1838NOTE:
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 I II
DATE: 8/16/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Jefferson Ave A .300' Worth of AV* 49th La Quint&
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION IID Hlettrical.
Conduit Crossing
DESCRIPTION OF CONSTRUCTION 109tAll 3-611 Ce"d"It
ACROSS Jefferson — Slurry Backfill
DIMENSION OF INSTALLATION OR REMOVAL 62x30" Slide
by 48' Depth
SIZE OF EXCAVATION, IF NEEDED 62'x30"148"
APPROXIMATE TIME WHEN WORK WILL BEGIN 8/17/93
Sketch (attach construction plans if appropriate)
SES ATTACHED CONDITIONS
SEK ATTACHED DRAWING
SEE ATTACHED TRAFFIC CONTROL PLAN
APPROXIMATE TIME OF COMPLETION 8/17/93 1 day
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction, and placing permanent resurfacing and/or replacing improvements)
1 '
In consideration of the granting of this permit, the applicant hereby agrees to:,
D Q 0
AUG 16 1993
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 per_m-itland all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the resu„t66f tWs work.
Indio
Name of Applicant (please print)
ature of Applicant or Agent
Business Address
Telephone No.
F -W, Developwnt Jack Burry (Ssmie As Above)
Name of Contractor and Job Foreman "�''jA°� Business Address Telephone No.
367841
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 $ 19' ,90
Permit Fee /,ep • 0449
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No
$ 7U. d0
Received by Date
PERMIT VALIDATION
PERMIT NO. 18.38
DATE APPROVED 8/16/93
EXPIRATION DATE 8/20/93
DATE ISSUED 8/16/93
By -W
rt Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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 lou, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
i -
�
DATE:-- /�� /�� Subdivision Improvement Permit — Class 111 � T_!
Minor Improvement Permit Class IV
`LOCATION OF CONSTRUCTION 100 �VP47-114 of -
(Street
�S
(Street address or Oescnption of Location)
�C PURPOSE OF CONSTRUCTION + Sketch (attach construction lana if
C011J014iT C,2DSS/� p appropriate)
DESCRIPTION OF CONSTRUCTION T.U.S%AGL
L11-irnSc ,TaGG17ln., ci:. 0._ i .�
,,(,DIMENSION OF INSTALLATION OR REMOVAL - ° X 30"cm(de
A %J , Ld d' A 1='_.�
%k SIZE OF EXCAVATION, IF NEEDED G e- ` X' 30
APPROXIMATE TIME WHEN WORK WILL BEGIN S
'APPROXIMATE TIME OF COMPLETION 3
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:
Sff- /�%7✓frf/ co.�l� �Tio�S
Indemnifv, defend and saw 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
happening or occurring a a proximate result of any work undertaken under the permit granted Pursuant to ��application. to Persons« 0 ropery
Notify the Administrative Authority at Isar twenty-four 124) hours in advance of the time when work will be stared.
Comply with all apOliCable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Ouinta and to pay for any additional replaoertent neee:esry as the result of this work.
X -fir/-OHO G�1�5j %'
Name of Applicant (please print)
2`7 Gv, DF 11670, MQ v - L;;�ce-e
Name of Contractor and Job Foreman
Y-3-62 6 L//
Contractor's License No.
r
Signature of Applicant or Agent /ri= 3y/$= vs';-
6zz arnTPe1 ccaB be ply SzZi/
Business Address
BUAI1 ` 774 2 > i
Business Address
Telephone No.
C�/� Pte. /D• gzzii 3 y3 =�lSS"�
Telephone No.
City Business License No.
Applicant's Insurance Company Policy Number "y
FEES: $ubolvlslon 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.
PERMIT VALIDATION
PERMIT NO. X838
DATE APPROVED V —1GO ^ 9
EXPIRATION DATE
e - 20 - 93
DATE ISSUED
Received by Date BY
Administrative Authority
Recorded by
TELEPHONE: (619) 564-2246
LN:3-8'CND.165'W - R
T17295-75'
PROPOSED RISER POLE
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INST. NO. ,
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The following General and Special Provisions are attached to and made a part of Permn No. �$3$
GENERAL PROVISIONS
The following shall always apply:
ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within Citv of La Quints right of way
ONLY. Whenever construction extends within private properly. it Shall be the responsibility of the perrhmas for his contractors, l0
secure permission from abutting properly owners. Such authorization must be Secured by the permittee prior to starting WOM.
TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated tradtleving construction equipmem shall not be permmedtooperate anany
Paved surface unless fined with smooth -faced street Peds. All mechanical outriggers Shall be fitted wnh 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 contraeL or if the pavement is marred,City of la Quints shall request
that these portions of road be resurfaced over their entire width. Resurfacing shall consist of one cost of two mates all of A.C.
surfaging plus appropriate seal coat as specified above.
PROTECTION OF TRAFFIC: All excavationsand work areas shall be -properly lighted and barricaded as deemed necvegn pt the City
Engineer or La Quints City Public Wrxfislnspeeors. Suitable detours and detoursignsshallbeplaeedand msintairtedfaMedurauon
of the proism The City $hall be notified 24 Ha. in advance of any traffic detours or delineations,
CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete lv
concrete structures encountered during excavation which necessrats rama event -it stert and
eel cculvbecomes necessary to remove cut skirtovsl shall Pope.pe,ay De replaced in kind. In the
existing drainage structures. City of La Quintsshall be notified prior to commencement of this work.
Drainage structures and open drains shall be kept free of debris et all Ames for proper drainage,
RIGHT OF WAY CLEANUP: Any surplus matenal resulting from excavation and backfill operations shall be removed from the right of
way. All paved surfaces shall be broomed dean of earth and other objectionable materials immediately after backfill and compaction.
Existing gutter line and drainage ditches snail be replaced to their original standard or better. All excess material shall be removed
prior to paving. Water tanker Shall be used, as required. to sprinkle the job site to keep down dust conditions anti shag be used
immediately after backfill.
OE -WATER OPERATIONS: If de -watering operations are required and pumps aro forcing wateron City of La Quints roads, it shall be
the responsibility of the permittee Icontractorl to control this water and to Provide off-street barricades when nepssary.
CLOSING STREETS: No street shall be dosed. A minimum of one lane of traffic shall be maintained at all times to provide limned
access for the adjoining property owners and emergency vehicles. In the event it i s fe It by the perlhmee that he mustclose a street for
any length Of time, permittee shall contact this office to obtain the necessary permission.
SPECIAL PROVISIONS
The follwing shall apply ONLY when indicated:
V NOTIFICATION: Pernimee shall notify the City at 664-2246 at least0hours in advance of Starting
R2 CASH DEPOSITS OR BONDS: A casts bond Oran a eontxruetion
n an amount of not less than$ _
shall be furnished in the name of City of La Quints o cover surety
1work involved in the restoration of the w
rNM La
roads and survey monuments. This bond shell be continuous until cancelled by the City Engineer. This bad MustQuinta
be
�posted prior to commencement of any work on this project.
LfTY CLEARANCE: (Substructures) Priorto making any excavation within thsCitV of La Quints right of
by perms. the Permmee shall comet all concerned utility companies relative to the location of existingSubstructures.
Damage Damage to existing substructures resufting from operations conducted under this $ubatntetures.
of the Permmee. Permit
R4 UTILITY CLEARANCE: (Surface atructuresl No work shall be dons under this permit until all utilities are dear of the
Proposed work site. The perntmes shall notify all concerned utility companies r the proposed work,
R5 PAVEMENT WIDENING: Area between the proposed concrete gutter fine and the existing road pavement shell be
surfaced with inches of A.C. Paving placed on inches of class
having an"R"valueofnot less than and in conformance with City of La Quints Road Improvement
entStandards
and Specifications, Ordinance 0481, rhProvementStandards
R6 PARKWAY GRADING: Area between the property line and top of the proposed concrete eurbshallbegradedtoaalopeof
1/4 inch to one foot (11.
R7 GRADES & STAKES: City of La Quints shall establish grades and stakes for the proposed comerete curb and goner
construction.
R8 GRADE CHECKING: City OfL.aQuintashall check grades up -on recerptofplanandprofileand/
a or gradeseseatabfiahedpy
lirensed engineer.
R9 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( fast)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 0207.
RIO DRIVEWAYS. A.C.: Driveways shall be constructed as not to after 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 (_ 1 of class
aggregate base. Driveway construction shall conform to attached drawing.
R11 CULVERTS: A:nchdiameterl-)culvertsha11beinstalledwiththeinvenapproximatelyI.1/2
inches below and in line with the existing flow line. Culvert installation Shall conform tO the attached drawing,
6) 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 coordinated with the State or
Citv of La Quints forces to preclude delay or interference with State or City of La Quints projects.
R15 SURVEY MONUMENTS: Prior o excavauon or beginning of construction, all survey monuments which exist on the
centerline of all streets or propertyfines when involved shall bscompletety tied out so they maybe readily and correctly
be reolaced by a licensed civil engineer or surveyor at the expense of the permittee. A complete set Of notes showing the
cies to thaw monuments $hall be furnished to the City Engineer prior to the►emovai of any monuments. Thisoft ceshall
be notified upon completion at. cement Of all survey monuments tar braider Project clearance.
c, - .F _ a..- : --.rot - : „r�-,•.+�: G..c�n� ..r ,-a•. _ .. _ - , . r -
of La Quints ano Suitable payment or guarantee Of payment snail `be'made as eimoursememsforla I warout
ilvCed.
R17 PAVEMENT CUTTING: Pavement will be macnanica iv cut to a stratght edge prior to excavation. Method of
cutting shall be approved through the office Of the City Engineer. (Under no circumstances shall excavatio (pavement+
be used to excavate prior to Cuttin0 of pavameml. Excavation material shall be placed to such a g equipment
facilitate the general flow of tratfic. Prior to final paving operations. any carnage to pavement straghtien as to best
C edge shall be
R1 PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paying Operations. any damage to
Pavement straight edge shall be corrected.
R19 LIMIT OF EXCAVATIONS: Excavations shall be limited to 1.000 lineal feet of open trench before backfill operations must
begin. All excavations snail be oronertv barricaded with lights overnight, on weekends ano holidays torthe protection of
the traveling public. The Public Works inspector snail determine the suitability of excavation barricading in each case. No
excavation shall remain open for a perioa exceeding five 15) days. No excavation snail be made unless the construction
material is actually On the work site.
BACKFILL MATERIAL Backfill shall be free of brush. roomor other organic substance detriments, :..ks use for purposes
Of producing an adequately consolidated backhll. Any material which the City of La Quints deems unswtable (spongyor
saturated material) which is encountered during excavation shall not be used for backfill. but shall be supplementetl or
replaced by an approved sand or gravel.
R21 BACKFILL SAND: Baddill shall be approved transit-mix sand or equivalent and shall be placed in lifts of not greater than
three feet (3') and vibrated using vibrotamperorequivatemequipment. Alternate methodsmaybesubsthuted but in any
case a relative compaction of 95 Percent shall be attained within the structural section of the roadway,
R22 BACKFILL PLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench
before flooding or a maximum of five-foot (51 lifts where trenches are of excessive depth& Care is to be exercised that the
backfill material is not subjected to extreme swell by flooding operations. Backfill material shall be placed 90 that the
resulting compaction shall be not less than 90trercem or equivalent to the surrounding ground. whichever is the greeter
compaction. Where ponding or flooding is used for a maximum settlement, adequate dikes will be constructed to retain
the water. Where letting is used. the jets shall be of sufficient length to reach the bottom of each :aver and the water
Supply shall be continuous.
Q0 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 it) 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 asoutlined in Section 6.3.01 of the
Standard Specifications, Division of Highways. State of California, dated January 1973,
24 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing
g� service line.
Convection tests shall be made as outlined in Section 6.3.01 of the Standard g Permanent repairs.
of California. dated January 1973. SpeelficatlOns. Division of Highways. State
R25 TEMPORARY PAVEMENT REPAIRS: Atter 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 Ona inch class baseshall be placed no later than
temporary road repair. days ahercompletionof
R27 PAVEMENT REPAIR: F.AS.: Upon completion of backtill and compaction. a temporary patch consisting OftWO inches (2-)
Of cold mix Paving (SC-800) shall be placed immedistely.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 0 5) days after completion Of temporary
Paving. Concrete base shall be of five-sack mix and shall conform to the City of La Quints Road Improvement Standards
and Specifications. Ordinance 0461.
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 seat coats existed prior to issuance of this permit. Seal or armor coats shall be applied as stuecified in Section
37. Standard Specifications. State of California. Divisionof Highways. dated January 1973. Work of pavement repair to
be accomplished by a licensed contractor engaged in the business of pavement repair.
R STREET RESTRIPING: Where street Striping isstill visibleonstreets tobeexcavated.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 mterference or hazard to the traveling public.
It shall be the responsibility of the permittee to maintain the tree in a vigorous growing condition at is new location.
Tracts to be removed shall be removed in sectipnswhich can be handled Safely without interference or hazard to highway
traffic. The entire width of the tree stump snail be removed and disposed Of so that no debris remains in view of the
hignway. The stump hole shall be backfilled and thoroughly compacted as specified inthe 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 backfilledand 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 Semon 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.
p. 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.
c. 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 oarmn.
d. Aft tree trimming on EVERGREEN TREES. PALM TREES. and other ORNAMENTAL TREES shall be accomplished to
Me satisfaction of the City Public Works Instimar.
e. Abutting property owners shall be contacted in all instances. prior to trimming or topping trees.
f. Pruning shall. in all instance& be at the shoulder of the crotch to insure even. fast healing in all cuts of two Inches
12"1 and above in size. Sealant shell be applied to as cut sections as directed by the City Public Works Instie inr
•_ - ... r; •... . .. � 1 x , �X..-p... _ : � ._.�mr4...^G.- Y.-..- «-]fir. .. .�.si. ,. . .. .. - • ,,.h ... ,. C � . : _ •. ->
:PEC I AL CONDITIONS --PERMIT NO. 1838
--- Electrical Crossing ---
In addition to the standard permit conditions, the fallowing shall
apply:
1. All work: shall be performed in accordance with the latest edition
of the Standard Specifications For Public Works Construction.
2. Permittee shall be responsible for providing continuous dust and
erosion control.
3. Streets shall be kept clean. They shall be completely cleaned at
the end of each working day and more frequently if required.
4. 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 fallowing time
periods:
October 1st, to April 30:
Monday -Friday
7:00 a.m.
to
5:30p.m.
Saturday
ewo a.m.
to
5:00p.m.
May 1st to September iii:
Monday -Friday
6:00 a.m.
to
7:00p.m.
Saturday
8wo a.m.
to
5:00p.m.
Mork: shall be prohibited
on .legal holidays
including
Sundays.
5. 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.
6. 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.
7. Street closures shall not be permitted. A minimum of one travel
lane on paved surface shall be maintained with flagmen at all
times.
B. 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. -
9. Prior to excavating; the permittee shall contact Underground
Service Alert at 1(800) 422-4133.
10. Should additional work, material=_., 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
Ouinta.
Special Conditions - Permit No. i838 Page 1 of 2
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GEORGE H. CHANEY CO.
Inspection Services
TO:
4-111�
THE FOLLOWING WAS NOTED:
6f/Ir
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6593
DATE
4?'
JOB NO.
PROJECT DESCRIPTION
eWPIJ? %—
LOCATIOJN�`��
N
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WEATHER
FROM
TO HRS
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TOTAL
72777
IW C , - � FFIX-
COPIES TO:
MI RD
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WHITE - CLIENT, YELLOW - FIELD FILE, PINK - OFFICE FILE
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� ♦r. /A1Er+ii..iet
GEORGE H. CHANEY CO.
Inspection Services
TO: / ./1_
THE FOLLOWING WAS NOTED:
_G� ��6��� Cf�/✓t7r� c � '�/ S�/i>�� � .jamrZ AP T-- /-� /, P - 9 IPA- 4) 44
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DATE
/ 17 -%
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JOB NO.
PROJECT DESCRIPTION
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LOCATIONp
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CONTRACTOR
WEATHER
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TOTAL
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COPIES TO:
SIGNED
WHITE -CLIENT, YELLOW- FIELD FILE, PINK - OFFICE FILE
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