3632E
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class I I I
DATE: 02/26/02 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 52-520 4 52-540 AVENIDA RUBIO
(Street address or Description of location)
PURPOSE OF CONSTRUCTION TVQ-rATT.ATTQV QV CAC MATV Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION SEE ATTACHED SPECIAL CONDITORS
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including -removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify; defend• and save the City, its authorized agents, officers, representatives and employees, harmless from and'adainst 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. d
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 this work.
Signature of Applicant or Agent' e
SOUTRERN CALIFORNIA GAS CO 75095 MAYFAIR DRIVE PALM DESERT CA 9221I 760 346 4248
Name.of Applicant (please print) Business Address I Telephone No.
S,#M AS ABOVE
Name of Contractor and Job Foreman Business Address
Contractor's License No.
Telephone 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 ..06
Inspection Fee $
Permit Fee 0.00
Penalty �..
Cash Deposit -Surety Bond
if required
TOTAL: $ 0.00
Receipt No.,
Received by Date
PERMIT VALIDATION
PERMIT NO. 3632
DATE APPROVED 02/25/02
EXPIRATION DATE 5/31/02
DATE ISSUED��✓
By . !,t.y, J,,-
r Administrative Authority
Recorded by
Telephone: (760) 777-7075
Sent By: GjAS.CO;:i 760 773 9243; -19 F0 02 10:43AM;Job 26; Page 2/3
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA r
encroachment permit
APPLICATION FOR PERMIT �
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
Par the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sawert, water mains
and other like public works imptova rants in connection with MINOR IMPROVEMENTS end APPROVE[) SUBDIV181ONS
- / 1 a rZ . Subdivision Improvement Permit - Class I I I
OATS: inar Improve ant Perm leas IV
' 1 LOCATION OF CONSTRUCTION 2� -0, � lee- /.�
(atraet atl/0ros o p./,,m�ption of Llonl
PURPOSE OF CgA8 66CTION L�/•/•y/L7.'1�
S zr vt Gt-S �^�-r sketch (attach construction plant if appropriaita)
DESCRIPTION OF CONSTRUCTION
IDIMENGION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
.r
APPROXIMATE TIME OF COMPLETION p�����/�
ESTIMATED CONSTRUCTION COSTS {I'�
{Inducing removal of all obstruction, materiels, and debris, backfilling, com.
pactlon and placJnp Permanent resurfacing and/or replacing Improvements) I
In eonsideretion of the granting of fills permit, the applicant hereby agrees to: FEB
I►idanlnlfY, tletiino and saw the City, Hs authalred eeermt, officers, recimontatives and arnploysas, law front and aegltyt any,and�4
tnnekle. 11 WIhIes or Iola resulting from claims it court nation and arialne out of, eery eCeloant,. I or R r
happanine w owurrino as a ofoxllerete rNelt of any walk utrdbWkew krnear the penult ennted pu--
Notify the Ad+nlnlatrative Autherity at Item taanty-tour i241 hours in advanaa of the tlnw when work wi 1 oe started-
CanMY atlth aN ellplltable CITY Ordlnanal, the tarns end owdltktns o1 the vattnh end all aeo kwe er rod reaulations or the Cky or
LA Culnu end to pay for sev eddltlanal raomment naaawery, as the twit it wo►Ir.
Signature off A�i"nil or Agent /� /
7Z., 7/E
Narrta of Applicant (Please prints Business Address Tal
�,- — Wo,?4
Name of Contractor and Job Foremen Business Address Telephone No.
Contractors Licenta No. City Business License No.
Appliicentes Insurance Campany 66)4.4IA6I6ITy Policy Number
FEES: Subdivision improvement Permit - Clash III
'Public Improvements; 3% of estimated construction costs
Prlvau Improvements: 3% of estimated construction costs
Minor Improvement Permit -- Class IV: Sea attached schaduls
Inspection Fee S PERMIT VALIDATION
Permit Fee D 3 G 3 Z
PERMIT NO,
Penalty
C4h Deposit -Surety Bond
if required
TOTAL:
Receipt No,
Received by Date
Recorded by
DATE APPROVED 2- ZS� D Z
EXPIRATION DATE � 3 f U 2
DATE
TELEPHONE: 1619) TJ7-'?07%
inistrative Authority
FEB-19-2002 TUE 10:07 TEL:760-777-7155 NAME:LA QUINTA PUBLIC WORKS P. 2
Sent By: GAS C0 --1
The Gas Company,.
FAX
760 773 9243; 19 Feb 02 10:43AM;Job 26; Page 1/3
PA LM DESERT DISTRICT
75095 Mayfair Drive, Palm Desert, CA. 92211-5102
Date: / i 1200
NUmber of pages including cover sheet:
TO':
Phone.:
Fax #: -7 -%%- Fax #: k7. 394
cc:
Comments:
Sowhofn California Gas ,nmp tri
FEB-19-2002 TUE 10:06 TEL:760-777-7155 NAME:LA QUINTA PUBLIC WORKS P. 1
Sent By: Mg., C0;: 760 773 9243; i 19 Feb 02 10:44AM;Job 26; Page 3/3
201
GD
TpTAL FEET I NOT D._....
BELOW __. �.. ...._ Lf.G�•�,
TOTAL FEET RETIRED ..
......._..:..
/ l �/
'rIREMENT
PERMI-1, UvElasy
PERMIT" NO,
�
DATE MOVED DATE MQV9D DATE OF
ON JOB—_.... _. OFF JOU OPER.
_....
CREW FOREMAN.....,.. ......_ ..._.._
COMPANr_....._. ._.....
�PLANI-1111.
REVIewco Yr
STAKED ❑
COMPANYFA I�TY/;��g0� [j.__ P.L.S. ❑
OR OVER ❑
6 SM.Y,S.
---
----
6TAKINQ FiFQ'D. ❑
.... '4
_._..,. .. DIVISION
a THnn soq i❑
oarR. eusvR.
NO.STAKE S NLkDED
W.O. �__..,.,,
FED-19-2002 TUE 10:07 TEL:760-777-7155 NAME:.LA QUINTA PUBLIC WORKS P. 3
NOTE:
With proper validation =
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC. WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class I II
DATE' _ / Minor Improvement Pe Class Class IV �- --
LOCATION OF �C NsTRUCTION J a�30 �i�ZZIE'
(Street address or Description of Location)
PURSE OF CONSTRUCTION IZI-5 Sketch (attach construction tans if 'Z �F •e- p appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION s-- d Z?
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, badcfilling, com• I
paction and placing permanent resurfacing and/or replacing improvements) i
In consideration of the granting of this permit, the applicant hereby agrees to:
pPR 2 9 200�
le atal 9c VgOAKS
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 proarty
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 lotions of the City of
Lo Quints and to pay for any additional replacement necessary -as the result of t rk.
7,46 Signature of Applicant or Agent l ,+ ` D
,'I lly/ L ���%� �z��� 32_7 —
Nag ole- �. f Applicant (please print) Business Address Telephone No.
!
Name of Contractor and Job
Contractor's License No.
Business Address Telephone No.
City Business License No.
•-rr••�+••• a nuu�a��w %,urn{wny WCr4. LIA61LITy 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: $
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 777-7075
SPECIAL CONDITIONS --PERMIT NO. 3632
--- SOUTHERN CALIFORNIA OAS CO. ---
Ira addition to the standard permit conditions, the following shall apply:
Pursuant to Section 14.16.320 of the La Quanta Municipal Code (Ordinance 10 § I (part), 1982), all
work shall be performed in accordance with the latest edition of the Standard Specifications For
]Public Works Construction (SS PWC) and as directed by and to the satisfaction of the City ]Engineer.
2. SOUTHERN CALIFORNIA GAS CO., hereinafter referred to as " IPermittee", shall be responsible
for providing conatnnuaouns dust aired erosion control. All areas Shall be kept watered down daily
including weekends.
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.O8.050 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 time periods:
October Ist to April 30: Monday -(Friday 7:00,a.m. to 5:30 p.m.
Saturday 8:00 a.m. to 5:00 0.m.
• May I 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.
Mork shall be prohibited on legal holidays and Sundays.
W1wor k/perf®a°aa e d Wdddadaa 500 jed of as signalized daadersecddon ig a°esda°iceead between She hours of 9
aa.m o 3 Jp.n& Trraaff ac control shall be sseg aapv agjfder 9 as-ffiL and removed d before 3 /poamao The PaDrmiddee
shall c0ndaad She Riverside Cowndry Traffic SSignaa§ Maadaadeaaaan ce IIDepaardaa eng aad (909) 275-6894
if sigma§ gp eraaddon aad ddae inge seccddon is d® be aaddere d in any wavy.
6. ]Pursuant to Section 14.16.110 of the La Quinta Municipal Code (Ordinance 10 § I (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.I6.250 of the La Quinta Municipal Code (Ordinance 10 § I (part), 1982),
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). 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 - Permit No. 363.2 Page I of 4
SPECIAL CONDITIONS --PERMIT NO. 3632
--- SOUTHERN CALIFORNIA GAS CO. ---
g. Pursuant to Section 14.16.290 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982),
street closures shall not be permitted. A minimum' of one travel flan of paved surface shall be
maintained with flagmen at all times.
9. Prior to excavating, if required, the Permittee shall contact Underground Service Alen at 1-800-422-
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.
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 § I (part), 1982),
backf 11 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), except as otherwise
specified herein.
Native material may be used as backfill material provided that minimum compaction, achieved in
the manner prescribed herein, is achieved. Backf ll shall be performed by mechanical means; no
water densif ed compaction via jetting or flooding or other means shall be allowed. It shall be the
Permittee's responsibility to provide appropriate geotechnical supervision, testing, and inspection,
onsite, at all times during backf ll operations.
Backf ll compaction shall be achieved by the following conditions:
A. When a farm foundation is not encountered due to soft, spongy or other unsuitable material,
such material shall be removed to the limits directed by the Oeotechnical Inspector and/or the
City Inspector and the resulting excavation backfilled with pipe bedding material.
B. backf ll materials shall be brought to or maintained at an appropriate moisture content for
compaction. The appropriate moisture content range shall be established at the onset of the
project and ensured prior to use of the materials through progress testing on the stockpiles.
C. The first length of trench backfilled shall be backfilled in the presence of the City Inspector.
Compaction shall be tested at random depths at approximate three-foot vertical intervals as
backf ll is placed to ensure the effectiveness of the compaction methods and to establish the
depth of lift that can be compacted.
D. If lifts greater than one foot are attempted in this trial length of trench, compaction tests shall
be taken within the lifts to ensure that the full depth of the lift is compacted. Upon satisfactory
completion of this portion of trench, the City Inspector shall establish the maximum lift
thickness to be compacted for the remainder of the project.
Special Conditions - Permit No. 3632 Page 2 of 4
SPECIAL CONDITIONS, --PERMIT NO. 3632
--- SOUTHERN CALIFORNIA GAS CO. ---
IF. In subsequent lengths of trench, the frequency of compaction tests shall equal one per each lift
of backlall, per 300 linear feet of open trench, at randomly selected locations within the open
length of trench.
G. The depth of the randomly selected compaction tests shall also be randomly selected except
that where multiple tests are required in a given length of trench, the tests shall be no closer
than three feet (vertically) from each other.
H. If any compaction test fails, previously placed backf ll (in the same length of open trench or
previous lengths of trench) which is represented by the failing test (as determined by the City
Inspector),, shall be tested for compliance with compaction requirements.
I. All costs in due to the conditions above shall be borne by the Permittee. Copies of all
test results shall be furnished to the City Inspector.
12. All excavations within City of La Quinta right-of-way shall be backf lled, 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 backf lied 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) feet
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. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be,replaced to
its original condition. L
14. Access and egress to all local properties shall be maintained at all times.
15. Pursuant to Section 14.16.375 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982),
permanent pavement replacement 'shall be completed n® later than seven (7) days after the
completion of the work. permanent pavement replacement shall conform to the following
conditions:
A. ]Existing asphalt concrete pavement shall be. sawcut. one (1) foot beyond trench edges. ]Edges
shall be straight sand clean:
B. Permanent pavement replacement structural section, within all trenches, shall be 1" thicker
than existing of asphalt concrete over the same existing thickness of crushed aggregate base
or crushed miscellaneous base, meeting the requirements of Sections 200-2.2 and 200-2.4 of
the Standard Specifications for public Works Construction. The replaced pavement and base
material shall be compacted to 95% relative compaction and respectively tested, for each 300
linear feet of trench. Verify exact structural replacement section thicknesses with the City
prior to installation.
Special Conditions - Permit No. 3632
Page 3 of 4
SPECIAL CONDITIONS --PERMIT NO.3632
--- SOUTHERN CALIFORNIA OAS CO. ---
C. Permanent pavement replacement shall be installed using a City approved 3/4" max medium
asphalt concrete as the base course flirt and a City approved %" max medium finish course lift
for capping. Asphalt concrete mix design shall be approved by the City prior to its placement.
D. Cold -Mill and Overlay - The existing pavement which was properly protected in place during
the trenching operation located adjacent to the trench sawcut shall be cold -milled to a depth
of 0.10 feet with butt joint created next to the existing unmilled pavement surface. The cold -
milled area and base asphalt concrete in the trench area shall be overlaid with a City approved
C2-AR-4000 asphalt concrete mix. The width of the cold milling area shall be as follows:
For longitudinal trenches located in a parking flan: two (2) feet outside the sawcut
removal lines.
For longitudinal trenches located in a traffic lane: two (2) feet outside the sawcut
removal lines, or to the lane line striping, whichever is greater.
For transverse trenches across existing street: two (2) feet outside the sawcut removal
lines.
E. If grinding and capping operations are not performed in the same day as base paving
operations, the base course lift of 3W' max medium asphalt concrete shall be installed from
saw -cut edge to saw -cut edge flush with the existing street surface. The base course lift of
paving shall not be left 0.10' low in anticipation of grinding and capping.
F. Any existing lane striping affected by this resurfacing shall be replaced in kind by the
Permittee, as directed by and to the satisfaction of the City ]Engineer. Affected traffic signal
loops shall be removed and replaced in kind. The finished pavement surface shall be smooth,
consistent, and shall conform to the surrounding grades.
16. Permittee shall permanently stabilize any and all soil that was disturbed as a result of work
performed under this permit with an approved dust control treatment. Soil stabilization shall be done
immediately after completing the operation.
17. ]Pursuant to Chapter 12.56 of the La Quinta ]Municipal 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 street to deliver street construction materials and/or equipment.
18. This permit allows for the installation of two (2) gas services to 52-520 and 55-540 Avenida Rubio
nearest cross street is Calle ]Ensenada.
19: The City of La. Quinta reserves the right to revoke, suspend or void this permit at any time.
Special Conditions - Permit No. 3632 Page 4 of 4
The
Gas
Company-
'''Sempra Energy"company
ok
55441-732
ml
�t4f
MAIN COND.
CODE
EXT INT
EXIST: [I INST: ❑ ABAND: ElINT:
CODE: P_ / LOT #:
Pi
A5 1
VI
0
2'PAM 2-92`,I
TIED
70234 2'PXM 8-92 ,_...-.
r
EM r
Isolation Area Affected
Yes
❑
No
C/
Pressure District
Affected
Yes
❑
No
p
Business District
Affected
Yes
❑
No
Supply Line Affected
Yes
❑
No
Regulator Station
Affected
Yes
❑
No
Valve(s) Required
Yes
❑
No
L1
`
Reviewed By:
. J.FNN1w c
C. P. Reviewed By:
9
22
(�L' vl
CURB ) �.
El
23
EXIST: ❑ INST: ❑ ABAND: 0 INT:
CODE: P / LOT #:
25
P.�
CURB )
CURB ) TUJUNGA
28
27
PLAN FILE # BASE SKETCH CONSTR. SKETCH COMPL. SKETCH W.O. SHEET #
J c, lt,Y:GSA 03-04-02 BY: BY: 01 OF 01
20-999
60'
I
i
i
60'
60'
O
c
z
0
/ TOTAL FEET INST'D
INSTALL MAIN WITH AT LEAST _Sv COVER BELOW!' .�� � �%%;',TOTAL FEET RETIRED
COUNTY RIVERSIDE RETIREMENT REASON: PERMIj ISSUED PEItMIT #:
DISTRICT PALM DESERT
i
1 " = 50'
LA QUINTA
PIPING LEAK TEST (MEDIUM)
TESTED AT: P.S.I.
[]AIR [-I NITROGEN OTHER
FOR: _ HRS. AND/OR — MIN.
(GAS STANDARD 9184.0150)
SIGN: DATE:,
PRINT NAME/TITLE:
GAS HANDLING WAS REVIEWED AND PERFORMED
AS PLANNED PER GAS STANDARD 9184.06
ENO❑ YES
�-IF NO PLEASE GIVE EXPLANATION TO LEFT
SIGN: DATE:
PRINT NAME/TITLE:
THOMAS GUIDE 849 G6
CITY OF LA OUINTA
PRESS. D i ST. N0.
DIST. PRESS./MAOP SET/MOP.
CLASS LOCATION ❑1 ❑2 El 1714
ISO MAP N0. 3
SUPPLY LINE N0.
SUPPLY LINE PRESS.
REGULATOR STATION. I.D.# / R.S.#
VALVES) REQUIRED Yes ❑ No ❑
PIPELINE MARKERS REQUIRED: Yes ❑ No ❑
IF YES SHOW LOCATION
THIS BLDG, OR AREA QUALIFIES
FOR ANNUAL LEAK SURVEY: Yes ❑ No ❑
(POST LIMITS)
REVIEWED BY PRINT NAME DATE
REG. ENG.
TECH. SUP.
L.P.A.
L.S.P.S.
P.A./F.P.A. rj j
D.O.M./P.m.
F.O.S./F.S.
Underground Service Alert
O�FORe r° -
`� Go Call Two Working Days
0
BEFORE YOU DIG
1-800-227-2600
Ticket #
PROJ. # 39899 WR. # 1256688
EPOCH # RER.#
- l PiZ1N T L�/ / i
DATE MOVED NOTIC�OF .DATE WOB�:'
COMPLETION
ON JOB: OPER. OFF DATE:
BY,:
'
TRACT #
CREW FOREMAN
FEET
ATLAS # IND 93
YEAR C.P. INSTALLED:
PUNNED