HomeMy WebLinkAbout0850-72_Tamarind Avenue Sewer Lift Station_18.7.3AMERICAN BUSINESS FORMS • (714) 793-5233 • FAX (714) 7984283
CONSTRUCTION PERMIT
CITY OF RIALTO
CITY ENGINEER'S' OFFICE
150 SOUTH PALM AVENUE
PHONE: 820-2530
Location of Work:
Name of Contractor.
Address:
Contractor's Phone No.: Contractor's
REMARKS OR SPECIAL CONDITIONS:
Name of Owner.
PERMIT NO. 3 5 2 2
DATE
Expires 90 Days from data Issued
Plan No. and/or Date:
cirr o
Address:
License No.:
(NO )
City Business License No.:
STREET
Signs $
Signals $
Wheel Chair Ramps $
Curb $
Curb and Gutter $
Gutter $
A.C. Paving $
Sidewalk $
PERMIT AND INSPECTION FEES
FEE
NOTICE $_
Government $ode
be issued before "Permr, _'^ _ u'r
your DigAlert
oe valid. For ms, �ava
i Alert I.D. Nu Pr
ervlce Alert $
Two working days Fuafnro you d g3$
Crossgutters $ $
Drive Approaches $ $
SEWER
Manholes $ $
Cleanouts $ $
Main Lines $ $
Laterals $ $
Y's or T's $ $
WATER
Backflow Devices $ $
Valves $ $
Pipes $ $
Water Lines $ $
Fire Hydrants $ $
STORM DRAIN
Catch Basins &
Appurtenances
Pipe
INSPECTION FEES ARE
BASED ON THE FOLLOWING:-
3% OF $1.00 to $25,000 VALUE
$750,000 + 2.5% OF NEXT $75,000
$2,625 + 2% OF NEXT $100,000
$4,625 + 1% OVER
$ $ TOTAL FEES $
$ $
IMPORTANT: FEE BASED ON AGREEMENT BETWEEN CITY OF RIALTO AND CITY OF FONTANA
1. 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION - Exclusive of Saturdays, Sundays and Holidays.
Forms and subgrades must be inspected and approved before Portland Cement Concrete orAsphaltic Concrete. Sewers
and other pipelines must be inspected and approved before backfilling. Failure to obtain approval before proceeding with
work may be cause for rejection.
2. TESTING EXPENSE SHALL BE BORNE BY THE PERMITTEE — Compaction requirements shall be as described in City
of Rialto Standard Drawing No. 110.
I agree to comply with the rules and regulations set forth on the back of this application and all provisions of City Ordinances,
Resolutions, Standards, and Specifications currently in force, and to pay for the removal and proper replacement of any item installed
under this permit which does not comply with the above. I agree to pay for any additional replacements in excess of the amount shown
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f,O;,.,,or <FM d Ct.',,,tA / /q 3 ,a
eel Chair -Ram
ti'and Gutter
ACC Pavia
�idewalk'e
;Crossgutters`:
lie Ap itoe
SE
-Maehi
CleanOi
Main.Linae
Lateral''
Y's or Ts.'.
WATER:,
Backflow De`v
Valves-:
Water Lines
Fire Hydrants
STORM DRAINh �:
Catch'Basins &
Appurtenartces>
• Pipe:
•
•
2 ;HOURSADVA
sutxgrades;rriusl:l� 1ps"'ected �
and other pipelines`m st b ' inspected: aril
m be ca
ort(=' ay use�foc;:'rejectio ,:;�fm::t
TESTINGEXpENS SHALL BE BORNE
of; Riafto.Stagdard;'.Q vi n o +' •,:t-.
I agree to:aomply with .the rules andegla
esolutions, Standardsi`andSpeclfication Curren
:under this permitwhich does not comply with tFte at
- Vvfiich ma be cut* a•resu an`
PERMIT APPROVED' Rv
RM T:ANQ; INSPECTION
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fru force,odtd:pf*.petheremoaaiip • OPI* a nent0 Olf.ftem iriatalla;
'9 :,tagroeto a fora Qdditlonal ro'laoer`r ent `ir�:ezcess o e n ;, f�.,,lf � , p,. .,�.. fth amounfsi�ovtrnt
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