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FOR OFFICE USE ONLY
CASE NO.: CC' -
DATE SUMMED: All 19 1 0-0
It *,?6
Attach 4 copies of a facility layout plan, which may include the following:
✓ Location, identification, and dimensions of ROW and pavement edgelcurb)
Location of all proposed improvements
7 J,ocation of all public utilities (existing) - dimensioned from right-of-way or back of curb, material, size
if applicable, the facility layout plan must include the following (these may be drawn on separate sheets):
N,A. A signage plan - include dimensions of sign (s), location from back of curb, materials, elevation drawing
Drainage and/or erosion control plan qao w /r7" .iq_-PA A 7- LY A-5, ,~zcrvo rzr:
Proposed waterway alterations with supporting drainage report
Landscape plan showing the location and type of plantings (existing and proposed, both common names and
scientific)
,v,A, The cost estimate for relocating any public facilities associated with the work
A A, An electrical plan
r,17v,QFIrrigation/Plumbing plan (must be sealed)
,ww:c A Structural plan showing details with anchoring, attachment, and material description (must be sealed)
NONE Private utilities plan- dimensioned from right-of--way or back of curb, material, size
Attach one copy of the following:
IVA Indemnity agreements from abutting fee owners aoFS ~cr A ~Gy
MINIMUM SUBMITTAL REQUIREMENTS
APPLICANT/PROJECT MANAGER'S INFORMATION (Party responsible for completion of all work associated with
the
rv C
Name c ~ \ R U ~
Mailing Address PO C3 tj G M
State I Zip Code N
Phone Number 4-0 RZ 9 '16 - S 8 o y Fax
PARTY RESPONSIBLE FOR MAINTENANCE:
Name/Group
Mailing Address
State Zip
Phone Number
PUBLIC IMPROVEMENT PERMIT (PIP) APPLICATION
Fax Number
City
E-Mail Address
IDENTIFY THE TYPE OF WORK TO BE PERFORMED: 'r'um /.s ~rti! S rA L c . _cr~ a /.~Ep
~Ti~~ETS~ftP~ ~ClL3L/C .~.f>,Nv,
Electrical
Irrigation system
Demolition
PIP APPLICATION
Pn'APP.DOC 3/23/99
City r o l ec
E-Mail Address
L(1)9/ .9 4(0=S-301
party is a group, please provide information for contact person)
Master Electrician
Master Irrigator
Structural Contractor
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Wood fence
Masonry fence
-Sign(s)
Facade
Awning
Cafe
-Canopy
Benches
-Bike racks
ZUddscaping
Waterway Alterations
Other (please describe)
*Structural Contractor
*Structural Contractor
*Sign Contractor
Structural Contractor
Structural Contractor
*Structural Contractor
*Structural Contractor
*Landscape Architect/Company 78 8f' 1F~G a~ z> - P~NA ~s ~y~ nr1Z-
,Sc i-okV
Design Engineer
Identify party to perform this work: 7-,q-- 4A1,1D
*the starred items may not require that structural contractors, sign contractors, or landscapers perform the work -
contact applicable City Departments for determination
IDENTIFY THE FOLLOWING:
The total valuation of the work: S 2 OGO. ®l} -
The total square footage of the site: % 3 9 73 Ac , g, 7 s, )
The total linear feet of water lines crossing under paved road: /)/,A ,
Estimated cost of future relocation of improvements: S NomE'
I hereby verify that the information contained in this application is true and complete, to the best of my knowledge.
understand that the City has the authority to inspect the work to be conducted within the public right-of-way at any time.
also understand that this permit may be revoked at any time at the discretion of the City Officials.
APPlicant's si ate aPPlied
Conditions of Approval:
Authorization of City Engineer
PIP APPLICATION
PIPAPP.DOC 3/25/99
Date approved
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