2623With proper validation X
this form constitutes an
encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT '
PUBLIC WORKS CONSTRUCTION' (ENCROACHME•NT)
For the construction .of public or private curbs, driveways, 'pavements, sidewalks, parking lots, sewers, water.' mains
ancl'other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED.SUBDIVISIONS
o
Subdivision Improvement Permit — Class III
IIS.
DATE:` June 20', 1907 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Various. Locations in Cute — AeA atr-aiahed
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Install and. maintain m brae Sketch•(attach con struction.plans if appropriate)
3atch (I") domestic water service Zine
I: DESCRIPTION OF CONSTRUCTION Ogen trench Co inatn,ll
I4 1" & 2" diamater water services with nnorox.
3 fact.of cover SEE ATTACHED CONDITIONS
' DIMENSION OF INSTALLATION OR REMOVAL Ap rO a- ft. .
V144 trahth with aft. to Oft. of cover €tt ealgh
of fiVe 10cationb/servicaf3
I . SIZE OF EXCAVATION, IF NEEDED Anor-Ax . 3 ft. 'wide
trench with 1ft, to 4 ft. of depth
APPROXIMATE TIME WHEN WORK WILL BEGIN 6/23/97
APPROXIMATE TIME OF COMPLETION 7/7/97
ESTIMATED CONSTRUCTION COST $
(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: `
l
Indemnify, -defend and save the City, its authorized agents; officers,•�epresentatives 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 underthe per 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' he resultrof thiAork.
/Signatur of Applicant orAgen�"'
CnAchellA Viki .ev GTnepr D1,Qtari t: P.Q1 Any, I 65 (nP^thgl'7.a: r,A f7An1 lag_9ARI
Name of Applicant (please print) Business Address Telephone No., .
Name of Contractor and Job Foreman Business Address Telephone.No. "
Contractor's License No. City Business License No. ;
Applicant's Insurance Company.Policy Number
FEES: Subdivision Improvement Permit —.Class III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction: costs
Minor Improvement Permit — Class IV: See attached schedule.
Inspection Fee $
Permit Fee ' �- 0, --
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
Receipt No.,
0"'
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 2.623
DATE APPROVED 6/20/97
EXPIRATION DATE 7/7/97
T
DATE ISSUED 6/20/97By
�i
{/ C� ,dministrative Authority
Telephone: (619) 777-7075
SPECIAL CONDITIONS --PERMIT NO. 2623
--- Coachella Valley Water District -
In addition to the standard permit conditions, the following shall apply:
This permit authorizes the installation of new 1" and 1.5" water.services and other Coachella Valley
Water District facilities, in with the City's "Various Citywide Landscape Improvements"
project for the same area. Work performed under this permit shall be coordinated with the City as
required herein.
2. All work shall be performed in accordance with the latest edition of the Standard Specifications For
Public Works Construction.
3. The Coachella Valley Water District ("The District") shall be responsible for providing continuous
dust and erosion control.
4. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and
more frequently if required.
The District shall comply with the local noise ordinance. Operation and maintenance of equipment
within one half mile of human occupancy shall be performed only during the following time periods:
October 1st to April 30: Monday -Friday 7:00 a.m. to 5:30 p.m.
Saturday 8:00 a. in. to 5:00 p.m.
May 1st to September 30: Monday -Friday 6:00 a.m to 7:00 p.m.
Saturday 8:00 a.m. to 5:00 p.m.
6. Work hours at signalized intersections or within 500 feet of a signalized intersection are typically from
9 a.m. - 3 p.m. to avoid peak traffic periods but may vary depending on the location of the
intersection. The District will be notified by the City of specific work hours (if different) during the
48 hour notice period.
7. Work shall be prohibited on legal holidays including Sundays. Work is.allowed on Saturdays only
if special arrangements, including payment of overtime inspection fees, have been'made two (2)
working days prior to the desired Saturday.
8. The District 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. Upon notification, the District shall respond immediately to correct said damage at its own
expense.
9. Advance warning signs and traffic control shall be installed and maintained in accordance with Cal
Trans Standards or the Work Area Traffic Control Handbook (WATCH Manual). The District shall
submit a traffic control plan that shall provide for a minimum of one travel lane on paved surface with
a flagman as necessary. Access and egress to all local properties shall be maintained at all times. It
shall be the the District's responsibility to detour and barricade the work site.
Special Conditions - Permit No. 2623 Page I of 3
SPECIAL CONDITIONS --PERMIT NO. 2623
--- Coachella ValleyWaterDistrict-
10. Street closure shall not be permitted. A minimum of one twelve (12) travel lane on paved surface
shall be maintained with flag man at all times.
I L Prior to excavating, the District shall contact Underground Service Alert at 1-800=422-4133.
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 the District as directed by_ and to- the satisfaction of the City Engineer at no cost to
the City of La Quinta.
13. 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.
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 trench backfill shall be
compacted to a minimum relative density of 90% using native material with a minimum frequency of
one test per every 300 linear feet per lift. All backfill shall be mechanically compacted in lifts of eight
(8) inches or less. Jetting or flooding of backfill material will not be allowed unless otherwise
approved by the City. All test data shall be.submitted to the City,'including failing tests and retests.
15. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to
its original condition.
16. Permanent pavement replacement structural section shall be one inch greater than existing, or 4"
minimum, which ever is greater, over 8" of crushed aggregate base meeting the requirements of
Section 200-2.2 and 200-2.4. of the Standard Specification for Public Works Construction. The
replaced pavement and base material shall be compacted to 95 %.relative compaction and
respectively tested for each location. A.C. mix design shall be approved by the city prior to
placement.
17. - The District shall notify the City Engineering Department a minimum of 48 hours prior to start of any,
work at (760) 777-7075.
18. The District shall stabilize any soil that was disturbed (shoulder areas, etc.) as a result of work
performed under this permit with an approved dust control treatment.,
19. Trenches in the street section shall be permanently paved within seven (7) days after completion of
the work unless otherwise approved by the City.
Special Conditions - Permit No. 2623 Page 2 of 3
SPECIAL CONDITIONS --PERMIT NO. 2623
a_
-= Coachella Valley Water District-
5 20. Where trenching is'performed in any P.C.C. or A.C. improved area the trench shall be saw cut an
additional Pon each side of the excavation area and a butt joint created. The edges shall be saw cut
to straight, stable, and unyielding edges. Feather joints are not acceptable. The finished pavement
surface -shall be smooth and consistent, and shall conform to the surrounding grades.
21'. The city has designated by ordinance certain city streets as Truck Routes. The weight limit for
restricted streets (i.e. streets not part of the Truck Route network) is three (3) tons; trucks exceeding
• the weight limit may use the 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/or equipment.
22. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time.
Special Conditions - Permit No. 2623 Page 3 of 3