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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 II I
DATE: January, 4, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION TR 25237.
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION street and storm' drainage Sketch (attach construction plans if appropriate)
r•nn.trtir•t.i on sr Y
DESCRIPTION OF CONSTRUCTION see plans
DIMENSION OF INSTALLATION OR REMOVAL• See plans
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION i
ESTIMATED CONSTRUCTION COST $
(Including' removal of all obstruction, materials, and debris, backfilling, cpm-
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 ernployees, 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 pursuantto this application.
Notify the Administrative,Authority at least twenty-four (24) -houts 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.
Signature of Applicant or Agent `
Ohio Citizens Investment Corn PO BOX 780 La Quinta. CA 92253 564-2155
Name of Applicant (please print) Business Address Telephone No.
n e
r -'-)l 0— V AIJ DtF �yU VAS '
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 Ill
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV.: See attached schedule
Inspection Fee
r. .
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ I�'.�G"% S'2)
Receipt No.
Received by Date
Recorded by
Q1%5S8�A H 9S29TOTA1 ii7r9iJa397.5 d
kT0
PERMIT VALIDATION
PERMIT NO. ry7—
DATE
DATE APPROVED r / I —7
EXPIRATION DATE IL 1 3 1 �� t
DATE ISSUED • i l 7 C1 1
By
Administrative Authority
TELEPHONE: (619) 564-2246
. IL
t (
;r
- _ — _ ° , M"w! a. b Y �� .rte. .�. �.:. T /L 19. �Y...q`-�N.. T+r�. � �T � 6..L4-!.1 nr.!1�lA- W !�.-/Siel. y !1• � �. �! (h -s .11�+� � w. —•• M� _ R �a �
NOTE:
With proper validation 4 Q'
�.0
this form constitutes an . CITY OF LA QUINTA
encroachment permit
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
January 4, 1991 Subdivision Improvement Permit — Class II I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION TR 25237
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION--atrnet and storm drainage Sketch (attach construction plans if appropriate)
r•nn�tritnt• it c7n
DESCRIPTION OF CONSTRUCTION see- mans
DIMENSION OF INSTALLATION OR REMOVAL see Plans
1
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 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.
Signature of Applicant or Agent
Ohio Citizens Investment Corn Lao Bax 780 Turk nu:int.a,. CA -92-253 564-2155
Name of Applicant (please print) 11 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
if required
TOTAL:
Receipt No
Received by Date
OIt� iAA ��'IUML Sid^9i�
A
01 j
PERMIT VALIDATION
PERMIT NO. ne:: '7-7
DATE APPROVED I / 1-7 1 Q 1
f Y
EXPIRATION DATE 12
DATE ISSUED
By t_
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
NOTE:'
'• With proper,.validation
this form constitute§•an '
CITY OF LA QUINTA
"
e,croachmeknt permit I
Y APPLICATION FOR ` PERMIT. !$ 4
r` +:` "• .*; PUBLIC WORKS. CONSTRUCTION- (ENCROACHMENT) � , C '• "�S4 (
OF
`
TFiB��.
For the eonstructioA' of- public or private curbs, driveways, pavements; sidewalks, parking lots, sewers, water mains
ff ti
, II
-• y - ,.. and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
* }•
r Subdivision Improvement Permit — Class III
' +DATE: January '4 , 1991
,
•, • ,. Minor Improvement Permit Class IV
-
LOCATION OF CONSTRUCTION . TR 25237 V
(Street address or Description'of Location)
PURPOSE OF CONSTRUCTION street and storm .drainage." Sketch (attach construction plans if appropriate)
rnnstruction w ,
• DESCRIPTION OF CONSTRUCTION ' { see plans K
'
r DIMENSION OF INSTALLATION OR REMOVAL see plans"•'
SIZE OF EXCAVATION; IF NEEDED
+
4
APPROXIMATE TIME WHEN WORK WILL BEGIN
_ APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
`.
`.' (Including removal of all obstruction, materials, and debris, backfilling; com- -
I i
paction and.placing permanent resurfacing and/or. replacing improvements)t
,
In consideration of.the granting of this permit, the applicant hereby agrees tio:
• -• ` Indemnify, -defend and save the City, its authorized agents, officers, representativesandemployees, harmless from and against any and all '
• -
I- t•,a ,
-
-. ,penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property
t
' -happening or occurring as a proximate result of any work undertaken the permit granted pursuant to this application. -
,under
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 appli le rules and regulations of the City of
t
.. La Ouinte and to pay for any additional replacement'necessary.as the reL11,ol i rk.
a ' „ Signature of'Applicant or Agent
r
' Ohio •Citizens Investment Corp -i'0 Box 780 La Ouinta `CA 92253 564-2155
- f Name of Applicant (please paint) '` Business Address Telephone No
p•
O_U)C,r ��W V\S S l.Lc9c—� oY�
-Name of Con ctor and Job Foreman Business Address = Telephone No.
rfi
Contractor's License No. City'Business License No.
Applicant's Insurance Company - Policy Number
{
FEES: Subdivision Improvement Permit _ Class -I I I,
Public improvements: 3%of estimated construction costs 0 5182 1p 92 Ve 9 0
i0 . ,.GASH i .TOTAL 1'~ 15397.53
;Private improvements: 3% of estimated construction costs > ,
Nb O ?_
Minor Improvement Permit - Class IV: See attached schedule
-+
I5 3 �'• 5 3 ,,
Inspection Fee. � $�_�� PERMIT VALIDATION
Permit Feer.. 4i 7
PERMIT NiNO.
. - - Penalty
)
Cash Deposit -Surety Bond - DATE APPROVED
if required EXPIRATION DATE 1 I clf�
e TOTAL: `l $ S
DATE ISSUE0, I
Receipt No.
By
. w
Received by Date Administrative Authority.
•'
Recorded by ` TELEPHONE: (619) 564.2246, + I
,. .
The following General a'iid Special Provisions are attached to and made a part.of Permit No. o q -1
GENERAL PROVISIONS
The following,shall always apply: '
ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within City'of La Quinta right of way
ONLY. Whenever construction extends within private property, it shall be the responsibility of the permittee (or his contractors) to
secure permission from abutting property owners. Such authorization must be secured by the permittee prior to starting work.
TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated tracklaying construction equipment shall not be permitted to operate on any
paved surface unless fittedwith smooth -faced street pads. All mechanical outriggers shall be fittedwith rubber street shoes to protect
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 Quinta shall request
that these portions of road be resurfaced over their entire width. Resurfacing shall consist of one coat of two inches (2") of A.C.
surfacing plus appropriate seal coat as specified above.-
PROTECTION
bove.
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 theduration
of the project. The City shall be notified 24 Hrs. in advance of any traffic detours or delineations. .
CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete 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 Quinta shall be notified prior to commencement of this work.
Drainage structures and open,drains shall be kept free of debris at all times for proper drainage.
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 and other objectionable materials immediately after backfill and compaction.
Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shall be removed
prior to paving. Water tanker 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 control this water 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
access for the adjoining property owners and emergency vehicles. In the event it isfelt bythe permitteethat he must close a streetfor
any length of time, permittee shall contact this office to obtain the necessary permission.
SPECIAL PROVISIONS -
The follwing shall apply ONLY when indicated: ,
(F)NOTIFICATION: Permittee shall notify the City at 564-2246 at least 48 hours in advance of starting construction.
R2 CASH DEPOSITS OR BONDS: A cash bond or an approved surety bond in an amount of not less than $ '
shall be furnished in the name of City of La Quinta to cover all work involved in the restoration of the various La Quinta
roads and survey monuments. This bond shall be continuous until cancelled by the City Engineer. This bond must be
posted prior to commencement of any work on this project .
R3 TILITY CLEARANCE: (Substructures) Priorto making any excavation within the City of La Quinta rightof wayauthorized
by 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..
�Prloiposed
LITY CLEARANCE: (Surface structures) No work shall be done under this permit until all utilities are clear of the work site. The permittee shall notify all concerned utility companies of the proposed work.
'R5 PAVEMENT WIDENING: Area between the proposed concrete gutter line and the existing road pavement shall be
surfaced with inches of A.C. paving placed on inches of class aggregate subbase course
having an "R"value of not less than and in conformance with City of La Quinta Road Improvement Standards
and Specifications, Ordinance #461.
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.(l'):
R7 GRADES & STAKES: City of La Quinta. shall establish grades and stakes for the proposed concrete curb and gutter
construction.
E>a
RADE CHECKING: City of La Quinta shall check grades upon receipt of plan and pFofile and/or grades asestablished 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 constructed in conformance with City of La•Quinta Standard #207. ,
R10 DRIVEWAYS, A.C.: Driveways'shall be constructed as not to alter existing drainage pattern. Surfacing between the
property line and the existing road paving shall be 2-1/2 inches of A.C. paving placed on ( ") of class
aggregate base. Driveway construction shall conform to attached drawing. -
R11 CULVERTS: A inch diameter ( ) culvert shall be installed with the invert approximately 1-1 /2
inches below and in line with the existing flow line. Culvert installation shall conform to -the attached drawing.
R1
SIGHT 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 sterilizer. Rate of application shall comply with the.
... ,... . ; z .a. ,
'manufacturer's specifications: +�`••.. •-• • -• •
R14 COORDINATE'WOAk: 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
Citv'of La Quinta forces to preclude-delay'or interference with State or: City of La Quinta projects.
RVEY 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 maybe readily and correctly
be replaced by a licensed civi1.engineer 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 tothe removal of any monuments: Thisoffice shall
be nofified'upon completion-'df'replacemehtof:all-survey-monuments.for- roper:projectclearance.
R16 -SURVEY MONUMENTS: Prior*cavation or beginning of construction,'all suomonuments 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.
6
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.t
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.
R19 LIMIT OF EXCAVATIONS: Excavations shall be limited to 1,000 linealfeetof opentrench 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 i nspector sha 11 determinethe suitabiIityof excavation barricading in each case. No
excavation shall remain open for, a period exceeding five (5) days. No excavationshall be made unless the construction
material is actually on the work site.
20 ACKFILL 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. r
R21 BACKFILL SAND: Backfill shall be approved transit-mix sand or equivalent and shall. be placed in lifts of not greaterthan
three feet (3') and vibrated using vibrotamper_or equivalent equipment. Alternate methods maybe substituted, but in any
ase a relative compaction of 95 percent shall be attained within the structural section of the roadway.
R�before
ACKFILL PLACEMENT: Backfill shall be applied in layers of not more.than 50 percent of the total depth of the trench flooding ora maximum of five-foot (5') 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 placed so that the
resulting .compaction shall be not less than 90 percent or equivalent to thesuirrounding ground; whichever isthe 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 ofeach layer and the water
supply shall be continuous.
R23 COMPACTION TESTS: If so required bythe inspector, compaction tests shall be made at i ntervals 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 as outlined in Section 6.3.01 of the
Standard Specifications;' Division of Highways, State of California; dated January 1973.
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 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..Yt.
R25 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 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 '.days after completion of
f• -
temporary road repair. t -
R27 • PAVEMENT REPAIR: F.A.S.: Upon completion of backfill and compaction, a temporary patch consisting of two 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 Cityof La Quinta Road Improvement Standards
and Specifications, Ordinance 1#461'
R28 FOG SEAL: A fog seal coat consisting of an application of asphaltic emulsion shall be applied over 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.
�)completion
STREET RESTRIPING: Where street striping iistill visible onstreets to-be excavated, such striping shall be replaced upon of permanent repairs. ,r .
B31 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 the following 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. r
:All broken or weak sections within.the:trimming shall.be removed:a
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: T 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. t, `
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 m all instances, prior to trimming or topping trees.f.::Pruning shall,.ip ol.l:instances be at the shoulder.of:the crotch to insure even,,fast.healing in all.cuts of.two inches..__..
(21'and above in size., Sealantshall be aoolied'to all cut`sections as directed bv-the Citv Public Works Insoector.-