2206/OTE:—!%
Mith 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
6-17-94
LOCATION OF CONSTRUCTION 49-990 Park
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION New water service
DESCRIPTION OF CONSTRUCTION sawcut, dist and replace
a/c pavement
DIMENSION OF INSTALLATION OR REMOVAL
2'x30'
6'x4'
SIZE OF EXCAVATION, IF NEEDED 4' deep
APPROXIMATE TIME WHEN WORK WILL BEGIN 6/20/94
APPROXIMATE TIME OF COMPLETION 6/24/94
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
In consideration of the granting of this permit, the applicant hereby agrees to:
Sketch (attach construction plans if appropriate)
EE A"1"I! ArVII Z d0AJD1TJ0A►S
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 �,.'}P I kx".
Boys & Girls Club 83-100 Date Ave., ]Indio, CA 92201 347-6715
Name of Applicant (please print) 4 Business Address Telephone No.
C.y.W.D. P.O. Box 1058 Coachella, CA 92236 398-2651
Name of Contractor and Job Foreman Business Address Telephone No.
on file
Contractor's License No.
on file
City Business License No.
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
I
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
0
$ 0
Received by Date
2,206 ' N
PERMIT VALIDATION
PERMIT NO 2206
DATE APPROVED
EXPIRATIQN DATE _
Ir
6-17-94
7-15-94
DATE Ism I D —17-94
By JdA'
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
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBO VIS ONS
DATE: n Subdivision Improvement Permit — Class III
LOCATION OF CONSTRUCTION ��V Il(� Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION s42Rv�c—�
Sketch (attach construction plans if approprim)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTAL, TIOkOR REMOVAL
% X 75A
X .1'
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.
Pwbon 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 autalms
Penalties. liabilities or loss resetting front etaims genreeesad agents. officers. representatives and amptoy. harmless from and against env and all
or court action and arising out of env *cadent, loss or
happening or oocumng as a proximate resutt of env work undertaken under the danis to Carson or prep y
Notify the Admininretrve Authority at lana tvvan a•rrrtrt granted pursuant to this eoptiation.
• ty-four (24) hours in advance of the time when work will be started.
COMWapplicable
y with all City Ordinances. the terms and conditions of the permit all applicable ruin and
La Ouinta and to pay for any additional reptaantertt necem,v as the result of tfii regulations of the City of
�j
5 Signature of Agpplicant or Agent
Name of A olicanr Inl � " 3 " 106 3 " -rE AViE- _FA1b O ei� 20 47-
1 3 A7is
Vi
Name of Contractor and Job Foreman
Contractor's License No.
Business Address Telephone No.
15� �/at,tt�c.c�t4
Cm -) 2 23 (,-- `3 C -I t r
Business Address Telephone No.
City Business License No.
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 Oeposit•Surety Bond
if required
TOTAL:
Receipt No.
Received by Date__
recorded by .�
J
T
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED Q
EXPIRATION DATE l
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564.2246
9
The following General aro Special Provisions aro attached to and mads a part of Permit No. -Z-w�Y
/ GENERAL PROVISIONS
The following snail always apply:
ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes wort to be accomplished within City of La Quints right of way
ONLY. Whenever construction extends within private prooenv. it snail be the responsioility of the vernimee (or his contractors) to
secure permission from abutting property owners. Such authorization must o8 secured by the permittee prior to starting wort.
TRACKLAYING CONSTRUCTION EQUIPMENT: Cleatedtrocklavingconstrualoneaulpmemshallnotbepermintedtoopersteonarty
paved surface unless fitted with smooth -faced street pads. 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 opertions in paved areas. If the existing
pavement is scarred. spelled, or broken during the term of this contract ff the pavement is marred. Ci of la
that these ttortions of road be resurfaced war their entire width. Resuor irfaf t Quince shall request
surfaging plus appropriate seal coat ass specified above.n9 shall consist of one coat of two inches 12") of A.0
PROTECTION OF TRAFFIC: All excavations and work areas shall be property lighted and barricaded as deemed necessery by the City
Engineer or La Quints City Public Works Inspectors. Suitable detours and detour signs shall be plaCed and maintained
of the project. The City shall be notdied 24 Hrs, in advance of any traffic detours or detineatrons. for thedurotton
CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete pipe, steel Culvert and
structures ructures encountered during excavation which necessitate removal shall be replaced in kind. In the avent.it becomes
necessary to remove or cut existing drainage structures. City of La Quints shall be natrfied onor to commencement of this work.
Drainage structures and open drains shall be kept free of debris at all times for proper drainage.
RIGHT OF WAY CLEANUP: Any surplus material resulting from excavation and backfill operations shall be removed fromthe right of
way. All paved surfaces shall be broomed dean of earth and other objectionable materials immedistety after backfi11 and Campsetton.
Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shall be removed
prior to paving. Water tanker shall be used. as required, to sprinkle the lob site to keep down dust conditions and shay be used
immediately after backfill.
DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing water on City of La Quints roads, it shall be
the responsibility of the permittee Icentraaor) to control this water and to provide off-street barricades when naceaaary.
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 emorgency vehicles. In the event it is felt by the permittee that he must tlose a street for
any length of time. permittee shall contact this office t0 obtain the necessary permission
SPECIAL PROVISIONS
The follwing shall apply ONLY when indicated:
R1 OTIFICATION: Permittee shall notify the City a717--107:
6 at least 48 hours in advance of tarting dortatruaion.
R2 CASH DEPOSITS OR BONDS: A cash bond or an approved surety bond in an amount of not less then •
shall be furnished in the name of City of La Quints to cover all work involved in the restoration of the various Ls Quints
posted prior to Commencement of any work an this project .
roads and survey monuments. This bond shall be continuous until cancelled by the City Engineer, This bond must be
R3 UTILITY CLEARANCE: (Substructures) Priorto making any excavation within the City of Lis Quin tarightp}viraysuthorized
by permn, the permmee shell contact all concemed utility companies relative to the location t sidling subtR►thori es.
Damage to existing substructures resulting from operations conducted under this permn shell be the Iola responsibility
of the permittee.
R4 UTILITY CLEARANCE: (Surface structures) No work shall be done under this permit until all utilities are dear of the
Proposed work she. The permmee shall notify all concerned utility Companies of the proposed work.
R5 PAVEMENT WIDENING: Area between the proposed concrete
surfaced with inches of A.C. paving l gutter line and tfie exiting road at subbase
shall be
having en"R"valueofnotlem than—and
inches ofclass aggregetesubbasaepurse
and in conformance with City of La Quints Road Improvement Standards
and ng an "eauons, of not less
#4e1,
Re PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be gradadto a stopeof
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.
Re GRADE CHECKING: City of La Quints shall check grades upon receipt of plan and profile and/or grades as established by
a lir-ensed engineer.
R9 CURB REMOVAL FOR DRIVEWAYS: A portion of the exiting concrete curb and/or curb and gutter ( fM)Shall be
removed. Curb and/or curb and gutter shall be Saw cut prior to removal. Depressed curb, matching concrete gutter and
concrete driveway approach shall be constructed in conformance with City of La Quints Standard #207.
RIO DRIVEWAYS. A.C.: Driveways shall be constructed as not to alter exiting drainage pattern. Surfacing between the
Property line and the existing road paving shall be 2-1/2 inches of A.C. paving placed an I _') of class
aggregate base. Driveway construction shall conform to attached drawing.
R11 CULVERTS: A inchdiameterl
inches below and in line with the exiting flow line.ventvert shall be installation shallled con oith rmthe inven to the attachedimately 1- draw ng. 1 /2
R12 SIGHT 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 soil sterilizer. Rate of application shall comply with the
manufacturer's specifications.
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.
R15 URVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the
centerline of all streets or property lines when involved shall be completely tied out So they maybe readily and correctly
be replaced by a licensed Civil engineer or surveyor t the expensis Of" permittees A Complete set of notestthpwing the
ties to these monuments shall be furnished to the City Enginew Prior to the removal of any monuments. This office shall
be hoMied upon Con tation of replacement of all survev monuments for orooer orotea cMerrtrtryi.
'
A16 =URVEY MONUMENTS. Prior to excavation or oeoinrnno or construction. all survey monuments snail be neo out by Cnv
Of La Quints ano suiteote oaymam or guarantee of payment snail be mace as reimbursement for all }yOrk Invc v".
i
R17 PAVEMENT CUTTING: Pavement will be mechanically cut to a straight edge prior to excavation. Method of pavement
cutting shall be approved throuqn the office of the City Engineer. (Under no circumstances snail excavating equipment
Jf/ be used to excavate prior to cutting of pavement). Excavation material shall be placed in sucr: a position as to best
facdnate the genera) flow of tranic. Prior to final paving operations. any damage to pavement straight edge snail be
corrected.
/ R18 PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations, any damage to
pavement straight sage shall be correcteo.
R1
LIMITOF EXCAVATIONS: Excavations snail be limiteOtO 1 .000 lineal feet at open trench before backfilicneranons must
begin. All excavations snail be properly barricaded with lights overnight, on weekends and holidays for the protection of
the traveling puolic. The Public Works inspector shall determine the suitability of excavation barricading in each ease. No
excavation shall remain open for a oertoo exceeding five 15) days. No excavation shall be made unless
�material is actually on the work site. the construction
9%9ACKFILL MATERIAL: Backfill shall be free of brush. roots or other organic substance detriments, ::..s use for purposes
of producing an adequately consolidated backfill. Any material which the City of La Quints deems unsuitable(spongyor
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: Backfill shall be approved transit -mix sand or equivalent and shall be placed in lifts of rdtgreaterthan
three feet 131 and vibrated using vibrotamper or equivalent equipment. Alternate methods maybe substituted, but in any
case a relative compaction of 95 percent shall be attained within the s:ructural section of the roadway.
BACKFILL PLACEMENT: Backfill shall be applied in lavers of not more than 50 percent of the total depth of the trench
before flooding are maximum of five-foot (51 I ifts where trenches are of excessive depths. Care is to be exan tsad that the
backfill material is not subjected to extreme swell by flooding operations. Backfill material shall be plated so that the
resulting compaction shall be not less than 90 percem 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 eacn :aver and the water
supply shall be continuous.
R23 COMPACTION TESTS: If so required bythe inspector, compaction tests shall be made at intervalsof not more than 1.000
feet and a minimum of one 11) test on each road. One (1) copy of each test shall be forwarded to the City Engineer for
approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Section 6,3.01 of the
Standard Specifications, Division of Highways. State of California. dated January 1973.
R2 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for eaen 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.
Compaaron tests shall be made asoutlinea in Seaton 6.3.01 ofthe Standard Specifications, Division of Highways, 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 nocase 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 ternpdrary patch
consisting of two inches (2'1 of SC -800 shall be placed immediately. A permanent patch of
surfacing placed on a inch class inches A.C.
base shall be placed no later than -days after
temporary road repair.
R27 PAVEM ENT R EPAIR: F.A. S.: Upon completion of backti I I a no compact ton. a tem core ry patch consisting of two inches (2")
of cold mix paving (SC -800) shall be placed immediately. A permanent patch of three inches (3'1 of A.C. surfacing shall
be placed on six inches 16'1 concrete base as directed. but not later than fifteen (15) days after completion of temporary
Paving. Concrete base shall be of five -sock mix and shall conform to the City of La Quints Road Improvement Standards
and Specifications, Ordinance #461.
2 FOG SEAL: A fog seal coat consisting of an application of asphaltic emulsion shall be applied over all patch areas as
determined by the City Engineer.
R29 SEAL ARMOR COAT: A seal coat consisting of an application binder and screenings shall be applied on all patch areas
where such seal coats existed prior to issuance of this permit. Seal or armor coats shall be applied as specified in Seaton
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 stree?strioing is still visible on streets to as 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 traveling public.
It Shall be the responsibility of the permittee to maintain the tree in a vigorous growing condition at its new location.
Trees to be removed shall be removed in sections which can be handled safelywithout interference or 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 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 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 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 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 provioed
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 heeling in all cuts of two inches
r21 and above -in size. Sealant shell ha armfif.11 rn .ti
i
SPECIAL CONDITIONS --PERMIT NO. 2206
--- CVWD ---
In addition to the standard permit conditions, the following shall apply:
1. All work shall be performed in accordance with the latest edition of the Standard Specifications
For Public Works Construction.
2. 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 1 st to April 30: Monday -Friday 7:00 a.m. to 5: 30p. m.
Saturday 8:00 a.m. to 5:00p. m.
May 1 st to September 30: Monday -Friday 6:00 a.m. to 7:00p. m.
t
Saturday 8:00 a.m. to 5:00p.m.
114, Work shall be prohibited on legal holidays including Sundays.
it
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.
Special Conditions - Permit No. 2206 Page 1 of 2
4.- 1
Q
SPECIAL CONDITIONS ---PERMIT NO. 2206
continued
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.
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. If the work is to be performed by forces other than that of the utility company the contracting
company shall be required to be a co -applicant and pay the appropriate fee.
14. 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.
15. All landscaping, irrigation, decorative rock, decorative concrete, lighting etc. shall be replaced
to its original condition.
16. Access and egress to all local properties shall be maintained at all times.
17. Permanent pavement replacement section shall be one inch greater than existing.
Special Conditions - Permit No. 2206 Page 2 of 2