1698d
NOTE:
With proper validation,
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
DATE: 3/19/93
LOCATION OF CONSTRUCTION 78-605 Sagebrush
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
(Street address or Description of Location)
i
PURPOSE OF CONSTRUCTION Install & maintain a 6" house 60 Sketch (attach construction plans if appropriate)
lateral for sewer service
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
e
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION 10 Data
ESTIMATED CONSTRUCTION COST $ 2100.00
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
SEE ATTACHED SKETCH
SEE ATTACHED CONDITIONS
i
In consideration of the granting of this permit, the applicant hereby agrees to: r
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 theiresult of this work.
Si
gyfature of Applicant or Agent
COACHELLA VALLEY WATER DISTRICT PO BOR 1058 COACHESLLA CA 92236 388-2651
Name of Applicant (please print) Business Address Telephone No.
SAM
Name of Contractor and Job Foreman Business Address Telephone No.
ON FILE Am ATT.V
Contractor's License No. City Business License No.
ON FILE
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class II I
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
w
PERMIT VALIDATION
PERMIT NO. 1698
DATE APPROVED 3/19/93
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form constitutes an
encroachment permit
I=
CITY OF LA QUINTA
APPLICATION FO�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
/ 9
DATE: Z4 :
LOCATION OF CONSTRUCTION JJ _
LDT:-TRAC7,
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION INSTALL AND MAINTAMI A FDUP_
I N G H ('f"J /-lOILSi✓ LA7F_aAZ_ V70 EL SE1WF-rZ ScfZV CE
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
APPROXIMATE TIME OF COMPLETION N/NF-Ty (: 20) DAYS
ESTIMATED CONSTRUCTION COSTS X02.20
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
Sketch (attach construction plans if appropriate)
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 a.
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or propertN
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 -lour 1241 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 Ciiy o:
La Ouinta ano to pay for any additional replacement necessary as the result of this work.
COACHELLA VALLEY WATER DISTRICT
Name of Applicant (please print)
i
�f
Name of Contractor and Job Foreman
Contractor's License No.
Signature of Applicant or Agent
P. 0. Box 1058 COACHELLA, CA. 92236 398-2651
Business Address Telephone No.
Business Address
i eiepnone No.
City Business License No.
Applicant's Insurance Company Policy Number
The following General and Special Provisions aro attached to and made a part of Permit No.
GENERAL PROVISIONS
The following shall always apply:
ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within City of La Quints right of way
ONLY. Whenever construction extends within private property it shall be the responsibility of the permittee for his eontractorsl to
secure permission from abutting property owners. Such authorization must be secured by the permittee prior to starting work.
TRACKLAYING CONSTRUCTION EQUIPMENT: CleatetltrecklayingeonatrUCtionequipmentshall not bePermitted tooperate onany
paved surface unless fitted with smooth -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 Operations in paved areas. If the existing
Pavement is scarred. Spelled, or broken during the term of this contract, or if the pavement is marred, City Of L8 Quints 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.
surfaging plus appropriate seal coat as specified above.
PROTECTION OF TRAFFIC: All excavations and work areas shall be -property lighted and barricaded as deemed necessary by the City
Engineer or La Quints City Public Works Inspectors. Suitable detours and detour signs shall be placed and
of the project. The City shall be notified 24 Mrs. in advance of any traffic detours or delineations, maintained for the duration
CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete Pips 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 commeneentent 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 dean of earth and other objectionable materials immediately after backtill 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 atter baddill.
DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing wateron City of La Quints roads it shall be
the responsibility of the permittee fcontractorl to control this water and to provide off-street bamcadea 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 bythe permittee that he mustdose.a street for
any length of time. permittee shall contact this office to obtain the necessary permission
SPECIAL PROVISIONS
The follwing shall apply ONLY when indicated:
0 NOTIFICATION: Permittee shall notify the City at 664-2248 at lees
ouro 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 Quints to coverall work involved in the restoration of the various La Quints
roads and survey monuments. This bond shall be continuous until cancelled by the City Engineer, This bond must be
s�Posted prior to commencement of any work on this project.
G)UTILITY CLEARANCE: (Substructures) Priorto making any excavation within the City of La Quinta right atweysuthorjzed
by permit, the permittee shall oorttsct all concerned utility Companies relative to the location of existing substructures.
Damage to existingsubstructures resulting from operations conducted under this permit shall be the soin respoylbility
of the permittee.
R4 UTILITY CLEARANCE: (Surface swucturesl No work shall be done under this permit until all utilities still dear of the
proposed 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 Oninches of class
having an"R'valueof not less than and in conformance with City of La Quints Road in rg�Subbaseco e
and Specifications, Ordinance #461. ent Standards
R6 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be gradedto a slope of
1/4 inch to one foot I �.
R7 GRADES & STAKES: City of La Quints shall establish grades and stakes for the proposed concrete curb and gutter
construction.
Re GRADE CHECKING: City of La Quints shall check grades upon receipt of Plan and piwfileand/or grades assstablishedby
a 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 Quints 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 da••
aggregate base. Driveway construction shall conform to attached drawing.
R11 CULVERTS: A inch diameter f
inches below and in line with the exiting flow I vert) installation alvert shall beinstllllcon oirmthe to the tachedinvertimately drawng.t /2
L ^J' 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
manufacturer's specifications.
R14 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 coodinated with the State or
9City of La Quints forces to preclude delay or interference with State or City of La Quints projects.
SURVEY 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 Civil engineer or surveyor at the expense of the permittee. A complete set of not" showing the
ties to these monuments shall be furnished to the City Engineer prior to the removal atanymotumems e. Thisofficeshall
be notified upon completion of replacement of all survey monuments for pro0er project m name n
R16 SURVEY MONUMENTS: Prior to excavation or begmnknq of construction. all survey monuments shall be tied out by City
of La Quints and suitable payment or guarantee of payment shall be made as reimbursement for all wv?k involves.
R17 PAVEMENT CUTTING: Pavement will be mechankeally cut to a straight edge prior to excavation. Method of pavement
cutting shall be approved through the office of the City Engineer. lander 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.
18 PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations, any damage to
pavement straight edge shall be corrected.
LIMIT OF EXCAVATIONS: Excavations shall be limited to 1.000 lineal feet of open trench before backfill operations must
begin. All excavations shall be properly barricaded with lights overnight, on weekends and holidays fortheprotectron 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 construi
material is actually on the work site. cton
R2 BACKFILL MATERIAL Backtillshall befree ofbrush. roots orother organic substance detrimenta,.;.;suse for purposes
of producing an adequately consolidated backfill. Any material which the City of La Quinta deems unsuitable (spongyor
saturated material) which is encountered during excavation shallnot be used for backfill, but shall be supplemented or
replaced by an approved sand or gravel. -
R21 BACKFILL SAND: Backfill shall be approved transit -mix sand or equivalent and shall be placed in lips of notgreaterthan
three feet (31 and vibrated using vibrotamper or equiva ient equipment. Alternate methods maybe substituted.
case a relative compaction of 95 percent shall be attained within the structural section of the roaway. but in any
BACKFILL PLACEMENT: 8801dill shall be applied in layers of not more than 50 percent of the total depth of the trench
before flooding are maximum of five-foot 151 lifts where trenches are of excessive depths. Care isto be exercised that the
baddill 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 90pereem or equivalent to the surrounding ground, whichever lathe 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 seen layer and the water
supply shall- be continuous.
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 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
One (1► Copy ofeach test shall beforwarded tothe City Engineer for approval and filed prior tomakinPermanent�orservtapeice I Its.
Compaction tests shall be made as outlined in Section 6.3.01 of the Standard Specifications, Division of repairs.
of California, dated January 1973. Highways. State
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
afters 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.
PERMANENT PAVEMENT REPAIR: After backfill and compaction
operations have been completed, a temporary perch
consisting of two inches (2) of SC -800 shall be placed immediately. A permanent patch f
surfacing placed on a __� inch class � base shall be placed no later than M,gg�< r inches A.C.
temporary road repair. S Cou�ITicN .�11 aftercompletionof
R27 PAVEMENT REPAIR: F.A.S.: Upon Completion ofbaekfilland compaction. atemporary Patch cons�gOftwo 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 (61 concrete base as directed, but not later than fifteen (15) days after completion of temporary .
paving, Concrete bass shall beat fN"ack mix and shall conform to the City of La Quints 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.
R3 STREETRESTRIPING:Wherestreetstripingisstillvisibleonstreetstobeexcavated.suchstripingshallbereplacedupon
completion of permanent repairs.
R31 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quints 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 safelywithout 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 anyone time. Adequate
signs, flagmen an 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
teats 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 500feetat 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 Quints 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,
a• Abutting property owners shall be comected, in all instances, prior to trimming or topping trees.
f. Pruning sha1L in all instances, beat the shoulder of the crotch to insure even, fast healing in all cuts at two inches
(2") and above, in sire, Sealant shall be applied to 811 cut section* as directed by the City Public Works instieeter
SPECIAL CONDITIONS --PERMIT NO. 1698
--- CVWD ---
In addition to the standard permit conditions, the following shall apply:
1. All work shall be performed in accordance with the latest edition of the Standard
Specifications For Public Works Construction .
2. This permit is only for work within the City of La Quinta and it's'R/W.
Permittee/contractor shall acquire a permit from any other abutting agency and/or
jurisdiction, ie, Caltrans, CVWD etc.
3. Permittee shall be responsible for providing continuous dust and erosion control.
4. Streets shall be kept clean. They shall be completely cleaned at the end of each
working day and more frequently if required.
5. Contractor shall comply with the local noise ordinance. 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 1st 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 including Sundays.
6. Permittee shall assume responsibility for repair of any pavement breakdown at the
haul road access to any public or private street and for any damage to other City
streets or facilities.
7. Advance warning signs and traffic control shall be installed and maintained in
accordance with Cal Trans Standards. .It shall be the permittee's responsibility
to detour and barricade this site. A traffic control plan shall be submitted for
review prior to permit issuance.
8. Permittee shall notify the City Engineering Dept. at 564-2246 at least 24 hours
in advance of starting construction.
9. In advance of excavation, Contractor/permittee shall submit to -the city for
acceptance a detailed plan, in accordance with Labor Code -Section 6705, •showing
the design or shoring., bracing, sloping, or other provisions to be made for
worker protection from the hazard of caving ground during the excavation of any
trench or trenches five feet or more in depth.
If such plan varies from the shoring system standards, the plan shall be prepared
by a registered civil or structural engineer. As a part of the plan, a note
shall be included stating that the registered civil or structural engineer
certified that the plan complies with the Cal OSHA Construction Safety Orders or
that the plan is not less effective than the shoring, bracing, sloping, or other
provision of the Construction Safety Orders.
10. If the work is to be performed by forces other than that of the utility company
the contracting company shall apply for an additional encroachment permit and pay
the appropriate fee.
11. Pavement replacement section shall be 4" of A.C. over 5" of Class 2 Base .
12. Permanent paving shall be completed within 72 hours of temp. cold patch.
13. All landscaping and irrigation shall be replaced to its original condition.
Special Conditions - Permit No. 1698 Page 1 of 2
14. Prior to excavating, permittee shall contact Underground Service Alert at 1800-
422-4133 and provide the city.inspector with an "inquiry no."
15. All backfill and subgrade soil shall.be compacted to 90% relative dry density,
all backfill soil within the top 2' of finish pavement surface shall be compacted
to 95% relative dry density, all base material shall be compacted to 95% relative
dry density.
16. When work is within 500' of a signalized intersection, the permittee shall notify
Riverside County Signal Dept. at (714) 275-6894, 48 hrs prior to beginning work.
17. All excavation at or near the travel way shall be backfilled at the end of the
work day for the protection of the traveling public.
18. Ingress and egress for all local properties shall be maintained at all times.
19. Street closures shall not be allowed at any time, a minimum of one travel lane
on paved surface shall be maintained at all times with flagmen present:
20. No excavation is permitted until thursday April 1, 1993.
r
Special Conditions - Permit No. 1698 Page 2 of 2
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