2457I'
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vv proper validation
phis form constitutes an
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CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
� I
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 S/1/96 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 75-110 Caleo
(Street address or Description of Location) I .,
PURPOSE OF,CONSTRUCTION Clear stand build Aad. Sketch (attach construction plans if appropriate)
' %= Bad & Breakfast
DESCRIPTION OF CONSTRUCTION Imnroveaents per `
a"roysd eradinit plan Bee attached conditions
DIMENSION OF INSTALLATION OR REMOVAL Balancinst
'N. Bziatina Site
V -.
SIZE;OF-EXCAVATION'' IF NEEDED
�.
' APPROXIMATETIME+WHEN WORK WILL BEGIN 5/2/96 `
� }
APPROXIMATE TIME OF COMPLETION 12/1/96
ESTIMATED CONSTRUCTION -COST $ $7.500.
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)In cons ideratiori'of the granting of this permit, the applicant hereby agrees to: ,T '
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
Signature of Applicant or Agent
idrrnlra' J4
9wrr44►t 1#wrriA 7A -19A Cmlwn Rrw Tw ( s4nlFwe (`A Q99R*A f011141 -AtRA QA1A
Name of Applicant (please print) Business Address Telephone No.
a f
Alberto Flores 38475 Jeffernnn 10dio. CA (619) 360-0255 '
Name of Contractor and Job Foreman Business Address Telephone No.
610003 497
Cont'ractor's License'No. City Business License No."
TSR Insurance Company of Micbiaan 914A4
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit - Class I I I w { 1A)1 i - $C A CNEZO ,
Public improvements: 3% of estimated construction costs -r;-.IA-7 G17y W0it i. 11.406 "To A'1L # mQs /-0 jZQ/,y
Private improvements: 3% of estimated construction costs PA
Minor Improvement Permit - Class IV: See attached schedule 2, 451
Inspection Fee $ 1224- , PERMIT VALIDATION
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required IF
TOTAL:
Receipt No.
Received by
Recorded by
f
$ 1224
Date
'PERMIT NO. - 2457
DATE APPROVED 5/1/96
EXPIRATION DATE 12/31/96
DATE ISS51[bFqt
ED - '
By
Administrative Authority
TELEPHONE: (619►"4'6t 777-7075
rI
The following General and Special Provisions are attached to and made a part of Permit No.S
GENERAL PROVISIONS
The following shall always apply:
ENROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within City of La Quinta right of
way ONLY. Whenever construction extends within private property, it is the responsibility of the permittee for his contractors to
secure permission from abutting property owners. Such authorization must be secured by the permittee prior to starting work.
TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated tracklaying construction equipment shall not be permitted to operate on
any paved surface unless fitted with smooth -faced street pads. All mechanical outriggers shall be fitted with rubber street shoes to
protect the paving during excavations. Rubber -tired equipment only shall be used in backfill operations in paved areas. If the existing
pavement is scarred, spelled, or broken during the term of this contract, or if the pavement is marred; City of La Quinta shall request
that these portions of road be resurfaced over their entire width. Resurfacing shall consist,of one coat of two inches (2") of A.C.
surfacing plus appropriate seal cost as specified above.
PROTECTION OF TRAFFIC: All excavations and work areas shall be properly lighted and barricaded as deemed necessary by the
City Engineer or La Quinta City Public Works inspectors. Suitable detours and detour signs shall be placed and maintained for the
duration of the project. The City shall be notified.24 hours in advance of any traffic detours or delineations.
CARE OF DRAINAGE STRUCTURES: Any drainage structure including 'corrugated metal pipe, concrete pipe, steel culvert and
concrete structures encountered during excavation which necessitate removal shall be replaced in kind. In the event it becomes
necessary to remove or cut existing drainage structures, City of La Quinta shall be notified prior 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 from the right
of way. All paved surfaces shall be broomed clean of earth and other objectionable materials immediately after backfill and compaction.
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 job site to keep down dust conditions and shall be used
immediately after backfill.
DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing water on City of La Quinta roads, it shall
be the responsibility,of the permittee (contractor) to control this water and to provide off-street barricades when necessary.
CLOSING STREET'S: 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 event it is felt by the permittee that he must close a street for
any length of time, permittee shall contact this office to obtain the necessary permission.
SPECIAL PROVISIONS
The, following shall apply when indicated:
Rl NOTIFICATION: Permittee shall notify the City at (619)777-7075 at least 48 hours in advance of starting construction.
LR2 T IUXrY CLEARANCE: (Substructures) Prior to making any excavation within the City of La Quinta right of way
authorized by permit, the permittee 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 sole
responsibility of the permittee.
UTILITY CLEARANCE: (Surface Structures) No work shall be done under this permit until all utilities are clear of the
proposed work site. The permittee shall notify all concerned utility companies of the proposed work.
R4 PAVEMENT WIDENING:, Area between the proposed concrete gutter line and the existing road pavement shall be surfaced
with inches of A.C. paving placed on ' inches of class aggregate subbase course having an "R"
value of not less than and in conformance with City of La Quinta Road Improvement Standards and
Specifications, Ordinance #461.
OPARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of
1/4 inch to one foot (1).
GRADE CHECKING: City of La Quinta shall check grades upon receipt of plan and profile and/or grades as established by
a licensed engineer.
07 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter (_feet) 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 Quinta Standard #207.-
R8
207:
R8 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 (___j of class aggregate base.
Driveway construction shall conform to attached drawing.
R9 SIGHT CLEARANCE: Sight clearance of 600. feet in all directions shall be assured and maintained at all times.
RIO SOIL STERILIZER: .The area to be surfaced shall be treated with soil 'sterilizer. Rate of application shall-commply with the
manufacturer's specifications. J
I1 COORDINATE WORK: The proposed work shall be subordinated to any operation which the State of California or City of
La Quinta may conduct in this area during the period of this permit. Work shall be coordinated with the State or City of La
Quinta forces to preclude delay or interference with State of City of La Quinta 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 shall be completely tied out so they may readily and correctly be
replaced by a licensed civil engineer or surveyor at the expense of the permittee. A complete set of notes showing the ties to
these monuments shall be furnished to the City Engineer prior to the removal of any monuments. This office shall be notified
upon completion or replacement of all survey monuments for proper project clearance.
1�a PAVEMENT CUTTING: Pavement will be mechanically saw cut to a straight to a straight edge prior to excavation. Method
of pavement cutting shall be approved through the office of the City Engineer. (Under no circumstances shall 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 traffic. Prior to final paving operations, any damage to pavement straight edges shall be corrected.
14 LIMff OF EXCAVATIONS: Excavations shall be limited to 1000 linear feet of open trench before backfill operations must
begin. All excavations shall be properly barricaded with lights overnight, on weekends and holidays for the protection of the
traveling public. The Public Works Inspector shall determine the suitability of excavation barricading in each case. No
excavation shall remain open for a period exceeding five (5) days. No excavation shall be made unless the construction
material is actually on the work site.
/R15)
BACKFILL MATERIAL: Backfill shall be free of brush, roots or other organic substance detrimental to its use for purposes
of producing an adequately consolidated backfill. Any material which the City of La Quinta deems unsuitable (spongy or
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.
R16 BACKFILL SAND: _Backfill shall be approved transit -mix sand or equivalent and shall be'placed in lifts of not greater than
three feet (3') and vibrated using vibrotamper or equivalent equipment. Alternate methods may be substituted, but in any case,
a relative compaction of 95 percent shall be attained with the structural section of the roadway.
R17 BACKFILL PLACEMENT: Backfill shall be applied in layers of not more than 50 percent of the total depth of the trench
before flooding or a maximum of five-foot (5') lifts where trenches are of excessive depths. Care is to be exercised that the
backfill 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 is the 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 layer and the water supply shall be continuous.
18 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made at. intervals of not more than 1000
feet and a minimum of one (1) 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.
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 of the Standard Specifications, Division of Highways, State of
California, dated January 1973.
/ R20J TEMPORARY PAVEAUM 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 3000 linear 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.
R21 PERMANENT PAVEMENT REPAIR: After backfill and compaction have been completed, a temporary patch consisting of
two inches (2") of SC -800 shall be placed immediately. A permanent patch of inches A.C. surfacing placed on a
inch class base shall be placed no later than days after completion of temporary road repair.
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.
STREET RESfRIPING: Where street striping is still visible on streets to be excavated, such striping shall be replaced upon
completion of permanent repairs.
R24 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quinta 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 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 as specified in the following paragraph. Where is 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.
SPECIAL CONDITIONS --PERMIT NO. 2457
--- TWO ANGELS INN / A: FLORES EXCAVATING. ---
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.
` Saturday ' 8:00 a.m. to 5:00p.m.
Work shall be prohibited on legal holidays including Sundays. Work. is allowed on
Saturdays.only if special arrangements, including payment of overtime inspection fee,
have been made two (2) working days prior to the desired Saturday.
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. AI.I work shall be coordinated with the City, the City's contractor and/or others
working within the area as -directed by and to the satisfaction of the City Engineer.
Special Conditions - Permit No. 2457
Page 1 of 2
SPECIAL CONDITIONS --PERMIT NO. 2457
continued
11. When the work is within 500' of a signalized intersection, the permittee shall notify
Riverside County Signal Dept. at (909) 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. Work authorized by this permit shall be as shown on the plan labeled "CUP 95-020
,TWO ANGELS INN, GRADING PLAN".
14. All excavations at or near the travel way, shall be backfilled and paved if necessary at
the end of each work day for .the protection of the traveling public.
15. All trenches that are -performed within the paved section of the street for laterals,
services etc. shall be backfilled with controlled density fill (CDF). Class II base will not
be permitted.
16.. -Permittee shall notify the City Engineering Department a minimum of 48 hours prior
to any work in the' street (i.e-oaved areas) at (619) 777-7075 when the work involves
lane closure(s) in a signalized' intersection or within 500 feet of a signalized
intersection. Permittee may: be required to submit a site-specific traffic control plan for
review and approval prior to commencing work at or near a signalized intersection.
17. Work hours at signalized iiiter-sections or within 500 feet of a signalized intersection
are. typically from gam - 3pm to avoid peak traffic periods but may vary depending on.
the location of the intersection: The permittee will be notified by the City of specific
work hours (if different) during the 48 hour notice period.
Special Conditions - Permit No. 2457
Page 2 of 2
4
MEMORANDUM
TO: Saundra Juhola, Admin. Services Director
FROM: Hector Guzman, Assistant Enginee I
VIA: David Cosper, Public Works Directoi/City Engineer
DATE: May 6, 1996
SUBJECT: C.U.P. #95-020 Two Angels Inn
The developer of the subject project has provided the City with a Cashiers Check (# 114937) in
the amount of $1,500. The check is security for the Fugitive Dust Mitigation Plan. Please keep
this check in your Development file.
c: File, Permit 2457
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ust m tigat on on or
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78120 Caleo Bay Drive, La Quinta.`"'�
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Two Angels Inn
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1114 9 3 7 `
3rold & Harriet Harris, Owners
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harles Martin, General Contract )
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REMITTER Iy
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VIB CIA #5-020996-01
EL CENTRO, CALIFORNIA • =' May''3 , j g 96 9038 11 2�
,.*,
PAY TO THE ..
* *City of La Quinta* *
c '• t -i'.
$ *1;,500.OU*
ORDER OF
` 1500dn' oohs
Y + y i
r .} Y-}� '�'-3"pOLLARS.
of
..
CASHIER'S CHECK.
CASHIER'S
- •
;
..'- �' -. - ' Al1THo IZED SI RE Ar e�•4,e �N�P�
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3 711' -11: 12
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2 2 38 4 201: 00 LIII 90.000'Su■
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NOTE: -
With Drooer vaudauon
this form commRm an
afWOSCflRym oarmR
CITY OF LA QUINTA
APPLICATION FOR PERMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENTI
For the oonstrueoon of public or prmts CuML dtivewatn. Pavenens. sidewalks. Darkim lot. twom: wotr neige
and other tike Oublie wofM i nWuv*mwm in eorueebon vette MINOR IMPROVEMENTS ane APPROVED SUBDlVIS10Ns
PUJ E OF,CONSTRUCTOarCG§Kl 1 A
DEscal
,:r
1 ENSIGN OF INST LL►AOVAL,9AL1=A ft -
SIZE OF EXCAVATION..IF NEEDED
APPROXIMATE TIME WHEN WORK WILL REGI
SubliMsion ImOrovenent Permit — Clara 111
MInw Improt etmem Pftft u ClassIV
APPROXIMATE TIME OF COMPLETION r
ESTIMATED CONSTRUCTION COST t
Undudinq rerno of sm. obsrumok matmuls. and debris, fitlinv, Obrl►
Sketdi Iattmh a mtrutson plartti it apwoprwml
CM OF LA QMTA
MAY 0 11996
Deebon and Draenha pernfeeeenit rewrfaeinq and/or repts" morovsff g nd
In consdastlon of the Ww" of this prim k the SPOlionc herby a¢em to
Inearrmrtlr, amw ma wn we Clrb. na ftewwmw'som s, effkwL rgrwMotire ane 400i'I vw, rurwraU'freWAS e 4ems ON ae aft
OwwtwL 14"Itin or Ms ROM" fmm efarw or men 'C"* mw/ new an of awm oocd ws. sm at down" is anew or papier
.ire or aaeamrr! • • OMwnme rrM ct arw waR Wteenaaae Wryer oe omnwrs er�rree prrsrare a phfa aapnheaert.
^ahh tte Aderwraesne Awe_" ti Mea r&wwfaew 124, harm a a0wa et ae ane Once vmm tail to ereL
ian+t Q.rsar/ q qo4� �!o-�3d
Name ofAODUnnt IDlasse , UmButtoWn Addeo Telephone Ns
Nano of Comractor ane Job Formren Burners Adds Telephpne No.
X. 01 oo 0
Contractors License No.
_rt Cry 8umm Licene No.
"0— 1F= %d Iv I I
A001want'sInsurance Can m GEu. l.aA 1LITh{ PrsllgrNunhOer
FEES: Subonmmn lmpromement Permit —Cram 111
Public im0rownen= 3% of eetimstpd ONUUUCtion am
Pflnte im0t o , moms: 3% of esttbshe o mnarucnw tons
Minor lmorayeRent Permit —CIM IV. See attded tdheduM
Inswcoon Fee
Perim Fee
PauNty
Cath OsOout•Surety Bond
it feOwred
TOTAL
Ream No.
122
Raahva0 W Oats—�
fiatereed by
138 F
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
1.41
EXPIRATION DATE 2 31
DATE ISSUED
By
Adminims0vs Authtrny
TELEPHONE: (SIM §111aMMI
13
TO:
FROM:
DATE:
MEMORANDUM
Jerry Herman, Comm y Devi lopment Director
Steve Speer, Senior Engine
April 2, 1996
RE: Two Angels Inn
CU 95-020
Please withhold $1,4� for engineering fees from the City check that will. be issued to the owner
of the Two Angels Inn and cause the following fee amounts to be placed in the budget accounts
as noted:
The fees .will be applied as follows:
$1,224 Encroachment Permit ($40;799 x 3% _ $1,224) Permit revenue account.
$200 . Additional deposit for plan checking. (Me plans were quite rough on the first and second submittal;
we expect plan checking to exceed the original deposit amount. Unspent,plan check funds will be returned to the Two
Angels Inn owner.) Budget Account 101-000-251-094
$1;424
Mark Harold has indicated an additional $72 should be withheld for the building permit due to
retaining wall and garden walls they will inspect. The additional $72 increases the Building &
Safety fee amount from $13,111.28 to $13,183.28
2-4
C�I_n
140
F:XP W OEPT%STAFF%SPEER W IEMOSM0402A
03/1996 15: G0 6197777155 ,CITY OF LA OUINTA PAGE
OF �� MEMORANDUM
TO: JOHN YONAI, RSG
,FROM:' JERRY HERMAN, COMMUNITY DEVELOPMENT DIRECTOR
DATE: APRIL 3, 1996
SUBJECT: ESCROW ACCOUNT FOR HAROLD AND HARRIET HARRIS -TWO
.ANGELS INN
li The attached check in the amount of $85,392.72 is the balance of the $100,000 approved by
Council on February 20, 1996, per the DDA, for the construction. of the above -noted project.
The disbursements were as follows:
M0,000.00
00,000.00
�Enginee g fees1,42
Building fees (all inclusive) -13,183.28
BALANCE $85,392.72
'These=fees will be aceredited.by the Finance Department -to: therappropriatDepartments:
t
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•
i
biL 0.0-
L- A�
Small Scale Construction/Demolition Projects (5 Acres or Less),
Fugitive Dust (PM10) Mitigation Plan
Date: 6-1 ) c, Jurisdiction: La- File
Part 1 - Project Information eUOes—o 2-0
Please provide the information below as completely as possible even if it has already been
provided on other forms related to this project. Failure to provide complete information or
provision of inaccurate information may delay the processing of your Fugitive Dust (PM10)
Mitigation Plan (Plan). It is recommended that you submit your Plan concurrent with your
grading or demolition permit application.
Project proponent,L ;
Address:' 35 11 I:Nt^ ZZ G,
Day phone number.
Emergency phone number: J%;34,6
Grading contractor (Contact Person):Lam
Address:
Day phone number. Emergency phone number: a l .'Q�
Construction site street address: .. 0•,
Construction site location:
(Please include an 8.5 x 11 location map)
Construction site assessor's parcel number (Tract
Parcel (Tract) size: Acres or Square feet
Anticipated date of physical project initiation: ,
A1, 46
Anticipated date of project completion:
Anticipated costs for dust suppression:
(Attachment B - Must also be completed and mailed to the appropriate address. when
construction activities have been completed)
1 All projects greater than one half (1/2) acre are also subject to SCAQMD Rules 403 and
403.1.
Part 2 - Fugitive Dust Control Actions
From the inventory of fugitive dust control measures provided in Attachment A, please indicate
which measures are to be implemented during the project by placing the letter beneath the
fugitive dust sources listed below. Please indicate at which phase the measure will be
implemented, either at Rough Grading (RG), Finish Grading (FG), or Final Construction
(FC). Demolition projects should only indicate measures in the Rough Grading (RG) column.
After indicating what measures are to be implemented, complete the 'Details" section by
describing how and when the measures are to be implemented.
RG FG FC Details (e.e., freauency of application, number and true of dust control implements. etc.
Please be as specific as possible)
Unpaved Roads {� „
Storage Piles
RG FG FC Details (e.e.. rreauencv of aDDlication, number and type of dust control implements, etc.
Please be as specific as possible).
[and Clearing or Earth -Moving
7
r
Part 3 - Agreement
I certify that the information contained in this Fugitive Dust.(PM10) Mitigation Plan is true
and accurate and that all measures specified in Part 2 will be implemented during project
construction. .1 authorize the City ofLa Qu i nta. to enter the above mentioned property
for inspection and/or abatement purposes, and I agree to hold harmless the City and its
representatives from liability for any actions related- to this project. I also agree to
comp to the record-keeping requirements included herein as. Attachment B once the
t has been completed.
I have read the conditions of the Fugitive Dust (PM 10) Mitigation Plan and the owner has
authorized the implementation of all its provi ' ns throughout project buildout.
(If not the same as above)
ATTACHMENT B - COST INFORMATION
Small Scale Construction/Demolition ProjectsAan
5 acres or Less)
Fugitive Dust (PM10) Mitigation
Date: _ . Jurisdiction: Project File #:
Project proponent: L9
Address:
Day phone number:'w _N( `KD Emergency phone number: `Ck)
In the space provided below please list the costs associated with implementation of all dust
control measures. The information provided below should include all implementation*costs
(including labor) for dust control throughout the project. Not all measures listed below will
apply to all projects.
Watering: IG'
Chemical stabilization:
Wind fencing:.
Covering haufvehi.cles: Z
Wheel washers:
Street sweeping:
Paving:
Wind. sheltering:
Coverings:
Vegetation reestablishment:
T
After project completion these records .shall be transmitted to the Jurisdiction where the
grading demolition permit was attained , `and to the .Coachella Dalley Association of
Governments (CVAG) at the address provided below.
PM 10 Cost Monitoring
Coachella Valley Association of Governments
73-710 Fred Waring Drive, Suite 200 .
Palm Desert, CA 92260
CONDITIONS FOR FDCP APPLICATION:
FDCP 96-5;.TWO ANGELS INN
CUP 95-020; ON CALEO BAY (PARCEL 8, PM 27892)
1. Applicant shall comply with all ' control measures as set forth in the approved
FDCP application, which shall include. the following additional measures.
2. The full amount of security furnished for the approved FDCP ($1,500.00) shall
be available to the City for any measure(s) deemed necessary by the City to
achieve adequate dust control, whether or not such additional measures are
included by the applicant for this application.
3. Applicant shall submit copies of all records/invoices related to cost
accounting for the dust control measures assumed during grading
construction. Said records shall be submitted within 30 days after completion
of all dust control measures as outlined in the plan, including any measures
made part of the plan as a condition to its approval. Security may be withheld
pending submittal of this information. All such invoices shall be provided,
along with the required completion of the PM10 Program Report Form, which
can be obtained from the Public Works or Community Development
Departments.
4. Track -out or other accumulations of soil material(s) shall be prevented onto any
paved public streets outside of the areas proposed for grading. Any track -out or
other accumulation of soil material(s) onto any paved areas, whether public or
private, shall be Wet -swept or water flushed by the end of the work day, and shall
be kept damp during construction operation hours until so removed. No blowers
or other dry sweep methods are. permitted.
5. Any soils associated with import/export activities shall be sufficiently stabilized
(watered down) so as not to create dust during loading, transport and spreading.
Minimum freeboard shall be as established by the Public Works Department. On
and off-site storage piles shall either be stabilized, covered'or watered down at
sufficient intervals in order to maintain a sufficient moisture content at all times.
6. Enforcement of these conditions shall be at the discretion of the assigned.grading
inspector, who shall monitor .and field verify that the spirit and intent of the
FDCP and its attached conditions are being complied with. Adjustments to
application frequencies, quantities and other aspects of this FDCP may be made
by the inspector, at his/her discretion, in order to assure compliance.
7. Employee and other parking areas shall not be permitted on any unpaved areas
unless properly stabilized by methods approved by the Public Works Department.
8. Disturbed but inactive 'development areas proposed for watering only shall be
watered daily in conjunction with active site watering. If the soil composition is not
conducive to formation of a hardened surface, an appropriate chemical binder shall
be applied as a remedial measure. The City may release a portion of the bonded
amount to the applicant for such work. Adequacy of all proposed and conditional
stabilization measures shall be determined by the assigned grading inspector.
9. All stabilized soil"areas where grading, construction or other land disturbance will
not occur within 30 days shall be staked, posted or otherwise restricted in order
to prevent any vehicular access onto or over those -areas. All areas where any such
land disturbance activities occur, shall be stabilized no later than four days. after
completion of the activity, in accordance with the provisions and conditions for this
dust control plan approval. .
PM 10 Program Report Form
I. GMMRAL ncroRh%=off
Project Developer Name : L
Address: ?hone: GR 3yb
Project Site 7b ZD - C(kO 67 Project Title TWt) *J(OES (U&I
Address: LA&Lskm 9ZS3
Tract No.:
acreage:
Grading Subcont-ractor (if different)
.Name:
A. "4
Address: .. OLX 1 Phone-
3(po OZ
PHASES? YES No Y
If• so how many?
Type of Development/Projec-�:.C--=mercialX-Single Family_
Multi Family_
Demolition other
Date.of Project/Phase Std-Uo:1&A+1qbkte oi. Project/Phase
Comnletion; �
II. COST INFORMATION
�
If actual costs are not available, please estimate to the.best
of your
ability.
1. WATffit: Amount: Total
Cost:
2'. BQUT?H= COSTS:
A. Rater. Truck: Number on' Site: , Total
Cost:
Hourly Rate:
Hours:
B. St-eet Sweeper: Number on Site: Total
Cost:
Hour'y.Rate:
Sours:
C. Temporary Irrigation: Total
Cost:
D. Rind Fencing: Linear Ft.: Total
Cost:
Cast/Ft.
S. Cbemical/Haterial Stabilisation: Total
Cost:
Sq. Ft.
Cost per Sq. Ft.:
F. Vegetation Cost: Material: Total
Cost:
Maintenance:
c
G. Other:. Type: Total
Cost:
Hourly Rate:
Hours:
3. LABOR COST: Hourly Rate: Total
Cost:
Hours:
4. ADIQN=ST4BTION COSTS: Total
Cost:
III. TOTAL COSTS: 8
Add items 1 - 4 for total cost. _XYVM COST:
'�
?LZASE RETURN FORM! AT.CO"LZT_ON OF PROJECT CR PHASE OR ANNUALLY FROM THE
DAT- OF ?ROjZCT/?FASE START U
3131/94
3U_i: CD ' rpt 11 �1 l i,��..1���• :.i � ��-
2 ZS yrs`,QPLAZA
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V'I� QTYM A
Date:
My OF LA QUV
MAY 0 11996.
ATTACHMENT B -COST INFORMATIO;�BLIC WORKS
Small Scale Construction/Demolition Projects (5 acres or Less)
Fugitive Dust (PM10) Mitigation Plan
Jurisdiction: Project File #:
Project proponent: L
Address: "1333. Ill
ZZ Ga :
Day phone number: bll *34t. d.ICID. Emergency phone number:
In the space provided below please list the costs associated with. implementation of all dust
control measures. The information provided below should include all implementation costs
(including labor) for dust control throughout the project. Not all measures listed below will
apply to all projects.
Watering:
Chemical stabilization:
Wind fencing:
Covering haul vehicles: V(00L 9
Wheel washers:
Street sweeping:
Paving:
Wind sheltering:
Coverings:
Vegetation reestablishment:
After project completion these records shall be transmitted to the Jurisdiction where the
grading/demolition permit was attained and to the Coachella Valley Association of
Governments (CVAG) at the address provided below.
PM10 Cost Monitoring
Coachella Valley -Association of Governments
73-710 Fred Waring Drive, Suite 200
Palm Desert, CA 92260
.1
A
Part 2 - Fugitive Dust Control Actions
From the inventory of fugitive dust control measures provided in Attachment A, please indicate
which measures are to be implemented during the project by placing the letter beneath the
fugitive dust sources listed below. Please indicate at which phase the measure will be
implemented, either at Rough Grading (RG), Finish Grading (FG), or Final Construction
(FC). Demolition projects should only indicate measures in the Rough Grading (RG). column.
After indicating what measures are to be implemented, complete the 'Details" section by
describing how and when the measures are to be implemented.
RG FG 'FC Details (e.g., frequency of application, number and type of dust control implements. etc.
Please be as specific as possible)
Unpaved Roads
Storage Piles
Paved Road Track -out
RG FG FC Details (e.g., frequency of application, number and type of dust control implements, etc.
Please be as specific as possible)
Land Clearing or Earth•Moving ll_
I� fi�
Disturbed Surface Areas
Part 37 Agreement
I certify that the information contained in this Fugitive Dust (PM10) Mitigation Plan is true
and accurate and that all measures specified in Part 2 will be implemented during project
construction. I authorize the City of La Qu i nta. to enter the above mentioned property
for inspection and/or abatement purposes, and I agree to hold harmless the. City and its
representatives from liability for any actions related to this project. I also agree to
comp to the record-keeping requirements included herein as Attachment B once the
t has been completed.
mature ot Uwner Or Authonzed Kepresentative (tate)
I have read the conditions of the Fugitive Dust (PM10) Mitigation Plan and the owner has
authorized the implementation of all its proviwns throughout project buildout.
01
not the same as above)
. �
a.
i. i�q . w' I� ! � Ar !�
1
PM 10 Program Report Torm
I. r.MCMIAL INFORMATION
Project Developer Name
Address: ?hone: G 3yb
Project. Site7V Vo -CAL& 64K -i Project Title -WO #JQe5 as
C
Address: ��� Z. w 3
Tract No.:
Acreage:
Grading Subcont—ractor (if different)
Name:
fps
Address JISNJ� &L45! -,GI hone-
_-2*0 �Z
PHASES?- YES ND` 74
Is so .how many?
Type' of Development/Project: C--zmpercialX Single .Family
Xulti. Family_
Demolition Other
Date of Project/Phase Stara-Un:1#A4q&te of Project/Phase
Comvletionlp%.%
II. COST EYFOPHATION
If actual costs are not available, please estimate to the.best
of your
ability.
1-=:. Amount: Total
Cost:
2. EQUtph= COSTS:
A. Rater Truk: Number. on' Site-: , Total
Casts 091l.J. C1.d
Hourly Rate.
Hours:
B_.Stxeet Sweeper: Number on Site: Total
Cost:
Hcurly Rate:
Hours:
C. Temporary Irrigatioa: Total
Cost:
D. Rind Fencing: Linear Ft.: Total•Cost:
• Cast/Ft.
S. Chemical/Xaterial Stabilisation: Total
Cost:
Sq. Ft_
Cost per Sq. Ft..:
F. Vegetation Cost: Material: Total
Cost:
Maintenance:
Type: Total
Cost:
Hourly Rate:
Hours:
3. LABOR COST: Hourly Rate: Total
Cost:
Hours:
4. ADMINISTRATION COSTS: Total
Cost:
III. TOTAL COSTS:
Add items 1 - 4 ' for total cost. 71(� COST:
•
PLEASE 'RETURN 7OR21 AT CJ2-Lo_L2TT_ON OF PROJECT OR ?RASE OR ANNUAL:.Y FROM THE
DA= OF PHASE STAT QP
3131/94
I - 17 , !:-. .
' 1
Small Scale Construction/Demolition Projects(5 Acres or Less)1
Fugitive Dust (PMIO) Mitigation Plan
Date: Jurisdiction: File #:
Part I - Project Information
Please .provide the information below as completely as possible even if it has already been
provided on other forms related to this project. Failure to provide complete information or
provision of inaccurate information may delay the processing of your Fugitive Dust (PM10)
Mitigation Plan (Plan). It is recommended that you submit your.Plan concurrent with your
grading or demolition permit application.
Project proponent
Address:"
Day phone number:
Emergency phone number:
zftik) 40b
Grading contractor (Contact Person):
Address:
Day phone number: ko Wtam Emergency phone number: i. 14 JVL IL
Construction site street address: -710>-11W CAVA41.
Construction site location:
(Please include an '&5 x 11 location map)
Construction site•assessor's parcel number (Tract .d i
Parcel (Tract) size: Acres or Square feet.
Anticipated date of physical project initiation:
Anticipated date of project completion: _b
Anticipated costs for dust suppression:
(Attachment B - Must also be completed and mailed to the appropriate address when
construction activities have been completed)
1 All projects greater than one half (1/2) acre are also subject to SCAQMD Rules 403 and
403.1. i