® THIS SLDG.OR AREA OUALIFIES Pressu�e District Affected Yee C3WR No ® FOR ANNUAL LEAKAGE SURVEY: N Business District Affected Yee O No ® O YES 0 NO I. Supply Line Affected Yes O No ® (POST LIMITS) INSTALL MAIN WITH AT LEAST 30 COVER BELOW GUTTER FLOW TOTAL FEET INST'D TOTAL FEET RETIRED Station Affected I Yes O No ® PIPING LEAK TESTED COUNTY RIVERSIDE RETIREMENT PERMIT ISSUED BY PERMIT N0. DATE MOVED NOTICE OF ON J06: OPER. DATE A MOVED M L! OFF JOB: DATE: Vavor el(s) Required ,Yes ❑ No ❑ AT P.S.I. , REASON: Reviewed Sy: BG FOR HRS. AND/OR MIN. PIPELINE MARKERS REOUIRED: DISTRICT DESERT CREW FOREMAN , tSEE SYS. *& 0184.0150) OYES ®NO TRACT NO. YEAR C.P. PLANNED BY COMPANY - -'I COMPANY FACILITY: SO. CAL.[_] P.L.S. C. P. Re�iewed By:INSTALLED BYt DATE: ,__ IF YES SHOW LOCATION ATLAS INDIO III PMD STAKED NO. OPER. 20% OR OVER JON BLACK I STAKI,gG REOID _jN4AN MP R �--i-E-REGION tATN001CALlY PROTECTED s.M.rs. YEsO N0 AT LESS THAN 20% - - - - DISTRICT SUPERVISOR -- - No STAKES NEEDED © W.O. �4L9_0.7� DRG. CODE I