12004;Low See below for Finance Revenue Codes
o
4
ENCROACHMENT PERMIT
OFT° PUBLIC WORKS CONSTRUCTION
For the construction of publ�C or private curbs, driveways; pavements, sidewalks, parking lots, sewers, water.mains and other likepublic
works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS:
KA a
REE COPY-*Subdiyision.lmprovement Permit -Class III
Minor Improvement Permit - Class, IV
DATE: 1/17/2012
LOCATION OF CONSTRUCTION: IID; Washington Street Northbound North of Miles Avenue
PURPOSE OF CONSTRUCTION: Maintenance.
DESCRIPTION OF CONSTRUCTION: Replacing Pad Mount Switch; #3 Cane Closed
DIMENSION OF INSTALLATION OR REMOVAL: N/A
APPROXIMATE TIME WHEN WORK WILL BEGIN:
ESTIMATED CONSTRUCTION COST: N/A
1/25/2012 TIME OF COMPLETION: 1/25/2012
(Including removal of all obstruction, materials, and debris, backfilling, compaction and placing
permanent resurfacing and/or replacing improvements)
COMMENTS City of La Quinta will Invoice the Permittee for Time & Material Expenses To Be Determined on Material Ledger
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 occuring 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 at (760) 777-
7097. To submit an inspection request, leave a message on the Inspection Request Hotline.at'(760) 777-7097 prior to 1:30 P.M. at
least twenty-four (24) hours prior to the anticipated inspection. .
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.
Imperial Irrigation District -*Joe Castillo
Name of Applicant
IID Forces
Name of Contractor and Job Foreman
Fof Applicant or Agent
81400 Avenue 58, La.Quinta; CA 92253 (760).275-2079
Business'Address . Telephone No
Business.Address Telephone No.
N/A N/A
Contractor's License Number City Business License No
Self -Insured Self -Insured
Applicant's InsuranceCompany Policy Number
FEES Subdivision Improvement Permit.- Class I
Minor Improvement Permit - Class I
Finance Revenue Code
.Inspection Fee E_1
$0.00
Permit Fee E-11
0.00
As -Built Deposit E-A
0:00
Cash'Deposit-Surety Bond,-.. EE=B
$0.00
if required
TOTAL
0.00
Public Improvements: 3% of estimated construction costs
Private Improvements: 3% of estimated construction costs
PERMIT NUMBER: 1.2004
DATE ISSUED:
EXPIR ION ATE:
BY:
WORK INSPECTED BY": ON
PERMIT COMPLETION DATE`:
If the work is covered by a Subdivislon Improvement Agreement, Subdivider
shall request final acceptance of improvements from the City Council.
f • 4
.. �ryi.
Date:
Tihf 4 4 a"
PUBLIC WORKS DEPARTMENT
APPLICATION FOR PERMIT
Tract No: Project Name:
Vicinity: U&&LlSf NO h a - S
Purpose of Construction (i.e.: Rough Grading, Offsite Street, etc.)
104,r6 74e- ,P 0 a -P
Desch tion of Con truction (i.e.: Sebe Plan Set No. 01234) ,°#
"Ve La�# .3
Dimension of Installation or Removal:
Approximate Construction Start Date: _
Approximate Construction Completion D
Estimated Construction Cost: $ N
Estimated Construction Cost shall include the removal of all d
placing permanent resurfacing and or replacing improvements
PA
materials, and debris, back -filling, compaction and
Contact Name: Phone Number: �%j a079
Name of Applicant/Owner: L) T
Applicant Address:
Applicant Telephone Number:
Applicant E-mail Address:
Name of Contractor: �DrzQ�
Contractor Address: 4t:6-�b cyn fDy 5g 6t t•+ n+q , CA R27_
Contractor Telephone Number:
Contractor State License Number:
Contractor City Business License Number:
Contractor E-mail Address:
►A COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED -4
Applicant or Contractor General Liability Insurance Company:
Ge.W - :1-h
Applicant or Contractor General Liability Insurance Policy Number:
Sel-r- ZV1SwrpPj .
ns/Applicat
Office Use Only:
Assigned Permit Number: 12- O � 4
Approval Date:
Expiration
Date:
Issue
Date:
Administrative Authority:
Office Use Onlv:
Inspection Fee:
Permit Fee:
As -Built
Deposit:
Dust Control
Deposit:
Credit
Amount:
TOTAL FEE DUE:
rive eC is s — Forms & APPI—icaT
ns/Applicat
Office Use Only:
Assigned Permit Number: 12- O � 4
Approval Date:
Expiration
Date:
Issue
Date:
Administrative Authority:
i
I
- City of La Quinta
The following General and Special Provisions are attached to and made a part of
Permit Number 12004
The following shall always apply:
ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within the City of La.Quinta's right of way
ONLY. Whenever construction extends within private. property, it is.the responsibility of the permittee for his contractors to secure permission
from abutting property owners. Such authorization must be secured by the permittee prior to starting work.
TRACK -LAYING CONSTRUCTION EQUIPMENT: Cleated track -laying construction equipment shall not be permitted to operate on any paved
surface unless fitted with smoother -faced street pads. All mechanical outriggers shall be fitted with rubber street shoes to protect the paving
during excavations. Rubber -tired equipment only shall be used in backfill operation 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 OF TRAFFIC: All excavations and work areas shall be properly lighted and barricaded as deemed necessary by the City
Engineer or City of La Quinta Public Works Inspectors. Suitable detours and detour signs shall be placed and maintained for the duration of the
project. The City shall be notified twenty-four hours (24) in advance of any traffic detours or delineation.
CARE OF DRAINAGE STRUCTURES: Any drainage structure to include 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 OPERTATIONS: 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 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 following shall apply when indicated:
® R1 NOTIFICATION: Permittee shall notify the City at (760) 777 - 7097 at least forty-eight hours (48) in advance of starting
construction.
® R2 UTILITY CLEARANCE: (Substructures) Prior to making any excavations within the City of La Quinta right-of-way authorized
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.
® R3 UTILITY CLEARANCE (Surface Structures) No work shall be done under this permit until all utilities are clear of the
proposed work site. The permittee shall notify all concerned utility companies of the proposed work.
❑ R4 PAVEMENT WIDENING: Area between the proposed concrete gutter line and the existing road pavement shall be surfaced
with ( ** N/A ** ) inches of A.C. paving placed on ( ** N/A ** ) inches of ( ** N/A ** ) aggregate sub -base course having an
"R" value of not less than ( ** N/A ") and in conformance with the City of La Quinta Road Improvement Standards and
Specifications, Ordinance #461.
® R5 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of
one-fourth inch (%") to one foot (1').
❑ R6 GRADE CHECKING: City of La Quinta shall check grades upon receipt of plan and profile and/or grades as established by
a licensed engineer.
❑ R7 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter (** N/A *') 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.
❑ R8 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 two and a half inches (2 %") of A.C. paving on ('* N/A **) of class (" N/A " )
aggregate base.
® R9 SIGHT CLEARANCE: Sight Clearance of six -hundred feet (600') in all directions shall be assured and maintained at all
times.
❑ R10 SOIL STERILIZER: The area to be surfaced shall be treated with soil strerilizer. Rate of application shall comply with the
manufacturer's specifications.
City of La Quinta
® 1211 COORDINATE WORK: 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 City of La
Quinta forces to preclude delay or interference with State or City of La Quinta projects.
® R12 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the
centerline of all streets or property lines when included shall be completely tied out so they may be readily and correctly,
replaced by a licensed civil 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 to the removal of any monuments. This office shall be
notified upon completion or replacement of all survey monuments for proper clearance.
® R13 PAVEMENT CUTTING: Pavement will be mechanically saw 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 or pavement.) Excavation material shall be placed in such a position as to best facilitate the
general flow traffic. Prior to final paving operations, any damage to pavement straight edges shall be corrected.
® R14 LIMIT OF EXCAVATIONS: Excavations shall be limited to one -thousand feet (1000') of open trench 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 Inspector shall determine the suitability of 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.
® R15 BACKFILL MATERIAL: Backfill shall be free of brush, roots or other organic substance detrimental to its use for purposes
of producing and adequately consolidated backfill. Ant 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.
❑ R16 BACKFILL SAND: Backfill shall be approved transit -mix sand or equivalent and shall be placed on lifts not greater than
three feet (3') and vibrated using vibrostamper or equivalent equipment. Alternate methods may be substituted, but in any
case, a relative compaction of ninety-five percent (95%) shall be maintained with the structural section of the roadway.
❑ R17 BACKFILL PLACEMENT: Backfill shall be applied in layers of not more than fifty percent (50%) of the total depth of the
trench before flooding or a maximum of five feet (6) 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 not be less than ninety percent (90%) 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 continuos.
❑ R18 COMPACTION TESTS: If so required by the inspector, compaction test shall be made at intervals of not more than one -
thousand (1000') feet and a maximum of one (1) test on each road. One (1) copy of each test shall be forwarded tot 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.
® R19 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 Sections 6.3.001 of the Standard Specifications, Division of Highways, State
of California, dated January 1973.
® R20 TEMPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporary patch consisting
of two inches (2") of SC -800 shall be placed on a prepared sub -grade. The SC -800 temporary paving shall be placed after
a maximum of three -thousand linear feet (3000') or 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.
® R21 PERMANENT PAVEMENT REPAIR: After backfill and compaction have been completed, a temporary patch consisting of
three inches (3") of SC -800 shall be placed immediately. A permanent patch of Asphalt Concrete.surfacing per City of La
Quinta Standard 600 shall be placed no later than ( 5 ) days after completion of temporary road repair.
❑ R22 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.
❑ R23 STREET RESTRIPING: Where street striping is still visible on street to be excavated, such striping shall be replaced upon
completion of permanent repairs.
❑ R24 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 permitte to maintain the tree in a vigorous growing condition at its new location.
Trees to be removed shall be 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 five -hundred feet (500'1 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 ninety percent (90%) or
equivalent tot 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.
PERMIT NO. 12004
IID / Maintanence — Replace Pad Mount Switch /Washington St NB N of Miles Ave
In addition to the standard permit conditions, the following shall apply:
.Pursuant to Section 14.16.320 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), all
work shall be performed in accordance with the latest edition of the Standard Specifications for Public
Works Construction (SSPWC) and as directed by and to the satisfaction of the City Engineer.
2. Prior to commencing the excavation of a.trench 5 feet in depth or greater and into which a person will
be required to descend, the Contractor shall first obtain a permit to do so from the Division of Industrial
Safety pursuant to 7-10.4.1.
3. The permittee has been found to be entitled to pay only direct expenses incurred by the City while
administering tasks related to the permit, in lieu of paying the standard inspection fee (3% times the
construction cost) adopted by the City Council. City staff (see attached to last page of these pages) and
its contract staff will maintain monthly time and material ledgers of expenses incurred, and the City will
invoice the Permittee on a monthly basis for the accrued cost.
The "T&M" note, and the "TBD" note, that appear in the "COMMENTS" section on the
face of the permit form, respectively mean "Time and Material" and "To Be Documented"
and is a reference to the direct expense method defined in the previous paragraph.
4. This permit or copy of it shall be on the work site (usually the job trailer) for inspection during the
actual work performed.
5. Imperial Irrigation District (Joe Castillo (760) 275-2079), hereinafter referred to as "Permittee", shall
be responsible for providing continuous dust and erosion control.
6. The permittee shall submit inspection requests by calling the City Inspection Hotline at (760) 777-7097
before 1:30 p.m. and at least twenty-four (24) hours prior to the anticipated inspection.'
7. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more
frequently, if required.
Pursuant to Section 6.08.050 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 1st to April 30; Monday -Friday 7:00 a.m. to 5:30 p.m.
Saturday 8:00 a.m. to 5:00 p.m.
May 1 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.
Work shall be prohibited on legal holidays and Sundays.
Note: Construction work (including setting up traffic control devices) is not permitted on any Arterial
street (ie any 4 lane street) before 8:00 a.m.
Special Conditions Page 1 of 5
PERMIT NO. 12004
IID / Maintanence — Replace Pad Mount Switch /Washington St NB N of Miles Ave
9. Work within 500 feet of a signalized intersection shall be performed between the hours of 9 a.m. - 3
p.m. Traffic control shall be set up after 9 a.m.. and removed before 3 p.m. The Permittee shall contact
the City Traffic Signal Technician at (760) 250-0571 if signal operation at the intersection is to be
altered in any way.
10. The permittee shall not encroach upon private property without prior written approval of the private
land owner whom is being encroached upon.
11. Pursuant to Section 14.16.110 of the La Quinta Municipal Code (Ordinance 10 § 1 (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.
12. This permit is not valid until the permittee submits, to the Public Works Department 2 weeks prior to
start of construction, a letter from any owners of the driveways/access ways that will be closed down
due to the construction. The letter must be approved by the city and at minimum state from the owner
the following:
A. Approval of the construction
B. Plan identification
C. Time Frame of Closure
D. Alternative Routes
13. Any land on which Williamson Act contracts apply shall remain undisturbed.
14. Pursuant to Section 14.16.250 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), at
residential streets, advance warning signs and traffic control shall be installed and maintained in
accordance the latest edition of the California. Manual of Uniform Traffic Control Devices (MUTCD).
On Collectors to Major Arterial Streets, the permittee must submit a traffic control plan which shall be
prepared under the guidance of the latest edition of the California Manual of Uniform Traffic Control
Devices (MUTCD). It shall be. the Permittee's responsibility to appropriately detour and barricade all
construction sites.
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 two (2) travel lanes of paved surface shall
be maintained at all times.
15. Prior to excavating, if required, the Permittee shall contact Underground Service Alert 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.
16. 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.
Special Conditions Page 2 of 5
PERMIT NO. 12004
IID / Maintanence — Replace Pad Mount Switch /Washington St NB N of Miles Ave
17. The City of La Quinta reserves the right to require modifications of the work be made at permittee's
sole cost for proper sight distance requirements per guidelines in the AASHTO " A Policy on
Geometric Design of Highways' and Streets, 5th Edition" or latest, in the installation of all
appurtenances abutting and within the public street right-of-way.
18. The permittee shall be responsible for calling the city inspector to arrange the city inspector to observe
random trench compaction testing performed by a city approved material testing firm. If the inspector's
phone number is unknown, the permittee shall call the Public Works front counter phone at 777-7075 or
the Assistant Engineer II. at 777-7047 to determine the city inspector's phone number. The inspector
shall determine the number and location of the test location/s. The above testing does not relieve the
permittee's responsibility for future repairs due to settlement at and near the locations of the work area.
Materials testing must be performed under direct supervision of a California Registered Civil Engineer-.
19. The issuance of this permit and the City approval of the related construction improvement plans do not
provide a vested entitlement for all design parameters that may have been utilized for the plans. As
such, plans approved for this permit may be "at risk" for further modifications as it relates to any follow
up improvement plan requirements as required by the. city or existing errors & omissions by the
architect or engineer of record.
20. 'This permit is not valid until the permittee submits, to the Public Works Department 2 weeks prior to
start of construction, the name of the City approved contractor,.who shall submit to the City the
following items:
a. General Liability Insurance Company and Policy Number
b. City Business License
c. Contractors State License Number
21. The Applicant or Contractor shall furnish the City satisfactory evidence of insurance in the amounts
provided in the Engineering Bulletin for Indemnification & Insurance Requirements. This insurance
shall be kept in full force and effect at all times by Applicant or Contractor during the prosecution of the
permitted work and updated Certificate of Liability Insurance shall be submitted to the City. Each
policy shall name the City as an additional insured.
22. The permittee shall haul all offsite debris to a certified landfill. Prior to hauling debris, the permittee
shall inform the City (Inspection staff or 777-7047) of the name and location of the certified dump site.
23. If public traffic lanes are required to be closed, this permit is not valid until the permittee submits, to the
Public Works Department, a traffic control plan for review and approval prior to start of construction or
parking on the paved R/W.
Special Conditions Page 3 of 5
PERMIT NO. 12004
IID / Maintanence — Replace Pad Mount Switch /Washington St NB N of Miles Ave
24. The permittee may be required by the City. Engineer to provide an informative message board (approved
by the City Engineer) informing the commuters using the affected roadways of
a. Possible traffic delays
b. Time of construction
c. Alternate routes.
The message board shall be provided for the commuters 48 hours prior to the start of traffic delays, and
the entire message should be readable with one pass at the posted speed limit.
25. No excavation anticipated or allowed without written approval of the City Engineer.
26. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to its
original condition.
27. Access and egress to all local properties shall be maintained at all times.
28. 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.
29. 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.
30. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time.
31. The permittee shall indemnify, hold harmless and assume the defense of the City from all damages,
delay costs, costs or expenses in law or equity that may arise out of work under this permit.
Special Conditions Page 4 of 5
PERMIT NO. 12004
IID / Maintanence — Replace Pad Mount Switch /Washington St NB N of Miles Ave
... _ _ .,_... _._._..._ .. ...._._...- ........ _............. .... . .......... _..._..........-.......
---... -....
t
City of La Quinta
j TIME & MATERIAL MONTHLY LEDGER
FOR: ( This time & material ledger summarizes the office and
MONTH: field staff time devoted to encroachment permits issued
to the subject Permittee, including contract staff.
STAFF MEMBER:
TIME HOURLY EXTENDED II
DATE PERMIT NO. RATE COST
START STOP TOTAL .
i
SUBTOTAL=
F270
&W Sheet of
Special Conditions Page 5 of 5
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NOTES: 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH THE 2010 CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROLS (M.U.T.C.D.) Traft Cwm Pmnmr
2. TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAY BE REQUIRED TO FACILITATE PUBLIC SAFETY AND TRAFFIC FLOW IF DEEMED NECESSARY BY Electrical System Improvements
CITY OF LA QUINTA REPRESENTATIVE. 1. PAmeConbactor corbct
3. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL (SIGNS, BARRICADES AND DELINEATORS) AND MAINTAIN SAME IN ACCORDANCE WITH TRAFFIC CONTROL PLANS. Imperial Irrigation District Joe (760) 275-2079
4. CONTRACTOR SHALL MAINTAIN A MINIMUM 10'(1 2'TYP.) TRAFFIC LANE WIDTH AT ALL TIMES. THERE SHALL BEA MINIMUM 2' BETWEEN THE EDGE OF CUT AND THE NEAREST TRAFFIC LANE. Tretnccontroi Design bywrorte Prepared By
5. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINED AT ALL TIMES. Tops N Barricades, Inc. (800)852 -TOPS Ron Fifield
6. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. AT END OF THE WORK HOURS, THE ROAD SHALL BE CLEAR OF DEBRIS AND RETURNED TO NORMAL.. street Data PetmitNambor
7. WORK HOURS TO BE DETERMINED BY THE CITY OF LA QUINTA. 1 REV 06/01/11 To Be Issued on Approval
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NOTES: 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH THE 2010 CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROLS (M.U.T.C.D.) Traft Cwm Pmnmr
2. TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAY BE REQUIRED TO FACILITATE PUBLIC SAFETY AND TRAFFIC FLOW IF DEEMED NECESSARY BY Electrical System Improvements
CITY OF LA QUINTA REPRESENTATIVE. 1. PAmeConbactor corbct
3. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL (SIGNS, BARRICADES AND DELINEATORS) AND MAINTAIN SAME IN ACCORDANCE WITH TRAFFIC CONTROL PLANS. Imperial Irrigation District Joe (760) 275-2079
4. CONTRACTOR SHALL MAINTAIN A MINIMUM 10'(1 2'TYP.) TRAFFIC LANE WIDTH AT ALL TIMES. THERE SHALL BEA MINIMUM 2' BETWEEN THE EDGE OF CUT AND THE NEAREST TRAFFIC LANE. Tretnccontroi Design bywrorte Prepared By
5. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINED AT ALL TIMES. Tops N Barricades, Inc. (800)852 -TOPS Ron Fifield
6. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. AT END OF THE WORK HOURS, THE ROAD SHALL BE CLEAR OF DEBRIS AND RETURNED TO NORMAL.. street Data PetmitNambor
7. WORK HOURS TO BE DETERMINED BY THE CITY OF LA QUINTA. 1 REV 06/01/11 To Be Issued on Approval
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City. of La Quinta
a Public Works Engineering Department
W Inspector's Ddily Log
Commercial/Resi&ntial Development
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Title: C'drtekadim Aopectan
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ENCROACHMENT PERMIT
PUBLIC WORKS CONSTRUCTION
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 III
Minor Improvement Permit - Class, IV
DATE: 1/17/2012
LOCATION OF CONSTRUCTION: IID; Washington Street Northbound North of Miles Avenue
PURPOSE OF CONSTRUCTION: Maintenance.
DESCRIPTION OF CONSTRUCTION: Replacing Pad Mount Switch; #3' Lane Closed
DIMENSION OF INSTALLATION OR REMOVAL: N/A
APPROXIMATE TIME WHEN WORK WILL BEGIN: 1/25/2012 TIME OF COMPLETION: 1/25/2012
ESTIMATED CONSTRUCTION COST: N/A (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing
permanent resurfacing and/or replacing improvements)
COMMENTS City of La Quinta will Invoice the Permittee for Time 8 Material Expenses To Be Determined on Material Ledger
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 occuring 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 at (760) 777-
7097. To submit an inspection request, leave a message on the Inspection Request Hotline.at (760) 777-7097 prior to 1:30 P.M. at
least twenty-four (24) hours prior to the anticipated inspection.
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.
Imperial Irrigation District - Joe Castillo.
Name of Applicant
IID Forces
Name of Contractor and Job Foreman
Applicant or Agent
81400 Avenue 58, La Quinta; CA 92253 (760).275-2079
Business 'Address Telephone No
Business Address
Telephone No.
N/A N/A
Contractor's License Number City Business License No
Self -Insured Self -Insured
Applicant's Insurance Company Policy Number ti
FEES Subdivision Improvement Permit - Class I
Minor Improvement Permit - Class I
Finance Revenue Code
Inspection Fee E_1
$0.00
Permit Fee EE=1
0.00
As -Built Deposit E-A
0:00
Cash Deposit -Surety Bond, E_B
$0.00
.if required
TOTAL
0.00
Public Improvements: 3% of estimated construction costs
Private Improvements: 3% of estimated construction costs
PERMIT NUMBER: 1.2004
DATE ISSUED: Z3 IZ
EXP DATE:
BY:
WORK INSPECTED BY*:
PERMIT COMPLETION DATE*: Z -f Lf
If the work is covered by a Subdivision Improvement Agreement, Subdivider
shall request final acceptance of improvements from the City Council.
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Public Works Engineering Department
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Com Mercial/Residential Development
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