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1935NOTE: With proper validation tls 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 f - Subdivision Improvement Permit — Class III DATE: 10/19/93 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 52070 AY99= "ONTRZINIAj (Street address or Description of Location) PURPOSE OF CONSTRUCTION Q0 NM Sketch (attach construction plans if appropriate) DESCRIPTION QFCOONSST�RUUCTION DIG AND BM 50 RM C�MM ATCACHM 838= DIMENSION OF INSTALLATION OR REMOVAL 50'x 2'z 36 888 AT ACM CO911<MITZO S RSM SIZE OF EXCAVATION, IF NEEDED ~ 10/20193APPROXIMATE TIME WHEN WORK WILL BEGIN :OGT191993 APPROXIMATE TIME OF COMPLETION 10 20 93� ESTIMATED CONSTRUCTION COST $ By (Including removal of all obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) t 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. 1 Signature of Applicant or Agent NAM CONSTRU MON P.O. =x'83. PALM DISUT. CA 343-1180 Name of Applicant (please print) Business Address Telephone No. - Name of Contractor and Job Foreman 23919 Contractor's License No. Business Address Telephone No. 566 City Business License No. HSLIAHG'8 usuRANCB i4wn Y AUTO/GROM" NG1223560 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class 111 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. 72.00 $ 82.00 Received by Date 1935 PERMIT VALIDATION PERMIT NO. 1935 DATE APPROVED 10/19/93 EXPIRATION DATE 10/22/93 DATE ISSUED 10/19/93 �By Recorded by 11 TELEPHONE: (619) 564-2246 Administrative Authority J .. 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 r- DATE: , Subdivision Improvement Permit — Class III �J / r Imp vement Permit Class IV LOCATION OF CONSTRUCTION /7`(� Oxi�C%r'�tK� (Street address or Description of Location).— PURPOSE OF CONSTRUCTION �" —� vl Sketch (attach construction plans if appropriate) rP —�. OST v ��t1-�vn cm ...gyp tT ro••.L.s DIMENSION OF INSTALL�=NWEMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION4 ME 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 saw the City, its authorized agems, officers, representatives and employees, harmless from and against any and ell 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 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 La Quints and to pay for any additional replacement necessary as the result of tbd Name of Applicant (please print) Business Address Telephone No. Name o��o�nJob Foreman Business Address Telephone No. Con act s License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subowision 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 applicable rules and rpOlgoons of the Vtv of Inspection Fee S Z Permit Fee 1 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 2 Receipt No. Received by Date Recorded by PERMIT VALIDATION PERMIT NO. f C1 3 (O DATE APPROVED t o - G — a3 EXPIRATION DATE I DATE ISSUED (0— By O— By Administrative Authority TELEPHONE: (619) 564.2246 ,. � r - \ _ � .• c', �- e'. �; • i �` t �� � ,�; `� � � � � • L i � _. y;ti r i y f � � � '� z �� � ,�; `� � � � � • L i � _. y;ti A SPECIAL CONDITIONS --PERMIT NO. 1935 --= THE GAS CO. 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. 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 following time periods: October 1st to April 30: Monday -Friday 7:00 a.m. to 5:30p.m. Saturday 8:00 a.m. to 5:00p.m. May 1st to September 30: Monday -Friday 6:00 a.m. to 7:00p.m. Saturday 8:00 a.m. to 5:00p.m. Work 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. 8. Prior to excavating, the permittee shall contact Underground.Service Alert at 1(800) 422-4133. 9. 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. 10. All landscaping, irrigation, decorative rock, & driveways etc. shall be replaced to its original condition. 11. All work shall be coordinated with the City's contractor and others working within -the area as directed by and to the satisfaction of the City Engineer. 12. When the work is within 500' of a signalized intersection, the permittee shall notify Riverside County Signal Dept. at (714) 275-6894 or Caltrans Signal Dept. At (619) 688-6845 as appropriate a minimum of 48 hrs prior to starting work. 13. 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. 14. All excavations at or near the travel way shall be backfilled at the end of the work day for the protection of the traveling public. Special Conditions - Permit No. 1935 Page 1 of 1 The following General and Soectal Provisions ars onsctled to and mads 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 Ls Quints 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 stenting work TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated treddayingconstruction equipment shall not bepermrttsdtopparataonany paved surface unless fitted with 1111100th -faced street pads. All mechanical outnggers shall be fitted with rubber mat e $ the paving during excavations. Rubber -tired equipment onty shall be used in baddill operations in paved areas M the rides [o pakrrotitecta Pavement is scarred, spelled. or broken during the term of this contras, or it the st pavement is marred Clq, of la Qyjhshalegwst I r that these portions of road be resurfaced ovat their entire width. Resurfacing shall Consist of one poet of hep inches s (2„) of A.C. surfaging plus appropriate $8111 Coas specified above. PROTECTION OF TRAFFIC: All excavations and work areas shall be -properly lighted and bsmeaded as deemed neens11ryby the City Engineer or la Quints City Public Works Inspectors. Suitable detours and detour signs sha ll ba pleted and mainninedfor the duration of the project. The City shall be notifiad 24 Hrs. in advance of any traffic detours or deflnestitipm CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pips Concreto p p♦ ataNCulvert and C concrete structures encountered during excavation which neeessi ate removal shall be replaced is kind. In the se becomes necessary to remove or cut existing drainage structures, City of La Quints shall be notified prior to commencemeof this work. Drainage structures and open drains shall be kept free of debris at all times for proper drainage, nt RIGHT OF WAY CLEANUP: Any surplus materiel resulting from excavation and backfill operations shall be removed fromthe right of way. All paved surfaces shall ba broomed dean of earth and other objectionable matenaIs immediately atter backfill and compaction. Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shay be removed prior di paving. Water tanker shall be used, as required, to sprinkle the job site to keep down dust conditions and shay be used immediately cher backfill. DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing water on City of La Quints roads it shall the responsibility of the permittee (contractor) to control this water and to Provide off-street bamades when ne0aaasry. be CLOSING STREETS: No street shall be closed. A minimum of one lane of traffic shall be maintained at all times toprovida limited access for the adoiningProperty owners and emergencyvehicles. Inthe event itisfahbythepermitteethathemustd any length of time, permittee shall contact this office to obtain the necessary permission. ossi $tenetfor SPECIAL PROVISIONS The follwing shall apply ONLY when indicated: NOTIFICATION: Permittee shall notify the City-77-7-7075 ity%7-77075 litb84-Q2dVat 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 s shall be furnished in the name of City of La Quints to coyer all 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 Myst be posted prior to commencement of any work on this project. UTILITY CLEARANCE:ISubstrusuresl Priorto making any excavation within theClty of La Quints right of wsyautharized by permit. the Permittes 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 $ole responsibility of the permntee. UTILITY CLEARANCE: (Surface structured No work shay be done under this permit until all utilities are dear of the proposed work site. The permittee shall notify all concerned utility companies of the Proposed work. R5 PAVEMENT WIDENING: Area between the proposed cericrste surfaced with inches of A.0 paving 1 gutter line and the existing road Pavement shell be P 9P seed On inches of class aggregate subbase course havirgan"R'valueofnotlesethan and in conformance with CltyofLaQuints Roadl and Specifications, Ordinance #461. r�mentSfandards Re PARKWAY GRADING: Area between the property line and topoftheProposed concrete curb Shall begrodedtasslopeof 1/4 inch to one foot (11. . R7 GRADES & STAKES: City of La Quints shall establish grades and stakes for the proposed concrete curb end gutter construction. Re GRADE CHECKING: City of La Quints shall check grades upon receiptotplanand profileand/or grades asestabyshedby a licensed engineer. Re CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( feasjthallbe removed. Curb and/or curb and gutter shall be saw cut prior to removal. Depressed curb. matching concrete gutter and concrete driveway approach shall be constructed in conformance with City of La Quints Standard #207. _ RIO DRIVEWAYS. A.C.: Driveway$ shall be constructed as not to atter 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 I of clams aggregate base. Driveway construction shall conform to attached drawing. R11 CULVERTS: A inch diameter 1 ) 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. 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 complywith 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 Quints may conduct in this area during the period of this permit. Work shall be coordinated with the State or City 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 may be readilyand correctlybe replaced by a licensed civil engineer or surveyor at the expense of the Dertnhtet. A complete "tat noes sfrowfng the ties to these monuments shay be turmshed to the City Engineer prior to the removal of any mohuments. ThIs o f as shad be notified upon completion of replacement Of all survey monuments for orooer erorea ctewanea. R16 SURVEY MONUMENTS: Prior to excavation or oeoinnina or construction. all survev monuments snail beitadout ipV 6tv of La Quint& and suitable payment or guarantee or payment shall be made as retmpursemem for all work involved. R17 PAVEMENT CUTTING: Pavement will be maerianicauy cut to a straight edge prior to exoavabon. Method of Davercent cutting shall be approved through the office of the City Engineer. lUnder no cdeumstancas shall excavating be used to excavate prior to cutting of pavememl. Excavation material shall be placed in such a 9aqutoJXM facilitate the general flow of traffic. Prior to final paving operations. any damage to pavement Straight as n pest corrected. edge sh>VI be RIS PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations. arty damage to Pavement straight edge shall be corrected. R19 UMITOFEXCAVATIONS:Excavationsshallbelimitedto1.000linealfeetofopentrenchbeforebackfilloperationsmust begin. All excavations snail be properly barricaded with lights overnight, on weekends and holidays for the protection of the traveling public. The Public Works inspector snail determine the suitability of excavation barricading fn each case_ No excavation shall remain open for a period exceeding five 15) days. No excavation shall be made unless the construction material is actually on the work site. t BACKFILL MATERIAL Backfill shall be free of brush. roots or other organic substance detrimenta,;;.-,suse for purposes Of producing an adequately consolidated backfill. Any material which the City of La Ouinta deems unsuitable lspongyor 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. _ R21 BACKFILL SAND: Bacdill shall be approved transit•mfx sand or equivalent and shall be placed in lifts of notgresterthan three feet 131 and vibrated using vibrotamper w equiva tent equipment. Alternate methods may be substituted, but in any dway, case a relative compaction of 95 percent shall be attained within the c:ructural section of the roa BACKFILL PLACEMENT: Backfill shall be applied in lavers of not more inan 50 percent of the total depth of the trench before flooding or a maximum of f iv6400t 161 lifts where trenches are of excessive depths. Care is to be exereissd that the backfill matenal is not subjected to extreme swell by flooding operations. Backfill material shall at the be placed so th resulting compaction shall be not less than 90 (ereent or equivalent to the surrounding ground. whichever fd the greater ill be consvuctedtp reta compaction. Where ponding or flooding is used for a maximum settlement, adequate dikes win the water. Where jetting is used. the jets shall be of sufficient length to reach the bottom of :ager and the water supply shall be continuous. each R23 COMPACTION TEST'S: If so required bythe inspector. compaction tests shall be made at intervals of not mars than I.ODO feet and a minimum of one 11) test on each road. One 11) 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 Speufications, Division of Highways. State of California, dated January 1973. R2 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 ofthe Standard Speeffieations. Division of HighNraya, State of California, dated January 1973. 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 121 of SC -800 shall be placed immediately. A permanent patch of surfacing placed ana inch class base shall be placed no later than utdhesA•C. temporary road repair. days ahereomptetion of R27 PAVEMENT REPAIR: F.A.S.: Upon completion of backfill and compaction, a temporary patch consisting Oftwoinches (2-) of cold mix paving (SC -800) shall be placed immediately. A permanent patch of three inches (3") of A.C. surfacing shall be plated on six inches (6') concrete base as directed. but not later than fifteen 115) days after completion at temporary Paving. Concrete base shall be of five -sack mix and shall conform to the City of La Quints Road ImprovemantStandards 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 seal coats existed prior to issuance of this permit. Seel 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. R30 STREET RESTRIPING: Where street striping is still visible on streets to be excavated. such striping shall be replaced upon 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 trawling 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 asspecified in thefollowing 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 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. 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 500 feet at 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. e. Abutting property owners shall be contacted, in all instances, prior to trimming or topping trees. I. Pruning shall, in all instances, be at the shoulder of the crotch to insure even. fast healing in all cuts of two inches f21 and above, in size. Sealant Shall he eeotiwa f� .ii E r) G CALL E i ,r cc , 10 co I 10 t�U:-AIN G0 312 1 2"PE1vi 3-79 0 r VAM rILC MV. I.!![ .. [TGM i... iw. !alicw I COY/L, !1{(1CY 7,G. 2?�1-e/ TOTAL FEET INST'O 3a T41 _ + :NSTALL MAIN WITH AT LEAST • COVER BELOW �� TOTAL FEET RETIRED PERMIT ISSUED BY PERMIT NJ, DATE MOVED DATE MOVED OATS OF I Cr_ RETIREMENT ON JOB—OFF JOB OPER _. COUNTY Z� r'1Ty 0)c- FDISTRICT LA C 12lnl7A oC SERT CREW FOREMAN DISTRICT— REASON TRACT PLANNED BY - COMPANY STAKED ❑ COMPANY FACILITY:SO. CAL. ❑ P.L.S. ❑ - — NO. t a ^ .. STD �1�%' y6AR C.P ocv, c,.rcn o