2111NOTE:. 4
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
DATE:_ 3/24/94
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Intersection of Adams St. & Westward Ho
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION pothole I.I.D. Utilities Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION potholes (4) Locations
to determine elevations SEE ATTACHED CONDITIONS
SEE ATTACHED DRAWING
DIMENSION OF INSTALLATION OR REMOVAL 2'Sq
r
SIZE OF EXCAVATION, IF NEEDED 2'Sq D
APPROXIMATE TIME WHEN WORK WILL BEGIN l
APPROXIMATE TIME OF COMPLETION I r,AR 2 4 1994
ESTIMATED CONSTRUCTION COST $1500 I
(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:
Inderrinify, defend and save the City, its authorized ager.ts, 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 Applican or Agent
Walt Kimball
Name of Applicant (please print) Business Address Telephone No.
Hendrickson Construction Inc. 68315 Kioley Rd. 619-328-1747
Name of Contractor and Job Foreman Business Address Telephone No.
654167—A
Contractor's License No.
194
City Business License No.
Golden Eagle Ins. Co, CCP 219895
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.
$ an, no
10.00
90.00
Received by Date
PERMIT NO
2111
PERMIT VALIDATION
2111
DATE APPROVED 3/24/94
EXPIRATION DATE __ / q
If
DATE ISSUED 3 24/94
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
.i
NOTE:
With proper validation
this form constitutes an
encroachment permit CITY OF LA QUINTA--
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION ' (ENCROACHMENT)
mor the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, saws, wst , rttairta
and other like public vl►oriks improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: I - Subdivision Improvement permit _ C1au 111
Mirror Improvement Permit Class IV
LOCATION OF CONSTRUCTION ?- Al
r,
(Stan address or Oester mn of Loceuml
PURPOSE OF CONSTRUCTION �1'2..Lr;�t! 7` /1
AL1 Ti,�s Sketch (attach construction plans if apOropriatel
DESCRIPTION OF CONSTRUCTION S
l.��a-'� orr s Z"a ��'T-,ti�-1 ►v.� � 1. �, n- �r p
c.A'c Y —t -T. tk K-*
�L
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
(Including removal of all obstruction, materials, and debris, backfilling, com.
paction and placing permanent resurfacing and/or replacing improvements)
In considerstlon of the granting of this permit, the applicant hereby agrees to:
Indemnity, defend and save the City. its authorized age. ' officers, representatives and arnployap. hanmlea from and
penalises, habilities or loss resulting from claims or court action and aria �� � eeh0 all
haMening Or Occurring as a prolimete nmtt of 1 Pursuant
Ot any acadent, IOU or damage t0 Personsa propeity
any
vwrk undertaken under the permit granted Ourant to chit applicetgm.
NoufV the Administrative Authority at Nast twenty-four 1241 hours in advance of the came when work wrll be stwte&
Comply vvidh all applieaple City Ordinarhon,
V Ouinta the tanand conditions of the permit and all 61306 'able ruin and regimlatiom of the City of
and to pay for any s additional redaeemerht neconoW as the result of this work.
Signature of Applicant or Agent
Name of Applicant (please print)
�(.rr
Business Address
Telephone Na
Name of Contactor and Job Foreman / d—
p /� Business Address Telephone No.
Contractor's License No.
Le City Business License No.
ApRlicant's Insurance Company^
Policy Number
FEES: Subolvlslon Improvement Permit — Clau III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor improvement Permit — Clan IV: See attached schedule
Inspection Fee $ '96 e
Permit Fee /O
'enslty
:ash Deposit -Surety Bond
f required
TOTAL: S O
leceipt No.
leceived by Date
ieeorded by
PERMIT VALIDATION
PERMIT NO. - ,/'
—2//,11
DATE APPR/ED
EXPIRAT ON DATE
DATE I UED
By
Administrative Authority
TELEPHONE: (619) 564-2246
I
I
a
0
'he following General and Special Provisions are enacneo to and meas a oars of Penn No.
• GENERAL PROVISIONS
The following snail always apply:
ENCROACHMENT ON PRIVATE PROPERTY: This Perm autnorxzes was to be accomplished within City of to Quints right of way
ONLY. Whenever construction extends witnin private orooenv. it snail be the resoonsioility of the Osrmmee lot his eontactmst to
secure permission tram abutting property owners. Such authorization must be secured by the Permines prior to starting work.
TRACKLAYING CONSTRUCTION EQUIPMENT: CleatedtroddmngconstructionequtpmemshelfnotbebermmNltodpersteonenv
the om"M during Paved surface unless fitted with Smooch.faceo street pads. All mechan ical outriggers shall be lifted wnh rubber strew aftosa to protea
pavemam is sca �xspvat� s. or orokenndunng the'termnof this contract, or ifused
tha psverdill rant marred.t�'ty of La Qu• paved area, M the eeq u st
that these Opinions of road be resurfaced over their entire width. Resurfacing ups shall request
surta4ing plus apaopnats teat Coat as specified above. n9 shall Consist of one coat o} two Inches 121 of A.C.
PROTECTION OF TRAFFIC: All excavations and work areas shall be.properlY lighted and barricaded asoaemep
EngineworLaQuintsCityPublicWorksInspectors.Suitabledetoursanddetoursignsshallbeplacesarid
of the protea. The City shall be notified 24 Mrs. in advance of any traffic detours or dolineauorts maintained dirttian
CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated meet pipe, concrete pipe, steel culvert and
concrete structures encountered during excavation which necessitate removal shag be replaced in kind. In the event.it becomes
necessary to remove or cut extsting drainage structures. City of La Quints Shall be notified prior to commeneengnt 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 shag be roxxwvodfroInttie nght of
way. All paved surfaces shell be brooded dean of earth and other objectionable materials immediately after baddill and Compaction
Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shag be removed
prior �imving. Water tanker shall be used, as required. to sprinkle the lob Site to keep down dust conditions apo she De used
ty otter backfill.
OE -WATER OPERATIONS: If dewvatering operations aro required and pumps are forcing waeron City of La Quints roam. it shall be
the rescampility of the permittee (contraaorl to control this water and to provide otf-atnet barricades when nedesmery
CLOSING STREETS: No street shall be closed. A minimum of one lane of traffic shall be maintained at all times to provide limned
access for the adjoining property owners arta emergency vehicles. In the event it is fah bythe permmee that he munctose a street for
any length of time. permittee shall contact this office to obtain the necessary permission.
SPECIAL PROVISIONS
The follwinig shall apply ONLY when indicated:
Rt NOTIFICATION: Permmee shall notify the Cityat 7 -7 _-7 D7'
24 ,t least 48 hours in advance of starting cornatruction
R2 CASH DEPOSITS OR BONDS: A cash bond Oran approved surety bond in an amountof notionthan s
shall be furnished in the name of City of La Quina to cover all wont involved in the restoration of the various La Quiff
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.
R3 UTILITY CLEARANCE. (Substructures) Priarto making arty excavation within theCityofLaQuints rightalwat,anaan,01'ated
by pent. the permnee shall Contact all Concerned utility Companies relative to the location of existing substructures•
of the permntPermit sh
Damage to existing substructures resulting from operations conducted under this Permit be the Soyrpon
psdWity
R4 UTILfTY CLEARANCE: (Surface structuresl No wont shag be done under this permit until all utilities an dear of the
proposed work ane. The penmee shall notify all Concerned utility companies of the proposed work,
R5 PAVEMENT WIDENING: Area between the proposed CC IC —e
surfaced with inches of A.C. paving pieced on inch line and the existing road p e subb i Shall be
inches W ossa aggregate subbaaecourse
ncamom
hmngan"R'valueofnot less than and in eonformeneewithCltyafLaQuints Read l
and Specifications, Ordinaries 0461. mprovemerte$tandards
R6 PARKWAY GRADING: Area between the property line and top ditheproposed concrete curb shall begradedionslopeot
1/4 inch to one foot (11.
R7 GRADES & STAKES: City of La Quints shall establish grades and stakes for the proposed Concrete Laub and queer
construction.
R8 GRADE CHECKING: City of La Quinta shall chockgradesupon recarm of plan and ppofile and/orgradas 03*st§Wished by
a licensed engineer.
R9 CURB REMOVALFOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( fso)Mag be
removed Curb and/or curb and gutter shall be saw cut prior to removal. Depressed curb, matching concne 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 alter existing drainage pattern. Surfacing between the
property line and the exusting road paving shall be 2-1/2 inches of A.C. paving placed on 1 —"1 of CWSS
aggregate base. Driveway construction shall conform to attached drawing.
R11 CULVERTS: A .nchdiametert lculvert shall beinstalled with the invenapproximately 1-1/2
mcries below and in line with the existing flow lime. Culvert installation shall conform to the attached drvvknng•
SIGHT CLEARANCE: Sight clearance of 600 feet in either direction shall be assured and maintained.
R13 SOIL STERILIZER: The area to be surfaced shell be treated with soil sterilizer. Rate of application Shalledmplywith the
manufacturer's specifications.
14 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 chthe Stat with the State or
City of La Quima 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 streets or Property lines when involved shag be complaety tied out so they may be readily arid cwreaty
be replaced by a licensed Civil engineer or surveyor at the expense at the Do, I ntaa A conlplen setet noes Showing the
time to them monunsmtshagbefurnished totheCityEngineerpriortothsnnteydotarnmonrmena.ThlsolfidaShag
be notified upon Comill"boi of heft of all survey monumens for erboerwerectefoomm.e.
rarto excavation or oeoinnmo or construction. aii survev monuments snail be tiea out by laty
31 La Murata ano suitable cavment or guarantee of navmem snail be mace es reimbursement for all wort Involves•
R17 PAVEMENT CUTTING: Pavement will be mechanically cut to a Straight edge prior to excavation. Method of ^2yamem
cutting snail be eoprovea through the office of fine Citv Engineer. lUnder no circumstances snail excatrtlting equipment
be used to excavate Prior to cutting of Pavement. Excavation material shall be placed In such a 00smon as to best
facilitate the general flow or 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 sage snail be corrected.
01, LIMIT OF EXCAVATIONS: Excavations snail be limited to 1.000lineal feet of open french before backfill operations must
begin. All excavations snail be orooerly barricaded with lights overnight, on weekends and nolldays forthe protection of
the traveling pualic. The Public Works Inspector snarl determine the suitability of excavation barricading in each case. No
excavation snail remain open for a period exceeding five 151 days. No excavation snail be made unless
material is actually on the work site. the construction
R20 BACKFILL MATERIAL Backtillshall befree ofbrush. toots orotherorganicsubstancedetrimenta.::.;suaefarpurposes
of producing an adequately consolidated backfdl. Any material which the City of La Quints deems unsuitable lapongyor
saturated material) which is encountered during excavation Shalt not be used for backfill, but shall be Supplemented or
replaced by an approved sand or gravel.
R21 BACKFILL SAND: Bac till shall be approved trarem-mat sand or equivalent and shell be placed in lifts of notgresterthan
three feet 431 andvibrated using vibrotamper orequivalent equipment. Alternate methods maybe substituted, but in any
case a relative compaction of 95 percent shall be attained within the c:ructural section of the roadway,
BACKFILL PLACEMENT: 88ddill shall be applied in layers of not more than 50 percent of the total depth of the trench
before flooding or a malumum of five -loot lb 1 lihS where trenches are of excessive depths. Care is to be esereoad that the
bacidill 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 90 percent 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 each tayer and the water
Dsupply shall be continuous.
COMPACTION TESTS: If so required bythe inspector. compaction less shall be made at intervals of not more than I,OD0
feet and a minimum of one 11) test on each road One 41) Copy of each test shall be forwarded to the Cltv Engineer for
approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Seaton 6,3.01 of the
Standard Specifications, Division of Highways. State of California, dated January 1973.
R24 COMPACTION TESTS: If so required by the inspector. compaction tests shall be made for seen crossing or same@ line
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 ea outlined in Section 6.3.01 of the Standard Specifications, Division of H'
of California. dated January 1973. Highways State
R25 TEMPORARY PAVEMENT REPAIRS: After Completion of bacidill 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 ahoy 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 12) of SC -800 shall be placed immediately. A permanent patch of — inches A.C.
surfacing plated on a inch class base shall be placed no later than
temporary mad repair. days afte►comtpletion of
R27 PAVEMENT REPAIR: F.A.S.: Upon completion of backfill and Compaction. a temporary Patch consisting Of?W0 inches (2-)
of cold mix paving (SC -800) shall be placed Immediately. A permanent patch of three inches 43'1 of A.C. surfacing shall
be placed on six inches 16') concrete base as directed. but not later than fifteen it 5) days after completion cf temporary
paving. Concrete baa shall beat five -sack mix and shall conform to the City of La Quints Road ImprovemattStandards
and SPmficaroohs, Ordinance #461.
R28 FOG SEAL A fog seal coat consisting of an application of asphaltic emulsion shall be applied over all p"M groes as
determined by the City Engineer,
R29 SEAL ARMOR COAT: A seal coat consisting of an application binder and screenings shall be applied an all patch areas
-here Such Seal coat* existed prior eeOfthispermit.SealorarmorcoatsshallbeappliedesspewiadinSection
37, Standard Specifications, State off Califoralifor nia. Division of Highways, dated January 1973. Work of pavemiem repair to
be accomplished by a licensed contractor engaged in the business of pavement repair.
3STREET 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 beadCpmplished
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 sectionswhich can be handled safelywlthout Interference or hazardto 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 spectf ied in the followi ng paragraph. Where"
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 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 week sections within the trimming shall be removed.
b. Where h becomes necessary to restrict traffic, the work shall be restricted to a maximum of 500feetatanyone 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 authorimUon provided
by this permit.
d All tree trimming on EVERGREEN TREES, PALM TREES. and other ORNAMENTAL TREES shall be atxomplishad to
the Satisfaction of the City Public Works Inspector,
e. Abutting property owners shall be atrrocted in all instances, prior to trimming or topping trees.
I. Pruning shag. in all instances, ba m the shoulder of the etotch to insure even, test heating in all arts at two inches
'!1 and above -in tie Ceebrw �w.0 ►� ��.-_..._ ..
SPECIAL CONDITIONS --PERMIT NO. 2111
--- Hendrickson ---
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/contractor shall assume responsibility for repair of any pavement damage to any public
or private street and for any damage to other City streets or facilities as a result of work
performed under this permit.
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 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.
r
Special Conditions - Permit No. 2111
Page 1 of 2
SPECIAL CONDITIONS ---PERMIT NO. 2111
continued
11. 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.
12. 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.
13. All excavations at or near the travel way shall be backfilled and paved at the end of every work
day as directed by and to the satisfaction of the City Engineer for the protection of the traveling
public.
14. Permanent pavement replacement section for the potholes shall be one inch greater than existing.
Special Conditions - Permit No. 2111 Page 2 of 2
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