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2008�IUOTE: r . 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 III DATE: 14/13/93 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION EM SIDE OF WASHINGTON ST. SOUTH OF EISENSONER (Street address or Description of Location) PURPOSE OF CONSTRUCTION STUB 4 — 4" TEL. CONDUITS INTO MANHOLE — CHANGR OUT NANHOLE LID ARD ADJUST DESCRIPTION OF CONSTRUCTION STUB 4 - 4" 'TEL. CONDUITS INTO MANik)(OLE — CHANGE OUT NIIHHOLE LID AND ADJUST DIMENSION OF INSTALLATION OR REMOVAL S"L x 29W x 4"D SIZE OF EXCAVATION, IF NEEDED 5% x 21W x 4"D APPROXIMATE TIME WHEN WORK WILL BEGIN 12/15/93 APPROXIMATE TIME OF COMPLETION 12/24/93 ESTIMATED CONSTRUCTION COST $ 900.00 (Including removal of all obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) Sketch (attach construction plans if apergpriate) 0.:s R In consideration of the granting of this permit, the applicant hereby agrees to: SEE ATTACHED CONDITIONS SBE ATTACHED SKETCH GTE WORK ORDER 543--9PNOMS Indemnify, defend and save the City, its authorized agents; officers, representatives and employees, harmless from and against any and all e 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. '!, J -J , 44�if trd D !/ Signature of Applicant or Agent "HONMS A McCoy, IAC. 155 N. EUCLA AVE., SAN DUMAS, CA 91773 (619) 329-7829 Name of Applicant (please print) Business Address Telephone No. SAME Name of Contractor and Job Foreman Business Address Telephone No. 183393 Contractor's License No. LIBERTY MUTUAL City Business License No. 862-631-004085-062 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 0 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 0 Receipt No. Received by Date PERMIT VALIDATION PERMIT NO. 2008 DATE APPROVED 12/13/93 EXPIRATION DATE 12/31/93 DATEI SU D ,J2 �� �— 13 By Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 LT d 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:. LOCATION OF CONSTRUCTION Subdivision Improvement Permit— Class III Minor Improvement Permit Class IV (Street address or Description of Location) PURPOSE OF CONSTRUCTION -574-25 'Y--9 72—Z Sketch (attach construction plans if appropriate) NS DESCRIPTION OF CONSTRUCTION 14V -P AJ• -rV .QVJ'. /j. /,j, cal DIMENSION OF INSTALLATION OR REMOVAL 6 �= X a ul ,� y �1�C-17 k!T1 3 , lel 01 g s SIZE OF EXCAVATION, IF NEEDED -COO' L 70' APPROXIMATE TIME WHEN WORK WILL BEGIN 15--932 APPROXIMATE TIME OF COMPLETION 42 —ZJ- 9.3; ESTIMATED CONSTRUCTION COST $ 9040 ► 0 1b (Including removal of all'obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, the applicant hereby agrees to: Indemnify, -defend and save the City, its authorized. agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started. Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of La Quinta and to pay for any additional replacement necessary as the result of this work. Signature of Applicant or Agent /_52V_ --4 s --if AQ r ens V.,�Nl' J.�'s' R/ l� Uc L'o,9U� qw, >>� Name of Applicant (please print) Business Address Thep�x ,49 Name of Contractor and Job Foreman Business Address Telephone No. i,3 ! Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class III Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required 19 TOTAL: $ Receipt No. Received by Date 2000 PERMIT VALIDATION PERMIT NO. • 2 1)d 9 DATE APPROVED - I2-13 ^613 EXPIRATION DATE �� 31� q3 DATE ISSUED By Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 The following General and Special Provisions are attecned to and made a part of Perim No. �DOV 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 resoonstbdity of the permmeS for hes contractors, to secure permission from abutting property owners. Such authorization must be secured by the permutes prior to starting work. TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated tracklaving Construction equipmem Shall not be parmhtedto operate an any paved surface unifies fitted with smooth -faced street pads. All mechanical outnggers shall be fitted with rubber street shoos to protea the paving during excavations. Rubber -tired equipment only shall be used in backfill operations in paved areas. If the existing pavement is scarred. Spalled• or broken during the term of this contras, or rfthe pavement is marred. City of La Quints shall request that these porttons of road be resurfaced over their entire width. Resurfacing shall consist of one coat of two inChas 12") of A.0 surfaging plus appropriate seal cost as specified above. PROTECTION OF TRAFFIC: All excavations and Work areas shall be properly lighted and bamcaded as deemed necessarybythe City Engineer or La Quints City Public Works Inspectors. Suitable detours and detour signs sha ll be placed and maintained for the duration of the project. The City shall be notified 24 Hra. in advance of any traffic detours or delinaattons. CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe. Concrete pipe, becomes stesl culvert end concrete structures encountered during excavation which necessitate remove, shall be replaced in kind. In the 0teal necessary to remove or cut existing drainage structures. City of La Quints Shall be notified prior to commencem Drainage structures and open drains shall be kept free of debris at as times for proper drainage. ent t. it this wok. RIGHT OF WAY CLEANUP: Any surplus material resulting from excavation and backfill operations shall be removed fromthe right of way. All paved surfaces shall be broomed dean of earth and other objectionable materiels immediately after 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 to paving. Water tanker shall be used. as required. to Sprinkle the job site to keep down dust conditions and ahas be used immediately cher backfill. DE -WATER OPERATIONS: If dewatering operations are required and pumps aro forcing wateron City of La Quints 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 evem it is felt by the permittee that he must Closes 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: ® 777-7077 NOTIFICATION: Permittee shall notify the City a 8 at least 48 hours in advance of starting Constttiaion• R2 CASH DEPOSITS OR BONDS: A cash bond or an approved surety bond in an amount of not less than a shall be furnished in the name of City of La Quints to cover 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 must be posted prior to commencement of any work on this project • UTILITY CLEARANCE: (Substructures) Prfor to making any excavation within the City of Le Quints right of waysuthorized by permit. the permittee shall contact all concerned utility companies relative to the location of existing suhatrtretures Damage to existing Substructures resulting from operations mnduasd under this permit shall be the cote Uburustu a. of the permittee.968M R4 UTILITY CLEARANCE: (Surface structures) No wont shad be done under this permit until all utilities ars tlesr 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 shalt be surfaced with inches ofA.C_paving placed on inchesofclasaa99regatesubbssseourse having an "R"valueofmat less than and in conformance with City of LaQuints RoadlmprovememS and Specifications. Ordinance #461. tandards _,.__..,.,. R6 PARKWAY GRADING: Area between the property line and too of the proposed concrete curb shall be graded to a slope of 1/4 inch to one foot (11. R7 GRADES & STAKES: City of La Quints shall establish grades and stakes for the proposed concrete curb and gutter construction. RB GRADE CHECKING: City ofL.aQuints shall checkgradesupon recatptofplanaridptwfileand/or gradesaseaabltshedby a lirensed engineer. R9 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( fealshall 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 I -') of clams aggregate base. Driveway construction shall conform to attached drawing. R 11 CULVERTS: A inch diameter 1 _ ) Culvert shall be installed with the invert approximately 1-1 /2 riches below and in line with the existing flow line. Culvert installation shall conform to the attached drawing. R12 IGHT CLEARANCE: Sight clearance of 600 feet in either direction shall be assured and maintains& R13 SOIL STERILIZER: The area to be surfaced shall be treated with sod sterilizer. Rate of application shall comptywith the manufacturer's specifications. R1 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. R1 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the centerline of all stresp or property lines when invotved shall be complastytied out so they maybe readilyandcorrectly be replaced by a licensed civil engineer or surveyor at the expense of the permittee• A complete set of none showing the ties to these monuments shall be furnished tothe City Engineer pito tome remove,ofenv monumems.Thtsoffice be notified upon completion of replacement of ail survey monuments for Proper erotectekrerarrshallw. A16 SURVEY MONUMENTS: Prior to excavation or Deoimmna of construction. au survey monuments snail be ilea out ov City of La Quints and suftacle Payment or guarantee at payment shall be mace as relmoursement for adwork invd4ved. R17 PAVEMENT CUTTING: Pavement will be mechanically cut to a Straight edge prior to excavation. Method of pavement cutting shell be approved through the office of the City Engineer. (Under no circumstances Snell 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. R18 PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations, any damage to Pavement straight edge Shall be corrected. LIMIT OF EXCAVATIONS: Excavations shall be limited to 1.00O lineal feet of open trench before backfill Operations must begin. All excavations snail be property barricaded with lights overnight, on weekends and holidays fortne protection of the traveling pualic. The Public Works inspector snail determine the suitabiliryof excavation barricading in 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. R2O BACKFILL MATERIAL Backfill shall be free of brush. rootsorotherarganicsubstance detrimenta.::.csuseforpurposes of producing an adequately consolidated backfill. Any material which the City of La Quinta deems unsuitable (spongy or saturated materiel) which is encountered during excavation shad not be used for backfill• but shall be supplemented or replaced by an approved sand or gravel. R21 BACKFILL SAND: Baddill shall be approved trartsit-mix sand or equivalent and shall beplaced in liftsof notgresterthan three feet (31 and vibrated using vibrotamper or equiva fent equipment. Alternate methods maybe substituted, but in any ®case a relative compaction of 95 percent shall be attained within the succtural section of the roadway, 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 manmum of five-foot 451lihswhere trenches are of excessive depths. Care isto be axarc>se backfill material is not subjected to extreme Swell by flooding operations. Baddd thatthe ill material shall be paced aso that the resulting compaction shall be not less than 90 percent or equivalent to the surrounding ground. whichever is the greater compaction. Where ponding or flooding is used for a maximum settlemem. 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 :ager and the water Supply shall be continuous. COMPACTION TESTS: If so required bytha inspector. compaction teats shall be made at intervals of not more Man t,0DO feet and a minimum of one 11) test on each road. One (1) Copy of each test shall be forwarded to the Clty 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 Spectficatlons, Division of Highways. State of California, dated January 1973. R24 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing Or ssrviee line One (1) copy of each test shall be forwarded to the City Engineer for approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Section 6.3.01 of the Standard Specifications. Division of H of California, dated January 1973. igltwsq, 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 an a prepared subgrade. The SC -800 temporary paving stall be pieced after a maximum of 3.000 lineal feet of trench has been excavated and backfill operations completed, but in no case shall the placemem 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 12.1 of SC -800 shall be placed immediately. A permanent patch of surfacing placed on a inch class inches A.C. beseshallbeplacednolaterthan daysaherCompletiChat temporary road repair. R27 PAVEMENT REPAIR: F.A.S.; Upon completion of backtill and compaction, a temporary patch consisting Of two inches 42-1 of cold mix paving (SC -800) shall be placed immediately. A permanent patch of three inches (3') of A.C. surfacing shall be placed on six inches (6") concrete base as directed. but not later than fifteen (15) days after completion of temporary Paving. Concrete bass shall be of five -sack mix and shall conform to the City of La Quina Road ImprovennentStandards and Specification, Ordinance 0461. R28 FOG SEAL: A fog seat 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 811 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 pavemem repair to be accomplished by a licensed contractor engaged in the business of pavement repair. R3O STREET RESTRIPING: Where street striping is still visible on streets lobe excavated. such striping shall be replacad upon completion of permanent repairs. R31 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quinaa road right of way shall be aCComplished by a licensed• bonded and insured tree service, and handled safely without mterference or hazard to the trmting 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 snail be removed and disposed of so that no debris remains in view of the highway. The stump hole shall be backfilled and thoroughly compacted as specified in the following paragraph. Where it becomes necessary to restrict traffic, the work shall be restricted to a maximum of 500 feet at any one time. Adequate signs• flagmen end/or barricades -shall be provided to protea the traveling public at all times. Large holes resulting from tree removal shall be backfilled and compacted to nat 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 week sections within the trimming shall be removed. b. Where it becomes necessary to restrict traffic. the work shall berestrfctedtoamaximum of5O0feet atanyone time. Adequate signs, flagmen, and/or barricades shall be provided to protea 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 ons Of two inches 121 and abovwtn size. Sealant snail brr Sao""" .ik «» -- ..____. _ - • , . 111111 film lip SPECIAL CONDITIONS--PERNIIT NO. 2008 --- HENKELS & McCOY --- 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 5:30 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. 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. Permittee shall submit a traffic control plan to the Engineering Dept. for approval prior to starting work. 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. 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. Permanent pavement replacement section shall be 1" greater than existing. 10. All landscaping irrigation decorative rock etc. shall be'replaced to its original condition. 11. Prior to excavating, the permittee shall contact Underground Service Alert at . 1(800) 422-4133. 12. 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. 13. 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. 14. 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. Special Conditions - Permit No. 2008 Page 1 of 2 15. When 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 16. 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 of shoring, bracing, sloping, or other provisions to be made for worker protection from the hazard of caving ground during the excavation of any trench greater than five feet in depth. If such plan varies from the shoring system standards, the plan shall be prepared by a registered civil engineer. As part of the plan, a note shall be included stating that the registered civil or structural engineer certifies that the plan complies with the Cal OSHA Construction Safety Orders or that the plan is not less effective than the Cal OSHA Construction Safety Orders. Special Conditions - Permit No. 2008 Page 2 of 2 k -1 r ERJCASE G.3 - P, V. C /N' CORD CAE, r � I � c4Re i I TDP j --o r0 LO® Zs/_ Co-Iq P,V.C. TC1P • i i2I DZT- *JDY DDT (DO N .� OG NORTH VALL I LK. N. 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