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2959NOTE.:. — 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 May 6, 1999 Subdivision Improvement Permit— Class III DATE: Minor Improvement Permit Class IV I nrATION CIF rnN1.;TRIJrTl(1N PGA West Tract 28603-1 (Street address or Description of Location) PURPOSE OF CONSTRUCTION Begin subdivision development Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION Rauivh GrArlin4 DIMENSION OF INSTALLATION OR REMOVAL SAA SIZE OF EXCAVATION, IF NEEDED 209867 CY ��— APPROXIMATE TIME.WHEN WORK WILL BEGIN May 1999 APPROXIMATE TIME OF COMPLETION June 1999 ESTIMATED CONSTRUCTION COST $ 84,000 (Including removal of all obstruction, materials, and debris, backfilling, com- See attached conditions. See approved plans. t r paction and placing permanent resurfacing and/or replacing improvements) {a 1 In consideration of the granting. of this permit, the applicant hereby agrees to. 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. e Signature of Applicant or Agent SWH Hermitage, LLC 7161 Indiana Avenue, Riverside, CA 92504 (909) 784--0840 Name of Applicant (please print) Business Address Telephone No. Game Name of Contractor and Job Foreman Business Address Telephone No. 748004 13934 Contractor's License No. City Business License No. Tudor insurance Co. GI,00001689 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 $ 2,520.00 100.00 Permit Fee `<Renali:y As Built Dep. 1,000.00 ,CashzDe— si SuFetygond (3,000.00) mifErequired Plan Check Credit 620.00 TOTAL: $ Receipt No. Received by Date Recorded by 959 PERMIT VALIDATION PERMIT NO. 2959 DATE'APPROVED 5/6/99 EXPIRATION DATE 5/6/00 DATE ISSUED, ,f By Administrative Authority Telephone: (619) 777-7075 NOTE: :*� •-Nlitl:'proper validation this form constitutas 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 iou, sawn, watermains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS DATE: Subdivision Improvement Permit — Claw III Mina Improvement Permit Claw IV LOCATION OF CONSTRUCTION PGA West Tract 2 8 6 0 3 -1 Lots 1-52 adtrress Or 08=016on of Location) IVIS1r^- PURPOSE OF CONSTRUCTI N " " ' i n.g I IAA . i 09i r•P_� a&2.nn . DESCRIFTI N OF CONSTRUCTION Rough Grading DIMENSION OF INSTALLATION OR REMOVAL ass SIZE OF EXCAVATION. IF NEEDED — 1 c. yards APPROXIMATE TIME WHEN WORK WILL BEGIN A 11 r i l 1 9 9 9 Sketch (attach conuruction plans if approprieta) C47, (./7 APPROXIMATE TIME OF COMPLETION a ESTIMATED CONSTRUCTION COST S 1000 ° v (Including removal of all obstruction, materials, and debris, badtfilling, Coln• petition and Placing —Permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, the applicant hereby agrees to: (ntlanhnity,.dafand and Sava the City, its out agents. officers. npnaanntives and employee, ntmna has from and aaainat anti and all w resultingpanalties, liabilities or loss from claims or court action and arising out of any amident, loss or damege to parsons or groping happening or occurring as a proximate result of any work undanakan under the permit granted pursuant to this application. Notify the Administtative Authority at least tv antyfour 1141 haws in advance of the tuna when work will be Karead, Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicaole rujes and regulations of am City of La Quin and to pay for any additional rettacemant necessary as the result of this work. Signature of Applicant or Agent SW-H Hermitage, L.L.C. 7161 Indiana; Ave. Riverside, CA (909) 784-0840 Name of Applicant (please print) _ Business Address _ _Telechone No. Name of Contractor and Job Foreman -1qm ContreaA s Lure No. I/ Applicant's Insurance Company rGN. L.IA61L'rT u d o r I n s. C O. FEES: Subdivision Improvement Permit — Class Public improvements.`3% of estimated construction costs Private improvements: 3%of estimated construction costs Mina Improvement Permit — Class IV: Sea attached schedule Inspection Fee S et5�0 Permit Fee (o O AS ) 000 itaquirad PtGcip�N (3 000 TOTAL G _ & 20 0 ' Receipt No. ' Received -by Date_.�� City Business Limo PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority 1: 1 04/16/1999 08:49 909-784-0844 STEVEN WALKER HOMES PAGE 02 _ _. F&F GRADING INC PAGE 02 �o GD.011V(9� Co P.O. Box 14117, La Quinta. Ca., 92253C760) 399-5530 Ca L.ic#727144 Az L.ie#] 19261 PROPOSAL Sheet No. Proposal Work To Be Performed 3-01-99 Name STEVEN WALIKER HOMES TMCT #29603-1 Street 7161 INDIANAAVENUE Street LOTS 1-52 City RIVERSIDE City State State CA Date of Phone 909-784-0840 FAX#909-784-0844 Architect We hereby propose to furnish the materials and perform the labor necessary for the completion of GRADING; 1) MOVE IN- 2) CL&4A & ORUB LOTS. 3) SCARIFY LOTS, 4) CUT & FILL TO BALANCE. 5) COMPACTION OF 90%. 6) BLUE TOP LOTS WITHIN .IOTH. 7) DUST CONTROL WHILE ORADINQ PADS. EXCLUSIONS: CONST. WATER BOIL TESTING, SURVEYINO. PERMIT PEES, OVER-X OF PADS. AD material is gUaranteed to be as specified. and the above work to be performed is—ardance with the drawings and apeoftcationa submitted for above work and oorrtpleted io a subst-bal worlonenlikc mermen for the sum of Payments nude NO follows; Progressive Payments Any alteration or deviation 9'om above specifications Involving extra costs, will be rxeoute'd ottly upon written otti m and will beoome en extra Charge over and above the estimate. All agroerttents contingew upon strikes, aooidoeu or delays bayood our control. Ow,er to entry fire, tornado and other necessary insumnoe Von above work. wortcmen'a Compensation and Public Liability Insurn m an above work to be taken out by Dollars SU-200•00 Respcc*dly eubmignd Per F & F Grading Inc. Felix Flores Nate - This proposal may be withdrawn by us if oot accepted wipes days. ACCEPTANCE OF PROPOSAL THE ABOVE PRICES, SPECIPICATlOA'S _� "7-4131TIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU A&E AIT 110R1ZED TO DO THE WORK AS SPECIFIED. PAYMENT WILL BE MADE AS OUTLfNED ABOVE. Date:. Signature: r . Prerequisites for Grading Permit Issuance U The La Quinta. Engineering Department assigns a specific city staff member as a Project Manager to every grading project that is proposed: If you have questions or need assistance regarding any of .he prerequisite items on this checklist, or regarding the City`s plan checking process, .please contact :he - Project Manager assigned to your project.. . Your Project.Manager is Marcus Fuller ; he may be reached at (760) 777-7O89. 1. Environmental Assessment ..... .......... ..................... O 2. Archeology Study ........................ ........ .... ❑ 3. Approved project concept .................................. Q 4. Compliance with specific prerequisite Conditions of Approval for grading ... O 5. Approved grading plan and soils report ... ....... 6. Third party approval(s) for offsite grading ............... M__ 7. Third party approval(s) for acceptance of drainage ......... !`)` ..... M- . 8. Approved Fugitive Dust Plan . PM . (O .A-WLX41.lr ... ..... . ai U 9. Approved Storm Water Pollution Prevention Plan (SWPPP) ............... O' 10. NPDES permit ................... ...................... ❑ 11. List of Professionals .. ....... ............ ............ 1311" Surveyor = � , �799 �t,a��A.re: S2 , I.�k�lill�rA,c�►........ __.... Mn9 C,044vl.twq � Soils Engineer/Technologist SLADOE�.J'EN(�lt�lGERtNC�, 3°►."jZ1 G&AVAaP, PAW CA. Archeologist 12. Application for Grading Permit ... APAC3� ................... !Y _- 13. Insurance Certificate ... . ............. .....:... . `........ O•-. _ 14. City Business License ...................................... ❑ flu 15(a). Plan checking fee .................................. . ... O 15(b).. Grading Permit fee ............................................ ❑ . - - 16. Fringetoe Lizard fee ....................:.................... .O _. 17. As -Built plan security deposit . ...:...................... . ❑ CAWMESION W RADINO.DC1 MDS Consulting Planners • Engineers • Surveyors 79-799 Old Avonuo 52 750/771. 4013 U La. Qulnta, CA 92253 FAX 7714. .013 , PROCEDURE FOR APPLYING FOR ROUGH GRADING PERMIT IN CITY OF LA QUINTA PRIOR TO GRADING, DRAINAGE & PAVING PLAN APPROVAL ITEM REQUIRED RESPONSIBLE _PARTY' OWNER/DEVELOPER­ MDS 1. APPLICATION X 2. NAME OF APPLICANT & TELEPHONE NUMBER X -A. APPLICANT'S INSURANCE CO. (GEN. LIB.) X _. AND POLICY NUMBER 3. NAME OF GRADING CONTRACTOR X A. ADDRESS X B. TELEPHONE NUMBER X C. CONTRACTOR'S LICENSE NUMBER X D..CONTRACTOR'S LA QUINTA BUSINESS. X LICENSE NUMBER AND CERTIFICATE E. CERTIFICATE OF INSURANCE X GENERAL LIABILITY AUTO LIABILITY WORKERS COMPENSATION & EMPLOYERS LIABILITY U (ALL INDEMNIFYING APPLICANT & CITY OF LA QUINTA) 4. GRADING CONTRACT AMOUNT X 5. APPROXIMATE START DATE X :......:. _-=.... 6. APPROXIMATE TIME OF COMPLETION X 7. .LETTER PER ATTACHED SAMPLE X _ .. _. 8. FUGITIVE DUST CONTROL PLAN (PM-1.0) ' A APPLICATION X B. ANTICIPATED COSTS FOR DUST SUPPRESSION, X WATERING PLUS CHEMICAL STABILIZATION, SEPARATELY C. LIST OF DUST SUPPRESSION EQUIPMENT, I.E. X WATER TRUCK, PULL TANK AND TOWER ` D. $1,000/AC..SURETY, IN FORM OF.CERTIFICATE OF - X DEPOSIT, LETTER OF CREDIT, OR CASH PLEASE SUBMIT ALL OF ABOVE INFORMATION TO MDS. MDS WILL PREPARE APPLICATIONS AND SUBMIT TO CITY OF LA QUINTA: FEES WILL BE DETERMINED BY CITY, GIVEN TO MDS, AND CHECK REQUESTED FROM APPLICANT. GAWlROFUSNAASTERSAGRADWGDOC MDS Morse Ookich. Schultz .. _ v SENDER: fm ❑ Complete items 1 and/or 2 for additional services. Complete items 3, 4a, and 4b. I also Wish to receive the follow - O Print your name and address on the reverse of this form so that we card to you. Ing services (for an extra fee): ID can return this O Attach this form to the front of the mailpiece, or on the back if space does not permit. 1 • ❑Addressee's Address 0 ❑ Write 'Retum Receipt Requested, on the mailpiece'below the article number. O The Return Receipt will show to whom delivered. the 2' O Restricted Delivery •° a article was delivered and the date 3. Article Addressed d E to: / 1 .,j_ p 4a. Article Number 5�4�� WQ l r-ReSou Ges C f u UU,w ©YIT-i3O {Jm No. ,� W4}eY Q U4ll T�/ 4b.Service Type Registered ❑Certified an, �v P/ ern„-�VHr I Q 7 ❑Express Mail ❑Insured El Return Receipt for Merchandise cc J QC mmte-". / C, 7. Date of Delivery ❑ COD f, w 5. Received By: nnttNa e) 2 j�`� ' �7 c _S9 6. Signature (A ddressee 8. Addressee's Add lee is paid) [vfvy/ fOn.1 r1 I reQ, t� and / t rAgen r. U v) ti -42i it i PS Form 3811 D December 1994 d) 1�9y 102595-99-B-0223 The following General and Special Provisions are attached to and made a part of Permit No. GENERAL PROVISIONS The following shall always apply: ENROACM11ENT 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, spalled, 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 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 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: 1 NOTIFICATION; Permittee shall notify the City at (619)777-7075 at least 48 hours in advance of starting construction. UTILITY 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. Ci3 j 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. R5 PARKWAY 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 l� a licensed engineer. R7 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. Depressedcurb, matching concrete gutter and concrete driveway approach shall be constructed in conformance with City of La Quinta Standard #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 (_� 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. SOIL STERILIZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall commply with the manufacturer's specifications. Rl 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. R12 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. R13 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. R14 LIMIT 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. R18 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. R19 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. R20 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 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. R22 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. R23 STREET RESTRIPING: 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.2959 --- SWH Hermitage LLC --- In addition to the standard permit conditions, the following shall apply: Pursuant to Section 14.16.320 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), all work shall be performed in accordance with the latest edition of the Standard Specifications For Public Works Construction (SSPWC) and as directed by and to the satisfaction of the City Engineer. 2. S WH Hermitage LLC, hereinafter referred to as "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. Pursuant to Section 6.08.050 of the La Quinta.Municipal Code (Ordinance 18 § 1, 1982), throughout the work site, the Permittee shall comply with City regulated work hours. 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 5:30 p.m. Saturday " 8:00 a.m. 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. Work shall be prohibited on legal holidays and Sundays. 5. Work performed within 500 feet of a major and/or signalized intersection is restricted between the hours of 9 a.m. - 3 p.m. Traffic control shall be set up after 9 a.m. and removed before 3 p.m. The Permittee shall contact the Riverside Country Traffic Signal Maintenance Department at (909) 275- 6894 if signal operation at the intersection is to be altered in any way. 6. Pursuant to Section 14.16.110 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), Permittee 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. 7. Pursuant to Section 14.16.250 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), 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). A traffic control plan, if required, shall be prepared in accordance with the WATCH Manual and submitted to the City for review and approval one (1) week prior to starting any construction. It shall be the Permittee's responsibility to appropriately detour and barricade all construction sites. Special Conditions - Permit No. 2959 Pagel of 3 %i SPECIAL CONDITIONS --PERMIT NO.2959 --- SWH Hermitage LLC --- Pursuant to. Section 14.16.290 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), street closures shall not be permitted. A minimum of one travel lane of paved surface shall be maintained with flagmen at all times. 9. Prior to excavating, if required, the Permittee shall contact Underground Service Alert at 1-800-422- 4133. It shall be the Permittee's responsibility to notify the Public Works Department of anticipated excavation which impact City facilities, including but not limited to traffic signal conduits and loops, irrigation lines, electrical conduits, and storm drain facilities. 10. 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. 11. Pursuant to Section 14.16.370 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), backfill compaction within street rights -of -way shall conform with Section 306-1.3 of the latest edition of the Standard Specifications For Public Works Construction (SSPWC), and as required by the Public Works Department. Backfill shall be completed in lifts, not to exceed F, compacted to 90% minimum relative compaction. Native material may be used, provided the material is suitable for.use as backfill after construction operations. Controlled Density Fill (C.F.) may be used as an alternative. 12. All excavations within City of La Quinta right-of-way shall be backfilled, and temporarily paved if within the existing travel way, at the end of every workday as directed by and to the satisfaction of the City Engineer for the protection of the public. Lengths of open trench shall not greatly exceed that which can not be backfilled in the same day. Excavated trenches shall not be allowed open overnight, however, Permittee may leave a length of excavated trench, not to exceed twenty (20) feet in length, open overnight at a point where construction will begin the next day, provided that this length of trench is completely covered by steel plating. 13. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to its original condition. 14. Access and egress to all local properties shall be maintained at all times. 15. Pursuant to Section 14.16.375 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), permanent pavement replacement shall be completed no later than seven (7) days after the completion of the work. Permanent pavement shall be replaced.as follows: a) Sawcut and remove existing a.c. surfaces a distance of one foot (1') beyond all trench walls, including any sloughing or cave in of adjacent soils. Undermined a.c. surfaces shall be removed. All a.c. edges shall be straight, clean and vertical. b) Provide an existing section (four -and -one-half inches [4'/z"] minimum) of crushed aggregate or miscellaneous base material, compacted to 95% minimum relative compaction. Special Conditions - Permit No. 2959 Page 2 of 3 SPECIAL CONDITIONS --PERMIT NO.2959 --- SWH Hermitage LLC --- c) Provide an existing section plus one inch (1") [four inches (4") minimum] of asphalt concrete in two (2) or more lifts; the first lift(s) comprised of a base course a.c. material, of a City approved mix design, meeting the requirements of Greenbook class B-AR-4000; the final 0.10' lift comprised of a wearing course a.c. material, of a City approved mix design, meeting the requirements of Greenbook class C2-AR74000. All pavement edges shall be flush with adjacent a.c. surfaces. Each lift of a.c. material shall be compacted to 95% minimum relative compaction. d) For trenches greater than two feet (2'.) in width, the Permittee shall perform a grind and a.c. overlay of 0.10' depth for three feet (3') in addition to the pavement replacement specified above. e) Multiple trench cuts,, depending upon location and quantity, may require complete grinding and 0.10' depth asphalt concrete removal and repaving, at the direction of and to the . satisfaction of the City Engineer. 16. Permittee shall notify the City of La Quinta Public Works Department a minimum of 48 hours prior to commencement of any construction at (760) 777-7075. 17. Permittee 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. 18. Pursuant to Chapter 12.56 of the La Quinta Municipal Code. (Ordinance'l0 § 1 (part), 1982) the City has designated 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 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/or equipment. 19. The City of La Quinta reserves the. right to revoke, suspend or void this permit at any time. 20. This permit authorizes rough grading for Tract 28603-1 as shown on the approved plans by MDS . Consulting. Special Conditions - Permit No. 2959 Page 3 of 3 I \ . Ie \1-1.. Medium -Large Scale Construction/Demolition Projects (Greater than S acres)' Fugitive Dust (PM 10),Mitigation Plan Date: G 199 Jurisdiction: Project File #: TI2 28Go3 -/ Part l - Project Information ,Atoc00 Please provide the information below as completely as possible even if W 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 bust (PM10) Mitigation Plan (Plan). It is recommended that you submit your Plan concurrent with your grading or demolition permit application. Project proponent: ' S W H Hermitage ,' . L.L.C. Address:7161 Indiana Avenue, Riverside, CA. 92504 ...Day'phone number: (90.9) 784-0840 Emergency.. phone number: Same - Gradingcontractor (Contact Person): Steven Walker. Homes (Chuck Frase) Address:*7161 Indiana Avenue, -Riverside; -CA- 92504 Day phone number: (909) 784-0840 Emergency phone number: Same Construction site street.address: Tract 28603-1 PGA West ..construction site location: (Please include an 8.5 z 11 location map) Construction site assessor's parcel'number (Tract #): 761-090-045 , -052 'A 1-055 Parcel (Tract) size: Acres or 19.73 Square feet Anticipated date of physical project initiation: 4 / 9 9 Anticipated date of project completion: 5 / 9 9 Anticipated costs for dust suppression: $ 8 , 000-10 , 000 (Attachment B - Must also be completed mate tot a appropnate address .when . construction activities have been completed) 4 66, y16/y y 1 All projects greater than one half (1/2) acre are also subject to SCAQMD Rules 403 and 403.1. Y ON Earthwork Information (Acreagef Cubic Yards): Project Area: 19.13 Total Disturbed Surface Area: Cut: 0,867 c:y. Fill: 12,551 c.y. Import: Export: 19 51 C.Y. -Phasing of Earthwork: -Date Date Phase I Grading (Acreage): 19.7 3 From: 4/ 9 9 To: 5/ 9 9 Phase II Grading(Acreage): n / a From: To: Phase III Grading(Acreage): n / a From: To: Phase IV Grading(Acreage): n / a From: To: (Attach additional information if necessary) Part 2 - Fugitive D.ust 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 corresponding letter. beneath the following sources. In. addition, please indtcate.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. Source Details (e freauencv of application number and type of dust control implements. No. RG FG FC etc. Please be as specific as possible) X.: 4,000 gallon water truck approximately 8hrs/day during rough grading operations.'. y t Pert 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. 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..... complete the record -keeping requirements included herein as Attachment B. once the project has been completed. .Signature Owner orAuthorized. a resentative ate gP _. I have read the conditions of the Fugitive Dust (PM10) Mitigation Plan and the owner has authorized* the implementation of all its -provisions throughout project buildout. :... ignature o Grading Contractor or Authorized Representative ate . . (If not the same as above) Y ATTACHMENT A - REASONABLY. AVAILABLE CONTROL MEASURES The left column contains the sources of fugitive dust which are intended for emission control under the City's dust control ordinance. The two right columns contain an inventory and description of reasonably available fugitive dust control mneasures. for each of -the • sources. Please use this information as a guide when preparing a Fugitive Dust (PM10) Mitigation Plan. (Source No) Reasonably Available . Source control Measures "Comments (1) Land" (A) Watering o Application of water by Means of truck, hoses and/ Clearing/ or sprinklers prior to any land clearing or earth Earth- movement will increase the moisture content thereby --moving increasing stability of material _. o Once the initial land clearing/earth movement activities are complete, a second round of watering can generate a thin crust which stabilizes the disturbed surface areas provided that it is not disturbed o Security fencing can be used to prevent unwanted future disturbances of sites where a surface crust has been created (B) Chemical stabilization o Only effective in areas which are not subject to daily disturbances o Vendors can supply information on product application and required concentrations (C) Wind fencing o Three to five foot barriers adjacent to roadways or urban areas can be effective in reducing the amount of wind blown material leaving a site o Should be used in conjunction with other measures (D) Cover haul vehicles o Entire surface area should be covered once vehicle is full (E) Wheel washers o Should be placed where vehicles exit unpaved areas onto paved areas o System can be adjusted to spray entire vehicle, including stored bulk material in -haul vehicles - (2) Unpaved (F) Paving o Requires street sweeping/cleaning if subject to material Roads accumulation.. _.. (G) Chemical Stabilization o Vendors can supply information as to application methods and concentrations o Not recommended for roads with high volumes or those used for heavy equipment (H) Watering o In sufficient quantities to keep surface moist o Required application frequency will vary according to soil type, U weather conditions, and vehicular use (Source No) Reasonably Available Source control Measures (2) Unpaved (1) Reduce speed'limits Roads Commen o 15 mile per hour ma)amum (Cont'd) (J) Reduce vehicle trips o Access restriction or redirecting traffic to paved roads in order to reduce vehicle trips by a minimum of 60 percent - (3) Storage (K) Wind sheltering o Choices include silos or enclosures Piles o Enclosures. should consist of three'tided barriers equal to height.of :... . material with no more than 50 percent porosity (L) Wet suppression o Application methods include: spray bars, hoses -and water trucks o Frequency of application will vary on site specific conditions h (M) Chemical suppression o .Best for use on storage piles subject to infrequent disturbances i (N) Altering loadin/loadout o Confine loadin/loadout procedures to leeward (downwind) side procedures of the material o Most effective when used in conjunction with wind sheltering (0) Coverings o Tarps, plastic, or other material can be used as temporary coverings o When used, these should be. anchored to prevent wind from removing coverings �J (4) Paved (P) Wheel washers o Should be placed where vehicles exit unpaved areas onta-paved - Road areas Track -out o System can be adjusted to spray entire vehicle, including stored bulk material in haul vehicles (Q) Sweep/clean roadways o Either sweeping or water flushing may be used (R) Cover haul vehicles o Entire surface area should be covered once vehicle is full -•-------------- ................................................... (S) ------------------------------------------------------------------------ Disturbed (S) Chemical stabilization o Vendors can supply information on methods for application„and Areas/ required concentrations Inactive Construction Sites ...(T) Watering o Would require frequent applications unless a crust can be developed over the site . (U) Wind fencing o Three to five foot barriers adjacent to roadways or urban areas can be effective in reducing the amount of wind blown material leaving a site o Should be used in conjunction with other measures (V) Vegetation o Establish as quickly as possible when active operations have establishment ceased o Use of drought tolerant, native vegetation is encouraged I 1\_/ ATTACHMENTS - COST INFORMATION— -- Medium -Large Scale Construction/Demolition Projects (Greater than 5 acres)I Fugitive Dust (PM10) Mitigation Plan Date: 11.46 jurisdiction: 2 Q , Project File #: 7k. z . .Project proponent: SWH Hermitage, 'L.L.C. Address:7161 Indiana Avenue, Riverside, CA 92504 __. Day phone number: (909) 784.7084o ]Emergency. phone number: Same _. . In the space provided below please list the costs associated with implementation of all dust control measures. The information provided belowshould include all implementation costs (including.labor) for dust control throughout the project. Not all measures listed below will apply to all projects. :... Watering: 15,000 Chemical stabilization: n / a Wind fencing: n / a Covering haul vehicles: n / a Wheel washers: ri / a .Street sweeping: n / a Paving: n / a Wind sheltering: n / a Coverings: n / a Vegetation reestablishment:. n /, a After project completion these records shall be transmitted to the City 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 All projects greater than one half (1/2) acre are also subject to SCAQMD Rules 403 and 403.1. M . M MNGTE..M . pyp.�11L111 RYI. TENTATIVE TRACT NO. 28603 - 1 AT PGA WEST LEO� LEflAL _,�.. ��..YM ��P•AWAAM _•fir ..• O� _ wr r wr Lai AND LAND LINE SLAM ANY ..�r_r-m..rra0 urn i �i : l�pi +i.�n 1R1;CJ .r. it _ r LQLAMW UE MDXp l .r r r.t TENTATIVE TRACT MAP NO. 28603 LA M PGA I S1 ® LAND CDR ON N-uo Lc► MW..W Lo) rN-r V 4.1.1.. G am na�era � N MDSL4'-` �` PM10 Program Report Form I. GZNXRAL * INFORMA=Off Project Devel Name• SWH ermitage, L.L.C. Address:7161 Indiana *Ave. iversi a Phone: 909 .784-0840 �'� Tract 28603-1 Project Site Project Title PGA West Lot 51-52 Address: Traci No.: Acreage: 19.73 Grading Subcontractor (if dif!erent) Name: Address: Phone: PFASES2 YSS No X I�. so how many? Type of Development/Project: C�ercial Single Family Mxlti Family Demolition other Date of Projecr/Phase Star-Cn: 4 99 Date of Project/?hase Comtletion:5 99 II. COST INFORkWIOM If actual costs are not available., please...estimate_._to the -best of...your ability. 1. WA=XR: Amount: Total Cost: 2 .. BQVXPlO1T . COSTS: A. Water Tzvck: Number on Site: 1 _... Total Cast: + $15.000 /..... Hourly. Rate: �— Hours: da B. Street Sweeper: Number on Site: Total cost: n/a Hourly Rate: Sours:* C. Temporary Irrigation: Total Cast: n/a D. Wind Fencing: Linear Ft.: Total Cost: n / a Cast/Ft. S. Chemical/?laterial Stabilisation: Total Cost: n / a Sq.. Ft.: Cost per Sq..Ft.: F. vegetation Cost: Material: Total Cost: n/a Maintenance: G. Other: Type: Total Cost: n/a -- Hourly Rate: Hours: 3. LdBOR COST: Hourly Rate: Total cast: 4, 000 . Hours: 4. ADA=STRATION COSTS: Total 'Cast: 600 I11. TOTAL COSTS: Add items 1 - 4 for total . cost. _`OIL COST: 19, 600 ?LEASE RETURN FORM AT COMPLETION OF PROJECT OR ?FASE OR ANNUALLY FROM THE DATE OF ?ROTC."/?EASE START UP.. 3/31 /94 IN N For City Use Only -'Based on all'of the provisions contained in this Fugitive Dust (PM10) Mitigation. -Plan - the Plan is: Approved X�4 Conditionally approved (Conditions specified below) Denied (Explanation attached) Signature of City Representative (Date) The following conditions of approval have been added to the Plan by staff in order to- ensure an adequate level of fugitive,dust control: (Attach additional information if necessary) I have read the above conditions of the Fugitive Dust (PM10) Mitigation Plan and I agree to implement of all provisions at the concentrations ana trequencies iuentu cu. CONDITIONS FOR FDCP APPLICATION 99-65: SWH HERMITAGE, LLC/STEVEN WALKER HOMES TR 28603-1; ± 19.7 ACRES GENERAL: 1 . Applicant shall comply with all control measures as set forth in the approved application for FDCP 99-65, and the following conditional measures. This dust control plan approval shall also apply to any haul/encroachment permit(s) issued by Public Works. Where any conflicts arise, the Public Works Director shall determine the appropriate controlling provision(s). 2. The full amount of security furnished for the approved FDCP (as. determined by Public Works) 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 in this application. Form of security shall be determined by Public Works. Any requests for bond amount revisions must be made in writing to the Public Works Director. 3. Applicant shall submit documentation for all costs incurred for dust control measures assumed during all pre -grade activity and grading construction. Said records shall be submitted within 30 days after completion of all dust control measures as outlined in and conditioned upon the plan, or upon any request for release/reduction in posted security. Documentation shall include a completed PM 10 Program Report Form. Security may be withheld pending submittal of this information. Applicant shall have completed all dust control measures, as verified by the assigned field inspector, prior to release of any posted security. 4. The contractor/vendor responsible for provision of all soil stabilizing agents shall submit the appropriate Material Safety Data Sheet(s), along with approval from the Water Quality Control Board, to the Public Works Department prior to any site application. Application of stabilizing agents must be in compliance with NPDES and the state Water Quality Control Board requirements. 5. Adequacy of all proposed and conditional stabilization measures shall be determined by the assigned grading inspector. The City may release a portion of the bonded amount to the applicant for any remedial measures beyond those identified or conditioned upon the project, which. the City deems necessary in the event such approved- measures are not effective. 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. C:\Wrkgrp\fdcp99-65. wpd 6. The conditions applied to this dust control plan are anticipated to cover the full range of construction operations associated with development of the 43 lots within the limits of TR 28603-1, as shown on the application tract exhibit. The approval provisions and conditions for this dust control plan shall remain in effect for the duration of all construction activities for this area of the tract. Transfer of any real property or other interests with respect to this project will have no effect on the validity of this plan approval or conditions. Implementation of all measures as proposed and conditioned shall be carried out for the duration of all construction activities, to the extent they are applicable. However, nothing herein shall preclude any future interest from filing a revised FDCP with the City for any portion of the site. 7. Approval of this dust control plan does not in and of itself constitute or otherwise authorize any site disturbance, preparation or construction. The developer is required to obtain all necessary permits and clearances as set forth in any development approvals issued and currently in effect pertaining to this site. This includes any type of testing, monitoring or sampling required as a condition of development approval, such as that conducted for archaeologic, hydrologic and geologic reporting purposes. SITE DEVELOPMENT: 8. Pre -watering of all areas proposed for grading shall be in accordance with recommendations of the grading contractor, based on the area soil conditions as described in the associated soils report(s). At a minimum, pre -watering time shall be for three days prior 'to any earth disturbance(s). 9. Track -out and other accumulation of soil material(s) onto any paved areas shall be minimized. Any unpaved construction exit/entry point along existing paved roads/areas shall be - improved with pavement, aggregate base or similar material, for a distance of 120' from the pavement edge into the site to minimize track -out. Wet sweeping/flushing of soil accumulations from all paved areas shall be conducted daily, and kept damp during construction hours until so removed. 10. All unpaved construction access and travel ways within the site shall be prepared for traffic prior to commencing grading activities and kept watered down and compacted to retain moisture. content during all construction traffic/activity, including building construction. At a minimum, temporary construction travel ways shall be improved to a 20 foot width. Road lengths shall be watered each day, prior to and at intervals during any traffic activity, and at the end of the day after all activity has ceased. All track -out shall be removed as per Condition #9. C:\Wrkgrp\fdcp99-65.wpd 11. FDCP 99-65 indicates export material will be generated by grading for TR 28603-1. All transported soils and stationary storage piles shall be sufficiently. stabilized, watered down and/or covered as appropriate. Minimum freeboard shall be as established by the Public Works Department as necessary. All on and off -site borrow and spreading areas shall be routinely watered and chemically stabilized after borrow activities to mitigate airborne dust. Off site areas shall secure necessary approvals, or show they exist, prior to use. 12. Any on -site temporary employee facilities (sales, construction, equipment storage, etc.) shall be provided with paved, compacted or otherwise stabilized, parking and access during their operation, with those improvements to be constructed to the applicable Public Works Department standards. This requirement shall apply to any approval for such facilities under a minor use or other permit process. 13. If approved on -site roadways or parking areas are constructed to ultimate. design prior to completion of construction activities, then traffic and parking shall be limited to those paved areas as feasible. No vehicular parking or traffic of any kind is permitted on or over any previously stabilized or other inactive soil areas. 14. Disturbed but inactive development areas subject to additional grading or building construction within 30 days of completion of the initial disturbance, shall be watered daily in conjunction with watering of access roads and developing areas, until an adequate crust is formed. If watering will not achieve this, an appropriate dust suppressant as defined in Chapter 6.16 of the.LQMC and approved by the California Water Quality Control Board, Region 7, shall be applied. All disturbed areas where no further grading, construction or other land disturbance will occur for at least 30 days, shall be stabilized with an appropriate dust suppressant no later than four days after completion of the initial grading. These areas shall be staked, posted or otherwise restricted in order to prevent any access on or across them. 15. Construction activity associated with .this project will occur during high wind activity (February through June) in the Coachella Valley. All active graded areas shall be watered daily at appropriate intervals. A minimum of 1 water truck shall be stationed on -site on weekends and holidays, in addition to the truck required for TR 28603-1. All security personnel shall be alerted to the need for dust control and .instructed to monitor graded areas for wind - generated dust as part of their routine duties. On Sundays, holidays and other non -construction days, personnel shall be on -call for emergency watering in the event of high winds. C:\Wrkgrp\fdcp99-65.wpd I -1 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 - (619) 777-7000 FAX (619) 777-7101 May 10, 1994 TO: ALL ACTIVE AND PROSPECTIVE DEVELOPERS/BUILDERS IN THE CITY OF LA QUINTA RE: PM 10 PROGRAM REPORTING REQUIREMENTS FOR FUGITIVE DUST CONTROL PLANS Dear D'eveloper/Builder: - - The Coachella Valley PM 10 Program has been in its implementation phase since December, 1992. Among the required control measures was the enactment by Valley cities of dust control ordinances which .require builders to implement dust... control actions. _during construction, demolition and paving activities. In conjunction with City staff members, we ask your help with the reporting requirements. A significant aspect of the. PM 10 Program is the'need to report statistical information to the Federal Environmental Protection Agency via the South Coast AQMD and the State of California Air Resources Board. In response to this requirement, a Dust Control Reporting Form has been created, a copy of which7is attached. It is requested that if any project developers have amounts to report for any PM* 10 mitigation, these forms must be filled out. This form is. intended to supplement Attachment "B" of the Fugitive Dust Control Plan by providing specific cost figures related only to dust control measures. The South Coast AQMD has requested that the retroactive operative date be January 1, 1993, for..... reporting purposes. This means that each jurisdiction is requested to review projects since that date where PM 10 control measure expenses have been incurred by developers, whether or not they have . been incorporated as part of a Dust Control Plan, and forward this data to CVAG as soon as practical. Your cooperation in completing these forms'as part of -the grading permit procedure will help assure - that the Coachella Valley and the development community as a whole receive deserved credit for the effort to attain Clean Air Act standards for PM 10. Very truly yours, ARRY HERMAN Planning & Development Director JH:WHN:bjs Attachment r* MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253 �, L A M 170164066-10 d � BANK&TRUST SWH Hermitage, LLC — 9467 Milliken Ave., Rancho Cucamonga, CA 91730-6004 Sue Gowan (909)481-3002 P.O. Box 2729, Rancho Cucamonga, CA 91729-2729 Attn: Construction Disburse Line lterrl No. Amount aw$ 11500,00 Voucher N 2 0 0 0 0 2 0 lezz ! 1 Off Site On Site. Lo Tract (If m`ore,than one lot involved, show Lot No's.) Pay to � �- .. $� of labor, seryice'?;;,e"quipment or material furnished) (Description of IabSorrservices, equipment or material furnished) (Property address) material furnished) r , g ate) (City) THIS VOUCHER MUST BE ACCOMPANIED BY PAYEE'S INVOICE (WHEN APPLICABLE), THE LABOR AND MATERIAL WAIVER AND RELEASE ON REVERSE MUST BE COMPLETED. For the purpose of inducing PFF Bank & Trust ("PFF") to make payment of the above sum, the undersigned certifies that the above described labor, services, equipment, or material have been actually performed or delivered by the persons, firms or corporations named herein, and that they conform to the plans and specifications for the job submitted to PFF and that there is no agreement to accept any rebate or "kickback" of money, labor, services, equipment, or material from any person or firm with respect to this Voucher. The undersigned also unconditionally requests PFF to pay this Voucher in full and holds PFF harmless in connection with such payment. T_ L/_L (Borrower Name) I (Authorized Signature) �c (relephone No.) (Date) PFF may, solely for protection of its security interest, at any time require an inspection before making payment on a voucher. California Penal Code Sections 484b and 484c provide that it is a crime to willfully submit false Vouchers and/or misuse construction loan funds. A Voucher may be mailed in or presented for payment in person during regular office hours. Vouchers are normally payable within one week after receipt by PFF, subject to sufficient funds being available and completion of any inspections required by PFF. (Office only) Payment approved: Check No. Paid by Date PAYEE TIN Tax Identification Number of Payee. is required formoucher payment. The individual signing the reverse side of this form certifies under penalty of perjury that the tax identification number shown on this form is the correct number for the payee of this voucher. The following Certification is a part of the Labor and Material Waiver and Release on the reverse side of this document. CERTIFICATION For the purpose of inducing PFF Bank & Trust to issue a check in payment of the total amount shown on the face of the accompanying voucher ($ amount of voucher) the undersigned Payee represents and certifies: (1) that the labor, services, equipment, or material, set forth below, have actually been furnished to the job site described below (or materials have been taken from Payee's stock if indicated); (2) that unconditional payment for such labor, services, equipment, or material (including any fringe benefit payments due pursuant to a collective bargaining agreement) has actually been made in full to the date indicated on the accompanying voucher, or that if any of such amounts remain unpaid, the proceeds of the accompanying voucher are being taken in trust for their payment; (3) that the listing below of laborers, material or equipment suppliers, and subcontractors is a full and complete listing of all those who were employed (or delivered services, equipment, or material) for this job in connection with the work described below; and (4) that there are no straw or dummy persons, nor padded bills, included, and that there are no rebates or "kickbacks" agreed to, or to be made to, any owner, general contractor, sub -contractor, or employee thereof, or any person, in connection with the work described below, or the job premises described below. 2310-A 1-98 BANK & TRUST LABOR AND MATERIAL WAIVER AND RELEASE ATTENTION ALL PAYEES: California Civil Code Section 3262 requires the use of specific forms for the waiver and release of claimant's rights. PFF reserves the right to require completion of the appropriate forms by any of the laborers, material or equipment suppliers, or subcontractors identified herein before making payment on the accompanying voucher. INSTRUCTIONS: Each section of this form which relates to the accompanying voucher must be fully completed in ink (please print or type). Failure to do so may make this form unacceptable and result in non-payment of the accompanying voucher. The Certification on the reverse side of this form applies to the undersigned payee; read it before signing this form (make sure the dollar amount is filled in). 1. LABOR OR SERVICE. If accompanying voucher includes amounts for labor or services performed, identify name of laborers, type of labor performed, and dates of employment represented by accompanying voucher. Dates Name Type of Labor/Service From - To 2. EQUIPMENT OR MATERIAL. If accompanying voucher includes amounts for equipment or material, identify items supplied, sup- plier's (company) name, address and telephone, and ATTACH A COPY OF YOUR INVOICE/DELIVERY TICKET (this information is required even if material was not delivered or billed to job site by supplier): EQUIPMENT OR MATERIAL SUPPLIER'S (COMPANY) NAME (Telephone) Check One: ❑ Material was billed or delivered to job site ❑ Material was taken from stock 3. SUBCONTRACTORS. If the 'accompanying voucher includes amounts Jor payment to a subcontractor, identify subcontractor's (company) name and telephone; kind of work, amount of subcontract, amount already received on the subcontract (not including amount of the accompanying voucher), and amount that is still due on the subcontract (including amount of the accompanying voucher): SUBCONTRACTOR'S (COMPANY) NAME (Telephone) Subcontract is for - (Kind of Work) Total amount of subcontract $ Amount previously received on subcontract $ Balance due on subcontract including amount of this voucher $ *********************************************** CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT Upon receipt by the undersigned of a check from PFF Bank & Trust in the sum of $ payable to and when the check has been properly (Payee) endorsed and has been paid by the bank upon which it is drawn, this document shall become effective to release any mechanic's lien, stop notice or bond right the undersigned has on the job of (Owner) located at also described as Lot , Block (Property Address) (City) Tract ,to the following extent. This release covers a progress payment for labor, services, equipment, or material fumished to (Customer) furnished after said date. (My retention amount to date is: (Date) By ut orized Signature Payee) through only and does not cover any retention or items (Date) (Company -Name if Applicable) (title if Applicable) Payee Address (Street) (City) (State) (Zip) Y //v e A 0 M E S Project: qc( Date Needed: Account: Amount: Payable To: CJ 1, -0.( I.D. #: Address: Phone City State ZIP Description: DISA Co,4,v) - CASH Le 4 4v- b CQrql Requested By: Voucher* Approved By: Check * Check Issued By: i Check Date: I ,"161 Indiana Avcnue,-1�•,crs1'dc, California92506 'gog,+%z 84-0840 F"-'c 1'1'Q09' —84-0841 1, 0 ° -° With proper validation this form constitutes an CITY OF LA Q0UNTA encroachment permit APPLICATION FOR PGR[N|l[ PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the construction of public o, private curbs, driveways, pavements, sidewalks, parking |ms, omwen' water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS DATE: - LOCATION OF CONSTRUCTION Subdivision Improvement Permit — Class III _-------__ Minor Improvement Permit Class |V (Street address o,Description mLocation) PURPOSESketch (attach construction plans if appropriate) DESCRIPTION OFCONSTRUCTION / DIMENSION OF INSTALLATION OR REMOVAL 2­� 4 /\�� SIZE OFEXCAVATION, |FNEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN. APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COSTu (including removal of all obstruction, materials, and debris, baokfi||ing'com- paction and placing permanent mou,fxoino and/or replacing improvements) In consideration of the granting of this permit, the applicant hereby xUmos to: |nuamnnv uo�nu and save mm uuv its aumvnzm� wnm� oo�om. mnm�nmuvo unuomn/ove�.xu"n/*m,mmumumw/nmvnvonu x '� �, ' °= y ��/ti� /��/m� m /ma mm/*� �m a�� o, �v� �m m� �mnu out m any a�me�' /ma o, uo�� m �omno o, n��,ty xunnen/no or uomu,,ino a, a proximate result of any wm,x undertaken vmm, the nenn/t granted pursuant to this application. wmih/ the Administrative xumv,/n, at /eom twenty-four (24) hours madvance mthe time when work will be started. comn|v with all apnxoamo oin/ onuinenoos' the m,mo and conditions of the permit and all unnxoomo rules and regulations o/the City of La Quinta and to pay for any additional replacement necessary as the result of this work. ~ ` Signature of,Applicant or Agent Name ofApplicant (please n,irt) 8udneaAddmo Telephone No. Name ofContractor and Job Foreman Business Address Telephone No. '/���8'�9� Contractor's License No. City Business License No. PAID Applicant's Insurance Company Policy Number MAY I (() IS* FEES: Subdivision Improvement Permit Class U| Public improvements: 3&nfestimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Perit Class |V See attached schedule Inspection Fee $ ^ Permit Fee TOTAL: $ Receipt No. Received by Date Of LA QUINTA PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By — Administrative Authority Recorded by 11Telephone: (Gi9)777-7O75