1021NOTE: ,
With proper validation
this form constitutes an
encroachment permit
0
CITY OF LA QUINTA
APPLICATION FOR PERMIT
5���1-039 PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)c�oF��Sw�
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
t
SubdivisionImprovementPermit — Class III
DATE- February 27, 1991 Minor Improvement Permit Class IV
` LOCATION OF CONSTRUCTION install 58' of 2" ' A1astic medium pressure cias' main
8' E/wpl of Avenida Navarro, beginning 42' n/npl of -Calle Sorneaoprocedding
(Street address or Description of Location) north
PURPOSE OF CONSTRUCTION natural gas Sketch (attach construction plans if appropriate) -
DESCRIPTION OF CONSTRUCTION con mbA�. v,
DIMENSION'OF INSTALLATION OR REMOVAL
yrs
SIZE OF'EXCAVATION,'IF NEEDED r*
` ',APPROXIMATE TIME WHEN WORK WILL BEGIN 3/11/91
APPROXIMATE TIME.OF COMPLETION 6/11/91
' 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 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.regul_ations of the City of
La .Quinta and -to pay for any additional replacement, necessary as the result of this work, r'
J.M. Snyder, DistributionSuperyisor
Signature'of Applicant or Agent
Southern California Gas Co. Pb Box 3003 Redlands, CA 92373 714'a-335-7742
Name of Applicant (please print) * Business Address . Telephone No.
Name of Contractor and Joby Foreman Business Address Telephone No.
Contractor.'s License No. 7 City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III t .
Public•improvements: 3% of estimated construction costs, _
Private improvements: 3% of estimated construction costs 1`0 `0 2 1
Minor Improvement Permit — Class IV: See attached schedule ;
Inspection Fee I$ —0— PERMIT VALIDATION
Permit Fee 1021
PERMIT NO.
Penalty 2/27/91
DATE APPROVED
Cash Deposit -Surety Bond ,
if required —0— EXPIRATION DATE 12/31/91
TOTAL: $_-0— DATE
ISSI fzD
Receipt No.
ay
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
;z.�.� ,>,r�, brit �.•�i""�'.`7�-'..�.1.:..,,�'�^t..�*ih.•-.3r�i�"•�++.n.Ji+��+�a,,-.�V..y„y.� .-q Y.+'%t«�+td..S ,�u•�^���ia .,i•^ � .. `},.'. *�,-.a:-', r. ,�. a .... � .. � �
.r___..�_.� __, __. __—_---_... _. � �— — � _ ... � V .
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NOTE:
With proper validation
this form constitutes an
encroachment permit
5x381-039
P
Jm, ., .
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class II I
DATE: February 27, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION install 58' Of 2" plastic medium pressure gas main
8' E/wpl of Avenida Navarro, beginning 42' n/npl of Calle Sozoonoprocedding
+ (Street address or Description of Location) north
PURPOSE OF CONSTRUCTION natural gas Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION sin- abo3sA
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 3/11/91
APPROXIMATE TIME OF COMPLETION 6/11/91
ESTIMATED CONSTRUCTION COST$
(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 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.
r
J.M. Snyder, Distribution Supervisor
Signature of Applicant or Agent
Southern California Gas Co. PO Box 3003 Redlands; CA 92373 714-335--7742
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
j if, required
TOTAL: $ -O-
Receipt No.
Received by Date
Recorded by
1021
PERMIT VALIDATION
1021
PERMIT NO.
DATE APPROVED 2/27/91
EXPIRATION DATE 12/31/91
DATE ISSUE -D —/'2/27/91
/2/27/91
By
Administrative Authority
TELEPHONE: (619) 564-2246
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The following` General and Special Provisions are attached to and made'a' part of Permit No.
GENERAL PROVISIONS`Yr
' �� j.;•
The following shall always apply:
ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within City of La Quinta rightof way
ONLY. Whenever construction extends within private property, it shall be the responsibility of the permittee (or his contractors) to ,
secure permissionfrom abutting property owners. Such authorization must be secured by the permittee prior to starting work.
1 i' M1 i
TRACKLAYINGCONSTRUCTION EQUIPMENT:• Cleated tracklayirig constrd6tion equipment shall not be permitted to operate on any,
.
, . paved surface unless fitted with smooth -faced street pads. All mechanical outriggers shall be•fittedwith rubber street shoes to protect
y+
a..
the paving during excavations. Rubber -tired equipment only shall be used in backfill operations in paved areas. If the existing
pavement is scarred, spalled, or broken during the term of this contract, -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 -coat of two inches (21 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 te duration
IV
of the project. The City shall be notified 24,Hrs. in advance of any traffic detours or delineations. s '
CARE OF DRAINAGE STRUCTURES: Any, drainage structure including corrugated+ metal concrete
,r
_ s
pipe, pipe, steel culvert and
. 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 Quints shall be notified prior -to commencement of this work. z
4
-
.'
Drainage structures and open drains shall be kept free,of debris at all times for proper drainage.
,:a •'
` 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 andother objectionable materials immediately after backfill andcompaction.
Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shall be removed
-prior to paving. Wateyanker 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 City of La Quinta roads, it shall be `+
the, responsibility of the permittee (contractor) to controLthistwater 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
► . - ; 7,
; access for the adjoining property owners and emergency vehicles. 'in tFie event it is felt by the permittee that he must close a street for
,' •
any length of time, permittee shall contact this office to,obtain the necessary permission.
,',•
`' SPECIAL PROVISIONS
,The follwingfshall apply ONLY,,when indicated:
Y
NOTIFICATION: Permittee shall notify the City at 564-2246 at least.48 hours in advance of starting construction.
��&ASH
t'
DEPOSITS OR BONDS: A cash bond or an approved surety bondin an amount of not less than $
" - ' • :"'
' '� - K ; shall be furnished in the name of City of La Quinta to coverall work involved in the restoration of the various La Quinta
a .�'' .i• t
..; roans and survey monuments. This bond shall be continuous until cancelled by the City Engineer. This bond must be
r
;#
posted prior to commencement of any Work on this project
s
'
`• R3 TILITYCLEARANCE: (Substructures)Priortomaking an.ye cavationwithintheCityofLaQuintsrightofwayauthorized
�by
i
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.
DR4Ur ILITY CLEARANCE: (Surface structures) No work shall be done under this permit until all utilities are clear of theposed
work site. The permittee shall notify all concerned utility companies of the proposed work. _
=";Rr s
PAVEMENT Area between the concrete line and the existing road shall be
,,". .• .
x.
�. R5 .WIDENING: proposed gutter pavement
surfaced with inches of A.C. paving placed oninches of class aggregate subbase course'
r
,'havingan"W'valueofnot less than • and in conforniancewithCityofLa_ Quints Road Improvement Standards
and Specifications; Ordinance #461.
' r{
R6 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of •
1/4 inch to, one foot (1').
t t'
R7 GRADES & STAKES: City of La Quinta shall -establish grades and stakes for the proposed concrete curb and gutter•.
1 wv .
construction. ,.
M1^ = A
_
R8' RADE CHECKING: City of La Quinte shall check grades upon receipt of plan and profile and/or grades as established by
licensed 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 constr'ucte'd in conformance with City of La Quinta Standard, #207. !`
F `
R10 DRIVEWAYS, A.C.rDriveways shall be constructed as not to alter existing drainage pattern. Surfacing between the -
1•.. '
prop ert line and the'existin road' avin shall'be 2-1 /2 inches of A'C. avin laced on ") of class
P p y 9 P 9 P 9P
I
aggregate base. Driveway construction shall conform to attached drawing.
- ' ,,
�. • 811 CULVERTS: A inch diameter ( )culJert shall be instajledwith the invert approximately 1-1 /2
ches below and in line with the existing flow line. Culvert• installation shall conform to the attached drawing.,.-...
IGHT.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 sterilize_ r. Rate of application shall comply with the
manufacturer's specifications.` �;
•
(, R�14�,COORDINATE WORK: The proposed workt. shal%l be sub rdinated to any operation which the State of California or f'
s.,, •
- "i ,',"
���City of La Quinta may conduct in this area during the period of this permit. Work'shall be coordinated with the State or,
,
s
City of La Quinta forces to preclude delay or, interference with State or City of La'Quinta projects.
R15 S VEY MONUMENTS: Prior to excavation or beginning of construction, allsurvey monuments which exist on the.
4! '
terline of all streets or property lines when involveb shell be completely tied out so they may be readily and correctly
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be replaced by a.licensed civiV engineer or surveyor at the expense of the permittee. A complete set of notes showing the -t'
a
ties to these monuments shall befurnishad tothe City Engineer prior tothe removal ofany monuments.This office shall,
_
be notified upon completion of replacement of all survey monuments for proper project clearance.
R16 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments shall be tied out by 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.
R9 LIMIT OF EXCAVATIONS: Excavations shall be limited to 1,000 lineal feet of open trench before backfill operations must
1 ` _J 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 determinethe suitabilityof 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 of brush, roots or other organic substance detrimental to its use for purposes
1of 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
\11� 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 (31 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 within the structural section of the roadway.
R/ 22 9ACKFILL PLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench
1.�/before flooding or a maximum of five-foot (5') lifts where trenches are of excessive depths. Care is to be exercised thatthe
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.
R23 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 (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 asoutlined in Section 6.3.01 of the
��Standard Specifications, Division of Highways, State of California, dated January 1973.
R/ 24 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line.
(,6ne(1)copyofeachtestshallbeforwardedtotheCityEngineerforapprovalandfiledpriortomakingpermanentrepairs.
\ _ Compaction tests shall be made asoutlined in Section 6.3.01 of the Standard Specifications, Division of Highways, State
of California, dated January 1973.
R25 J, EMPORARY 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") 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 !`�7_ days after completion of
temporary road repair.
R27 PAVEMENT REPAIR: F.A.S.: Upon completion ofbackfill and compaction, a temporarypatch consistingoftwo inches(2")
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 repair to
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 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 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 thefollowing 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 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
(2") and above in size. Sealant shall be applied to all cut sections as directed by the City Public Works Inspector.
• ADDITION,'. --=ENCROACHMENT PERMIT NO.1021----CONDITIONS:
''Survey
R3 3 -monuments shall be protected in place. or P.
re=established'• pursuant to City standards and' the. State ` of
California 'Land Suzrveyor's''Act.
R34`_
Work shall be coordinated with the City- of La' Quinta's
.
forcesf:to .preclude delay or interference with• the City of. La t
•
Quint'.projects
�� • R35;;
Contractor, shall comply` with the local noise ordinance and
construction operations .,and maintenance , of, equipment within
�' _
•- one half mile of . Yiuman `occupancy shall be. p-erformed, only ,
- -
A .<
during the ' time`s periods ` as ,follows
October 1st, to April- 30. '.•Monday -Friday .-7 OOa:m.-5.30pr.m`.
Saturday 8.00a.m.-5..00p.m.
�. May=' -1st to` September,.30. Monday-Friday_'6 00a:m.-7 00 5
r
- tSaturday.. $:OOa.m:,-5` OOp.m.
``_.
Work shalrl be prohibited' -anytime on',Sunday.-and,'Federal�
•_
`.
holiday.
f f. _R36
yTraffic controldshialr, be as. per.. Cal, Trans -,Traffic Manua -1 �5• t . ~,
,•
Field adjustments. in detouring shall bd,accomplished as, Y4«
directed in order to 'adjust to actual field-, conditions " -
• }r •
shall be the:'contractor's' responsibility ;to ' adequately
'barricade and 'detourf this 'site•.,,.A Traffic -control plan..sliall y
.
,' be submitted for ' approval. -by the City Engineer. 5 �'
R37;,
-All excavationiat 'or near the 'travel'way. shall backfilled'° +•.
_
,be
at. the end -of ,the work .day, for• the `.protection of the-
'
'traveling public.
R3_-8
'Street closures shall .be,.allowed at any,. time.",,'
.not
%R39"l":A
minimum of one :travel 'lane • shall be maintained at all
times .`with flagmen during working hours: x•
R40
=All :work beperformed witYiri" the existing paved 'section
..to
shall• be- -temporaryh paved and maintained;, by,'the Permittee,
ermanent avement' sliall. be' laced no later than -15, days'�.
r.
after. completion of the teinporarY,,road repair.
g
R41 '
Ingress and egress__,for local properties ' shall- be maintained
{.
at 'all times r F ,
` R42 ,A Prior` to work staarting,, Underground Service, Alert-` shall. be','
--.contacted at. 1-800-422-4133' 'and.. an'", inquiry .'number!' ;shall be
provided. to' :the- City Public. Works Inspector,.
R43,:=
Pavement shall be sawcutprior '-to, removal'.
-
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,..• ;' ' fila '- d _ , - - _ x r _
' ;Additional
Conditions .Encroachment'Permit-No. 1021
.; '. Page
2
R44`
All backfill sdbgrade soil shal•1 be rcompacted to nothing
;?
less than. 90 a relative .dry density, ,'all backfill soil within
-
•
the top '2' of finish pavement surface shall be' compacted -'to
w
-w
nothing; less ":than 95% relative dry density, ail; -;base
-
material shall be'compacted'to nothing less than'95N
,.�
M
relative dry density..-. f *
_
R45
Replacement • pavement sections shall be: - 3•'. '" AC.''`over, , 4 "',Class ' t
•IIS aggregate base.'?"t
-
-R46
r
If the work is to be*`'performed by,'forces 'other than•%that'j`of f -,.
•' '
the utility company � ,the contracting company =wills be4
required,' -to apply -f.or, an additional encroachment_ permit'' '
'
and pay •the',"appropr ate fee. - k
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53441-039
NOTE:
With proper validation
this form constitutes an CITY OF LA GUINTA
encroachment permit
APPLICATION FOR PERMIT
0
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: FEB. 25, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION To install 58' of 2" plastic medium pressure gas main 8' E/WPL of
Avenida Navarro, beginning 42' N/NPL of Calle Sonora, proceeding north.
Mass t address or Oesaiption of Location)
PURPOSE OF CONSTRUCTION Natural Gas Sketch(attach constructionlans if appropriate)
ppropriate)
DESCRIPTION OF CONSTRUCTION See Above
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 3-11-91
APPROXIMATE TIME OF COMPLETION 6-11-91
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 authorised apents, officers, representatives and employees, harmless from and apainst any and all
penalties, liabilities or loss resulting from chins or: court action and arising out of any accident. Ions or damage to persons or property
FEES: Subdivision Improvement Permit — Glass III
Public improvements: 3% of estimated construction casts
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee . $
Permit Fee
Pwsalty
Cash Deposit -Surety Bond
if required
TOTAL: "'' $
Receipt Nsi.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246
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TOTAL FEET INST'D -
Isolation r` 1. •� �; j 4
A ea"Affected' Yes O No O'�`� r h
INSTALL MAIN WITH AT LEAST 'u COVER BELOW _rad �%". S y' TOTAL FEET RETIRED
+ Pressure District Affected Yes -,O No''O _ - -PERMIT ISSUED BY PERMIT NO. ` . - -
•" - - _ - t , - 'DATE MOVED DATE MOVED DATE OF.
Business .District'Affected. Yes O No O - .
r *j ��Vi='f_� D� RETIREMENT '
_ r s{:C�.- I Qlil T' - PER. -
,,- COUNTY >�
$uPPIY^Lirie'Affected,, Yes O No O [%��� T r, '^
ON J08 OFF.JOB O
Valves) Required - ` Yes.O No O Z DISTRICT _REASON y. CREW FOREMAN
_ - • TRACT PLANNED BY .COMPANY
Reviewed B ;" s'
NO T.r�/ • t STAKED ❑ COMPANY FACILITY: SO. CAL.' P.L'.S: ❑
By: ATLAS YEAR C.P. , c rU a �M
i Y REVIEWED BY'
t, - • ? NO. INSTALLED _ STAKING• REQ'D: ❑ I I iL�,6 �1-3 D" X1`1 P l ��-DIVISION.'
C.P. Reviewed By,:!' CATHODICALY 'OPER. • 2014 OR OVER ❑ `.n �%
p - No ❑ S.M:Y.S.: "S lff FFi�K GO35oRG.. .
PROTECTED YES ,� AT - LESS THAN x014 • ❑ • DISTRICT -SUPERVISOR NO STAKES NEEDED, W,p;•' _ CODE '
SOUTHER - - _ -
- . N -CALIFORNIA GAS C0:=2988,3J