2572f
` ' •�
With •proper, validation
`this form constitutes an
£ CITY OF LA QUINTA
encroachment permit
f.,
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
+ BIANM PMUT — 1997
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 II I
DATE: Daaember 17. 1996 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Various locations within 'the City of La Quinta
(Street address or Description of Location) '
PURPOSE -OF CONSTRUCTION I AIRtOVA11CO r6*ftiJt* tO Sketch (attach construction plans if appropriate)
existinft CV0 facilities
t DESCRIPTION OF CONSTRUCTION - VArlea+
SBM ATTAiCM CONDITIONS
DIMENSION OF INSTALLATION OR REMOVAL Variea 88PARATB • ERKITS R81)UIR1111, FOR
f CONSTRUCTION ON ITOR STRESS,
OAR 6it;MIZF•D INTURSBGTONS, OR �
SIZE OF EXCAVATION, IF NEEDED jlaxiQa FOR WORK PERFORMED BY AN OMID8
COMUCTOR. 7
APPROXIMATE TIME WHEN WORK WILL BEGIN - L/2/97
'•� NOTIFY TRH CITY AT (619)-777-7075
I APPROXIMATE TIME OF COMPLETION ' - 12/31/97 48 ROM PRIOR TO CONSTRUCTION TO
ESTIMATED CONSTRUCTION COST $ unknown RECEIVE WORR AUTHORIZATION .NUM ER.
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 �pe'rmit, the applicant hereby agrees to:
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and ac.ainst any, and all
penalties, -liabilities.or Joss' resulting from claims or court action and arising out of any accident, loss or damage to • persons or property r
happening'or occurring as a proximate result of. any'work,undertaken under the permit granted pursuant to thisapplication.
Notify the Administrative'Authority at least twenty-four (24) hours in advance of the time when work will started.:
Comply'with 'all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of tii City of
r La Quinta -and to pay for any' -additional replacement necessary as the result'of.,this work.
+ y 'R!!'
I' ,`+Yi` ` • �t Signature of Applicant o Ag nt' %' `-x:,,
Y:if.D. P.0. Box 1038 Cudch CA 92236 (619) '3964#61" imt'.: 507
I Name of Applicant (please print) Business Address Telephone No. '
I ' Name of Contractor and Job Foreman Business Address Telephone No.
f.
Contractor's License No. City Business License No.
Applicant's'lnsurance'Company Policy Number 1.
1
FEES: Subdivision Improvement Permit — Class I
Public improvements: 3% of'estirnated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit - Class IV:•See attached schedule `57`
nspection Fee I PERMIT VALIDATION
I
Permit Fee r
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
-0-
$ —0—
Date
PERMIT NO. 2572
DATE APPROVED 1/2/97
EXPIRATION DATE 12/31/9.7
DATE/ISSUED 1./2/97
By
Administrative Authority -
Telephone: (619) 777-7075
19
e*
GENERAL CONDITIONS PERMIT NO. 2572
--- Coachella Valley Water District ---
BLANKET PERMIT - JANUARY 1 - DECEMBER 31, 1997
In addition to the standard permit conditions, the following shall apply:
1. Work authorized by this permit shall be limited to the maintenance and repairs of
existing underground equipment, installations, and facilities owned and operated by the
Coachella Valley Water District (CVWD). New equipment, installations, and facilities
shall be authorized through separate permit. All work shall be performed by CVWD
employees.
PRIOR TO COMMENCEMENT OF ALL WORK, CVWD shall notify the City at least 48
hours in advance at (619) 777-7075, giving the location and description of the work
to be performed, the dates and times the work will occur, and the name of the
foreman responsible for the work. A work authorization number will be issued for each
occurrence of work. WORK PERFORMED PRIOR TO CITY NOTIFICATION AND
WITHOUT A WORK AUTHORIZATION NUMBER IS PROHIBITED.
2. SEPARATE PERMITS ARE REQUIRED FOR ALL OF THE FOLLOWING:
A. Work within any major, primary, or secondary arterial street. Those streets
include, but are not limited to:
Eisenhower Drive, Washington Street, Adams Street, Dune Palms Road,
Jefferson Street, Madison Street, Monroe Street, Fred Waring Drive, Miles
Avenue, Westward Ho Drive, Avenue 48, Avenue 50, Avenue 52, Avenue 53,
Avenue 54, Airport Boulevard, Avenue 58,*and Avenue 60.
B. Construction of all new equipment, installations, and facilities, and realignments
or changes to existing facilities.
C. Construction work performed by an outside contractor for the utility company.
D. Construction work performed within 500 feet of any signalized intersection, see
Condition #9.
3. All work shall be performed in accordance with the latest edition of the Standard
Specifications For Public Works Construction.
4. CVWD shall be responsible for providing continuous dust and erosion control.
5. Streets -shall be kept clean. They shall be completely cleaned at the end of each
working day and more frequently if required.
Special Conditions - Permit No. 2572 Page 1 of 3
i
GENERAL CONDITIONS -- PERMIT NO. 2572
--- Coachella Valley Water District ---
BLANKET PERMIT - JANUARY 1 - DECEMBER 31, 1997
6. CVWD shall comply with the local noise ordinance (LQMC 6.08.050). 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 and Sundays.
7. CVWD 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.
8.r Advance warning signs and traffic control shall be installed and maintained in
accordance with Caltrans Standards or the Work Area Traffic Control Handbook
(WATCH Manual). It shall be CVWD's responsibility to detour and barricade all work
sites.
9. When the work site is in, or within 500' of, a signalized intersection, additional
planning and coordination is required:
A. CVWD shall submit for City approval traffic control plans for the work site.
B.. CVWD shall also notify the Riverside County Signal Department at (909)
275-6894 or Caltrans Signal Department at (619) 688-6845 as appropriate,
48 hours prior to beginning work.
C: Work shall be restricted to those times when the work will affect the least
amount of traffic during that day, commonly between the hours of 10:00
A.M. to 12:00 P.M. and 2:00 P.M. to 4:00 P.M.
10. Street closures shall not be permitted. A minimum of one travel lane on paved surface
shall be maintained with flagmen at all times.
1 1. Prior to excavating, the CVWD shall contact Underground Service Alert at 1(800) 422-
4133. Note: USA does not locate signal conduits or other city owned facilities such
as storm drains, electrical services, median sleeves, etc.
Special Conditions - Permit No. 2572 Page 2 of 3
s GENERAL CONDITIONS-- PERMIT NO.. 2572
--- Coachella Valley Water District--.
BLANKET PERMIT - JANUARY 1 - DECEMBER 31, 1997
12. 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 CVWD as directed by and to the
satisfaction of the City Engineer at no cost to the City of La. Quinta.
13. All work shall be coordinated with the City's inspector and others working within the
area as directed by and to the satisfaction of the City Engineer.
14. Backfill compaction within improved street rights-of-way shall conform with Section
306-1.3 of the Standard Specifications for -Public Works Construction (SSPWC). All
.backfill soil shall be crushed aggregate base or crushed miscellaneous base, meeting
the requirements of Sections 200-2.2 and 200-2.4 of the SSPWC. Native soil shall
not be used as a backfill material. Compaction tests (one per 300 linear feet of trench)
shall be provided for areas of excavation large enough to accommodate compaction
equipment. For areas of excavation smaller than that which would accommodate
compaction equipment, controlled density fill (CDF) or any equivalent sand -slurry
mixture shall be used. As an alternative, CDF or its equivalent may be used for all
areas of excavation, eliminating the need for compaction testing. Material tickets and
compaction test results shall be submitted to the City. The work authorization number
shall be referenced on all correspondence.
15. All excavations at or near the travel way shall be backfilled and paved at the end of
every workday as directed by and to the satisfaction of the City Engineer for the
protection of the traveling public.
16. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be
replaced to its original condition.
17. Access to properties shall be maintained at all times.
18. Permanent pavement replacement section shall be one inch greater than existing and
be 'paved within seven '(7) calendar days from completion of the work. Asphalt
concrete shall be of a mix design approved by the City. Material tickets and
compaction test results shall be submitted to the City. The work authorization number
shall be referenced on all correspondence.
19. The City has designated by ordinance certain city streets as Truck Routes. The weight
limit for restricted streets (i.e. streets not part of Truck Route network) is three (3)
tons; trucks exceeding the weight limit may use a restricted street if making a delivery
or pickup on the subject street, or if this permit specifically grants permission to use
the street to deliver street construction materials and equipment.
20. The City reserves the right to revoke this permit upon 30 -day written notice to CVWD
for any reasonable cause, and reserves the right to revise conditions by amendment
as may be necessary.
Special Conditions - Permit No. 2572 Page 3 of 3
A�.
CVWD Blanket Permit - 1997
Work Authorization Sheet
�
Work
Authorization u Date Work Date(s)/Time(s)
Location of Work
* * Foreman Description of Work
Materiel
Tickets/Compaction
Tests Rec'd
97-100
97-101
97-102
97-103
97-104
97-105
97-106
97-107
97-108
97-109
97-110
97-111
97-112
97-113
t
97-114
97-115
97-116
97-117
97-118
97-119
97-120
97-121
97-122
97-123
97-124
97-125
97-126
97-127
97-128
97-129
97-130
F:\PWDEPTSTAFF\FULLER\PERMITS\FORMI.WPD ' • Work is within 500' of signalized intersection