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3267..,NOTE;^ With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION •(ENCROACHMENT) For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit— Class III DATE: 8/9/00 a Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 78-070 Calle Cadiz in alley way cross st. Desert Club Dr (Street address or Description of Location) PURPOSE OF CONSTRUCTION Replace 1" water service Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION See Attached Special Conditions DIMENSION OF INSTALLATION OR REMOVAL See Special - SIZE OF EXCAVATION, IF NEEDED 5' x 5' bell bole. APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION 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: Indemnify, defend• and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started. Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of La Quinta and to pay for any additional replacement necessary as the result of this work. Signature of Applicant or Agent CVWD P.O. Box 1058, Coachella, CA 92236 398-2651 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 I I I 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" J Penalty Cash Deposit -Surety Bond if required TOTAL: $ "0" Receipt No. Received by Date. Recorded by S -'y7j .1 3 267 i PERMIT VALIDATION t PERMIT NO. 3267 DATE APPROVED 8/10/00 EXPIRATION -DATE _;19130100 DATE ISSUED SAID/00 AdministriveAuthority Telephone: (760) 777-7075 NOTE: With proper validation this form constitutes an encroachment permit CITY OF LA QUINTA APPLICATION FC{R PERMIT, PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS DATE: �5 — S —O d Subdivision Improvement Permit — Class III Minor Improvement, Permit Class IV LOCATION OF CONSTRUCTION % 9 —o % 0 C4 LLL C4/i/Z / ti,Q?i(i[ �� d1/•� �/ S r'i�Lsc2i c wd /9 t Do 6/3 g /1-oo (Street address or Oescription of Locationt PURPOSE OF CONSTRUCTION Sketch (attach construction lens if l�12-1 -1 L1� P appropriate) DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED k/-to LE. APPROXIMATE TIME WHE14 WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST S (Including removal of all obstruction, materials, and debris, baccfilling, eom. Pacuon and placing permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, the applicant hereby agrees to: ea>� f�� ate•-s. ff-A�41-L Indemnify,- defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or Iota 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 -lour 1241 hours in advance of the time when work will be started. Comply with ell apphCAlble City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of La Quints and to pay for any additional replacement necessary as the result of this work. 1 ' Signet a of Applicant or Agent ' �a130y 10rl t^_oAcHrc�09 cA it0' 3 Se z1Ji 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 GEN. LIAtSILITy Policy Number FEES: Subdivision Improvement Permit — Class I II Public improvements: 3%of estimated construction costs Private improvements: 3%of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ _ --— Permit Fee _ —�— Penalty Cash Deposit -Surety Bond if required TOTAL: S Receipt No. Received by Date PERMIT VALIDATION PERMIT NO. J 1?1 01 1 DATE APPROVED A(_/p — ZOOy EXPIRATION DATE 119 " .30 — Zad C:> DATE ISSUED AP "Zoo a BV v �S G r Administrative Auinonty I3°uc° IM t CUSTOMER REQUESTS operatlon Deparhnen Service Center AND WORK REPORT (SERVICE DEPARTMENT) Trades and Support E ineeri (OPERATIONS) (TRADES) Acc°untirg Department $" _ Date: Time: �aease Area No: Meter No. Location: _ O �c /� C-f Work Order or USA DigAlert No 21 y / S Repair Code #: Account No: O%c 024- C Time Received: Time Responded: Time Arrived: Time Departed: Remarks:"r J� D& Repair Codes Circle all that apply) © Main/Service Leak S i .�. ; e .� A No Water / Pressure Cause, action and/or damage report: B Sand/Air in Lines F Odor/Taste C D Referred By: c' Turn On / Off G Assist Gust./emp. Mtr Leak/valve/box/et H Call Out Flow Test results. Meter: Size: Model: GPM Customer contacted: ( ) Yes (?() No IMeter Reading 3116 g' Static PSI: Flow PSI: Comments: /r" - System pressure below 5 PSI?: Yes( )*No( ( ) Comments: *If Yes, Disinfectant used: Gas ( ) Granular ( ) Tablet ( ) Solution ( ) None ( )•' **If None, explain: /n // Cc w S Mainlin : iz and T e W/S: Size andTVpe No. of Job Numbers) Sawcut(s) Size Sa.Feet Jobs LABOR and EQUIPMENT ID NAME REG 9T EQUIPMENT NUMBER/TYPE MILES MATERIALS USED: IBM NO. DESCRIPTION IBM NO. DESCRIPTION -QT--Y Total Coliform Test Rg uest and result Summary For Water Resources Sample Location: Same as above; OR: SSNO: 49900 Sample Date, Time, and Collector ID (YYMMDDHOURID#): CL2 Residual: mg/I Type: Test (TS) I Matrix: Groundwater I Preservation: Iced Test.Results: Present ( )Absent ( ) Corrective Action: If any information on back side, Check here ( ) 1J� �' Supervisor Service Worker The following General and Special Provisions are attached to and made a part of Permit No. ' GENERAL PROVISIONS The following shall always apply: ENiROACHNTLNP ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within City of La Quints 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. TRACRLAYING CONSTRUCTION EQUIPME14P. Cleated tracklayiug 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, Ciiy.of La Quints, 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 cast as specified above. PROTECTION OF TRAi'I Q All excavations and work area 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 materiel 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 requited, 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 Quints. roads, it shall be the responsibility of the permittee (contractor) to control this water and to provide off-ftreei 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 muse close a street for MY length of time, permittee shall contact this office to obtain the necessary permission. SPECIAL. PROVISIONS The following shall apply when indicated: Rd NOTTFTCATTON' . Permutes shall notify the City at (619)777-7075 at least 49 hours in advance of starting construction. RZ I rEUTY 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. R3 11TELM 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 claim _ aggregate subbase course having an 'R' value of not lemur than and in conformance with City of La Quints Road Improvement Standards and Specifications, Ordinance #461. RS 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). R6 GRADE• CHECENG: Cityof Le Quinta shall check grades upon receipt of plan and profile and/or grades as established by 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. Depressed curb, matching concrete gutter and concrete driveway approach shall be constructed in conformance with City of La Quinta Standard./207. Ra 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 clew aggregate base, Driveway construction shall conform to attached drawing. 4RIO5" SIGHT CLEARANCE: Sight clearance of 600 feet in all directions shall be assured and maintained at all times. SOIL gn= ZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall commply with.the manufacturer's specifications. 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OOO1 o3 PQ)!m I Oq ilvgs saopeneoxg :SNOLLVAVOXZ AO JJw I PT I pv3*ottom oq tIM -Spe 3g8!eA8 3aomoAsd m o8emep dae 'veopuodo 8auad temJ o1 toud •otWm mod puml aq3 9MIP*9; 3saq at ae act lead v qmn m pametd aq 118g9 lauamm cotteAsmxg (3aomened;o 8op3nm of Loud *3ana*xa o) peen oq 3o*mdln6o HBpaAemxa ilaga sa*avlamnmtw on tapuN '•tgemft A!O sip jo ao!I;o sip 48nmip paewdde aq Hvg9 Hug3nm 3aomanad;o pog3oyg aogeAsmxo of Loud o8pa 3g8leAs a o3 3g8tvt3s a o3 inm Mw dliemioeymam oq Ii!M ioomanad :9NLLL(I0 .IN3p vj £ T2I ooauealm ioefwd todwd mg stuamnuom doAttw ile;o iusmaavidat to uopoldmo* uodn poypoa aq nags -via slay •s3Qamnaom f-jo leAomot aal at toud taaulfwa 4!O ag3 of p9g9tatn; aq nags staemnuom amp r o3 sap sip Huy-gv emou;o tas aividmoo V •aanimtad sip jo vsaodxv aql 3s to.(aAtns to taeutguo I!A!o pasa*an v dq pamaidai aq dpmauom pee (itpsat (era dag3 os lno pap Almaldmom ag hags paAloAu! aagm saug (ltadwd to s3aat3s lls;o augtalaam -^ agl no ls!xo go!gm sivamnuom daAtno lie 'aottonttsaom;o Huluut89q to ao!38ABmxa of Loud :&LV3W HOW AaAHM Z j •st*afwd elmn0 eZ;o Ala jo 9mS Qt!M a*aetejj*iu! to dvlep opnlmatd of s*oto; elainb TIJo Alto to ate3S am (mm paiemptoo* aq Begs )uotA •i!mtad sigi;o pound ag3 Haunp eats 9!gt at tonpuo* kam e3tgnb eZ ;o Alto to BmtoJ!le0 Jo o3etS aq3 gmlgM 0opetado doe of palemptogns a911egs titoM pasodwd vgy :}niOM tZLVHI0I1i000 j j 2I SPECIAL CONDITIONS --PERMIT NO.3267 ---Coachella Valley Water District (CVWD) --- In addition to the standard permit conditions, the following shall apply: 1. 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. Coachella Valley Water District (CVWD), 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 i 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 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. Pursuant to Section 14.16.290 of the. La Quints 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. Special Conditions - Permit No.3267 Page 1 of 4 SPECIAL CONDITIONS --PERMIT NO.3267 ---Coachella Valley Water District (CVWD) --- 9. Prior to excavating, if required, the Permittee shall contact Underground Service Alert at 1-800-422- 4133. It shall be the Pernuttee'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), except as otherwise specified herein. Native material may be used as backfill material provided that minimum compaction, achieved in the manner prescribed herein, is achieved. Backfill shall be performed by mechanical means; no water densified compaction via jetting or flooding or other means shall be allowed. It shall be the Permittee's responsibility to provide appropriate geotechnical supervision, testing, and inspection, onsite, at all times during backfill operations. Backfill compaction shall be achieved by the following conditions: A. When a firm foundation is not encountered due to soft, spongy or other unsuitable material, such material shall be removed to the limits directed by the Geotechnical Inspector and/or the City Inspector and the resulting excavation backfilled with pipe bedding material. B. Backfill materials shall be brought to or maintained at an appropriate moisture content .for compaction. The appropriate moisture content range shall be established at the onset of the project and ensured prior to use of the materials through progress testing on the stockpiles. C. The first length of trench backfilled shall be backfilled in the presence of the City Inspector. Compaction shall be tested at random depths at approximate three-foot vertical intervals as backfill is placed to ensure the effectiveness of the compaction methods and to establish the depth of lift that can be compacted. D. If lifts greater than one foot are attempted in this trial length of trench, compaction tests shall be taken within the lifts to ensure that the full depth of the lift is compacted. Upon satisfactory completion of this portion of trench, the City Inspector shall establish the maximum lift thickness to be compacted for the remainder of the project. E. In subsequent lengths of trench, the frequency of compaction tests shall equal one per each lift of backfill, per 300 linear feet of open trench, at randomly selected locations within the open length of trench. Special Conditions - Permit No.3267 Page 2 of 4 SPECIAL CONDITIONS --PERMIT NO.3267 ---Coachella Valley Water District (CVWD) --- F. The depth of the randomly selected compaction tests shall also be randomly selected except that where multiple tests are required in a given length of trench, the tests shall be no closer than three feet (vertically) from each other. G. If any compaction test fails, previously placed backfill (in the same length of open trench or previous lengths of trench) which is represented by the failing test (as determined by the City Inspector), shall be tested for compliance with compaction requirements. H. All costs incurred due to the conditions above shall be borne by the Permittee. Copies of all test results shall be furnished to the City Inspector. 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 replacement shall conform to the following conditions: A. Existing asphalt concrete pavement shall be sawcut one (1) foot beyond trench edges. Edges shall be straight and clean. ' B. Permanent pavement replacement structural section, within all trenches, shall be 1" thicker than existing of asphalt concrete over the same existing thickness of crushed aggregate base or crushed miscellaneous base, meeting the requirements of Sections 200-2.2 and 200-2.4 of the Standard Specifications for Public Works Construction. The replaced pavement and base material shall be compacted to 95% relative compaction and respectively tested, for each 300 linear feet of trench. Verify exact structural replacement section thicknesses with the City prior to installation. C. Permanent pavement replacement shall be installed using a City approved %" max medium asphalt concrete as the base course lift and a City approved %2" max medium finish course lift for capping. Asphalt concrete mix design shall be approved by the City prior to its placement. Special Conditions - Permit No.3267 Page 3 of 4 SPECIAL CONDITIONS --PERMIT NO.3267 ---Coachella Valley Water District (CVWD) --- D. For transverse trenches across improved streets, the existing pavement surface, three (3) feet on either side of the excavated trench, shall be cold -milled to a depth of 0.10', with a "butt" joint created along each edge of the cold -milled area, and a new 0.10' lift of %" max medium asphalt concrete pavement overlay applied throughout the cold -milled area. E. For longitudinal trenches within improved streets, the existing pavement surface, through the lane width (within lane line striping), shall be cold -milled to a depth of 0.10', with a "butt" joint created along each edge of the cold -milled area, and a new 0.10' lift of/z" max medium asphalt concrete pavement overlay applied throughout the cold -milled area. F. If grinding and capping operations are not performed in the same day as base paving operations, the base course lift of/4" max medium asphalt concrete shall be installed from saw -cut edge to saw -cut edge flush with the existing street surface. The base course lift of paving shall not be left 0.10' low in anticipation of grinding and capping. G. Any existing lane .striping affected by this resurfacing shall be replaced in kind by the Permittee, as directed by and to the satisfaction of the City Engineer. Affected traffic signal loops shall be removed and replaced in kind. The finished pavement surface shall be smooth, consistent, and shall'conform to the surrounding grades. 16. Permittee shall notify the City of La Quinta Public Works Department, Mr James Lindsey, 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 10 § 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. Stock pile shall be permanently stabilized with an approved material at the completion of the operation. 21. This permit allows for the installation/replacement and to maintain a one inch house water service at 78-070 Calle Cadiz. Special Conditions - Permit No.3267 Page 4 of 4