Loading...
3369MOTE: With proper validation this form constitutes an encroachment permit u CITY OF LA QUINTA u 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 I I I DATE: 1-17- 01 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Tract 28409 - Avenida Montezuma (Street address or Description of Location) PURPOSE OF CONSTRUCTION Domestic Water Service DESCRIPTION OF CONSTRUCTION 8" stub out - ti tee 3-8" gate valvea & 2-6" to 0- reaucers DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED lV X to APPROXIMATE TIME WHEN WORK WILL BEGIN r—t—uL Sketch (attach construction plans if appropriate) APPROXIMATE TIME OF COMPLETION a tip—Ul 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: Cm See attached conditions Indemnify, Mend, 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. Name of Applicant (please print) Signature of Applicant or Agent P.O. Box 1058 Coachella CA, 92236 398-2651 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 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 $ Permit Fee _0— Penalty Cash Deposit -Surety Bond if required —0— TOTAL: $ Receipt No. Received by Date Recorded by PERMIT NO 3331) PERMIT VALIDATION 3369 DATE APPROVED 1-17-01 EXPIRATION DATE 4-25-01 DATE ISSUED 1-17-01 Administrative Authority Telephone: (760) 777-7075 The following General and Special Provisions arc attached to and made a pan of Permit No. -3� GENERAL PROVISIONS The following shall always apply:, ENROACHNEM 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. 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 Quints shall request that these portions of road be resurfaced over thew entire width. Resurfacing Shall consist of one coat of two inches (I') of A.C. surfacing plus appropriate seal cost as specified above. PIt07EC ON OF TRAFFIC- All excavations and work areas shall be properly lighted and barricaded as deemed necessary by the City Engineer or La Quints City Public Works inspectors. Suitable detours and detour signs shall be placed and maintained for the duration of the project. 7'he City shall be notified.24 hours in advance of any traffic detour$ 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 Quints 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 shalt be removed from the -fight 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-WA7ER 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-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, perminee shall contact this office to obtain the necessary permission. SPECIAL PROVISIONS following shall apply when indicated: M03MCA71ON: Permittee shall notify the City at (619)777.7075 at least 48 hours in advance of starting construction. ®R2UTILITY CLEARANCE: (Substructures) Prior to making any excavation within the City of La Quints right of way authorized by permit, the permittee aball .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. RUTELM CLEARANCE: (Surface Structures) No work shall be done under this permit until all utilities.am clear of the proposed work site. The perminee shall notify all concerned utility companies of the proposed work. R4 PAVEMENT WIDENING: Area between the proposed concrete gutter fine 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 leas than and in conformance with City of La Quints Road Improvement Standards and Specifications, Ordinance 0461. R'S PARKWAY GRADING: Area between the property fine and top of the proposed concrete curb sball - be graded to a slope of 1/4 inch to one foot (1�. R6 GRADE- CHECKING: City of La Quints shall check grades upon receipt of plan and profile and/or grades as established by a ficensed 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 Quints Standard #207. Re DRIVEWAYS: A.C. driveways shall be concocted 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 concoction shall conform to attached drawing. (i9) SIGHT CLEARANCE: Sight clearance of 600 feet in all directions shall be assured and maintained at all times. R10 SOIL STERILIZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application sball eommply with.the manufacturer's specifications. EL6I [ palep 'aloto;llgO;o altos 's(emg8.H }o uoislA!Q 'suoneoyl7adS ptepuviS aN Jo 10•E'9 uoaoaS qt!* kldmoo Iptgs stsat uonaedmo0 •pogtam play to lnedml aqt Aq pau!mtalap se uopoedmoa totsat8 aqt g! taAaga!gM'panwl 8alpanouns aqt 03 taap3A!nbe to taawad 06 uegl seal too of patoodmoo pus P011ytloaq aq Ilagg IeAomat Mn mot; Bopinsat safoq a8te-1 gomn Ile 1s oggnd 8allaAen aqt t»totd cl pap!Amd ail 1pge eapaauteq to pas aoni ft 'gulp atenbapV -amp aao Aug to tool 005}o mnmlxem.e of patoutsat aq !logs tuom alp '?y;en loutgat of tnessooa eamooaq gt atogA#, •gdwhnd 8atmollo; aqt at poy!a dg ge palosdmoo klggnmogi pus PollYA313q aq Ilegg Oloq dmnto atLL 'Ss*q8!q oqt Jo —1A aI tmnmat sugap ou lsgt oe }o posodolp pae paAomot aq 1ptgo drams am- stp Jo gtpiM atpua oily •atgsA dti*g8tq of px-q to oaaaolJalai tno%- tlaIn PalPueq aq ueo goigm gaopoae at aq hags PQAomat aq of gnat,i •aopgool *ou stl le uon!paoo 8a!*w8 mwo81A a m rail aqt alelapm of aon!mtad oqt }o Lt!I!q!guodsOt aqaq !loge 11 'o!Ignd 8mlaAen otp of pisteq to aauoioltotm inogtt* Aloles Polpavq pas'aoLuas am painsa! pug popuoq'paoaaog a Sq page!ldmoaoe aq IFge X—Jo 11189 pew etmna s•l;o 40 aql mgl!m uonuwla ooty :'IVAOW31l NO NOLLY30- l 331LI. K*d •ajmdat tuoasttuod )o aonoldmoa aodn poosldot aq negs 8utdutg gnnt'pvteAenxo oil of gleans ao alq!g!A l!!ts gi 8mdutg lootte atagM :9NidI1LIS31l 1331LLS £Z)j toaallo3 41:) aql ,(q pau!auoiap w gaols gated Ips tone po!ldds ail 1ptp aoulnmo aplsgdge to oopeaildds as;o 8a!w!guoo )eoa psoo 90) V - IV3S 90d Z`Z2I •nedot pew kmodmal Jo aonoidmon toys sXwp asgl total ou paneld aq hags mil mla goat e co poosld 8aiosltro •yV ragoat ;o goled taouetatad V -Xistsipomm! pooeld aq Iletle 008-OS )o (.i) gagoal oAv l0 8anelgaon gated dtstodmvt s 'pololdmoa aoaq QA9q aopoedmoo pas pytlaeq tayV - jVd31j ,/!tl3W3AVd'.LN3NVVfd[3d i Z d •ttmq ,(gp (s) aAy a peonxe tusmaAed 4swodmat aql }o taomooeld oqi $eqe oseo ou to tnq 'paloldmoo eaonetodo Ilytlaeq pae poteAsoxa uoaq seq gouan Jo too; teaall 000E Jo mnia xeia . s toye peoeld aq Ipggs 8aued tmodmat 008-OS oq.L •opwlgns potedaid a ao psaeld aq IIv 008-JS Jo sogoa! z;o lupslgaoo gored Ctetodmat a 'sao.1wado aonaedmoa pug IIyipeq }o aonaldmoa tayV :S-dly 1i .Il•13HI3AVd dllVItodi-M Z11 'EL6I ,(tenaef Polgp'o-onleO ;o oislS 't(e*gBlg to aopu lQ 'saoneoy!aadS PnpttmS aql to 90•E'9 uonnaS at poalnno se ahem ail !logs sisal aopaedmoO stlsdot luausmtad 8a.4em of loud poly pus p3Amdde io; taoalla3 f4!J aql of POPn^+toJ aq Ilttgs leas qmm Jo .(doe (1) Otto oral **!Alas to la!000tn gnea iol opera aq llegs gim act aedmoa'iojaodsu! otp (q•pw!nboi osll :&Ls2LL NOLL.7Vdwoa 6'1g 'EL6I Jtenael POtgP 'e!tttoJ!IgJ Jo attgg 'sLe*q8!H Jo ao!s!A!Q 'saopeoyloodS ptgpcmS Oql to [0'E 9 aonooS to paalnno go Opera Oil Ipsgo algal oopat4dmoj atledat tuaagmtad Bur im of loud poly pug feAoidds tol taoa!8a3 14!3 sip of poptemtol aq llsge isat gaeo Jo Ldoa (1) ao0 'pew goeo ao wet (1) aao;o mnm!a!m a pug tool Opp[ asgt atom loa;o sptAtatm le Opera ail pegs otgat aopaedmoa'totaodout aqi Xq pat!nbai oo11 :SiC3t. NOLL)VdW03 ' 811i monanaoa ag hogs Llddro tote* aql pas iaAel gaga }o monoq oin gaeat al tplual laa!oylro }o aq !loge otaf aqi 'peen g! 8a!uaf aeon! vats* oql alalat of potantteaoa OR f1I* Oail!p aienbope'laamoluse mnm!xem a tol pasn at 8a!pooy to 8uipood atogtA aonagdmoo totea8 aqt el toAogolq*'putat8 8mpanomns oqi of luopgeinbo to taeotad 06 asgl soot too aq IIsgs aopoodmon Sup I— aqt iegt oe p—ld aq pqo ptuatam 1lyil3eg gaopgtado 8atpoog Xq hams amonxa of potoofgro too a! piuotem IIyXoeq oql teat p--- aq of et otsO •sgidep oAimoxa }o am oagaaaA atagM sy!I GS) too}-oAg )o mnmlxgm a to 8mpool} ato}aq goaon aqt Jo gldap Istot aqt lotaamad ps aetp atom too }o ua,(el a!'pagdde aq hogs Ily:loug jAG3VMV'[d TU_DIOVH Ulf •Atempew oqt;o aogow lwntatuts aqt qtt* paalane aq Iloilo tuawad 56 Jo aogaodmoa awpe!a e 'neeo Aus in inq'patinttogro sq ,(era gpogiom amwailV •lusmdlnba tualeAlnbe to tadmetmq!A Baton patgtq!A pae LE) toaJ aatgi usT.tatea8 too Jo syll al paaeld.oq IRgs Pall tuoptA!nbo to puss x!m-1!9-4 psAwdds aq Iloils pyXaaH :QNVS TILDIOVH 91H •leAstB to pass poAotdde us dq ponsidoi to potaomgiddro ail 11egs ltiq'pyi(aeq tot peon ail too !pigs ao. eaxo 8aunp patatanooao o! go!gA% (feuaiem patattyeg to dlaode) olgetlnoun smoop elupto rl Jo dl!O aqt ga!gm leuatem daV •Ipj:gmq patep!losaoo Clatenbaps us 8uionpotd;o suodtnd tot age AI of pitaom.nap aoaetggro ome8to togto to stom'ggntq}o rat} aq llegs llyt(ooH :INIIULVW TULMVC[ olu-tiro* oqi ao XIIM s s! pguotem aogan=oa oql m1un opera aq !lags aopeAeaxa ON •sLep (S) My lalpoaaxa pouad a tol *ado ammat Ipgge aolteAeaxa ON. ossn goeo m 8mpenutsq aonsAeaxo to (tlllqul!ns aqt aa!aualap hags imoodsul stuoM o!Ignd OtLL '•3!ignd 8ulloAen oql}o aonaotmd aqt tttJ s(eplloq pall tgmoilaa* ao'tg8!ataAo gtgl!! g11m popsautgq Aliadmd aq llegg auopeneaxq llV al8aq isnm gaopetado II.Neq ao;aq gaaan aodo to laa; MUM 0001 m Pal!m!1 ail 1(ggg gaopeneax3 :SNOLLVAV X3 30 LIi1Q'I pill palaottm ail Ipggs go8po tg8lane taamoAed of a8emep Aug 'guopetado 8u!Aed !gay of loud •oy}eA *oy fWaaal aqt alelll!og) teoq of as aoppod a gnro at paoeld ail !pogo ptltatam aopene3x3 ('laamaAed}0 larttnn of loud aleAeoxa 01 peon ail taomdlnba SMUSAgaxa Iptgs saoaetgmnotlo oa topall) '•toaal8og 4!O ay }o aoy}o aql g8nmgl panotdde aq hags 8alunn 1 am* it }o pogloNl 'aopeAaoxa ot'toud o8pa tg2tum a of lggmng a of In* met kljwpngaam aq p!m toamaned• :9lML«13.1j43W3AV(1 •ooasteolo laofwd todotd tot gtaomnaom .(aAtng lie }o tasutaoeldat to aonaldmoo aodn poy.too aq llege anylo ojiLL •etaomnaom dtis }o leAomat aqt at loud iaaal8eg 14!O oqt of pagg!atn} aq hogs staemnuom aoot6 of sap aql Balmogg oatoa;o tog atoldmoo V aaniae mtad aqt )o aodxo aql to to (aAtro to taaol8ao l!A!o paeaao!! s (q paoeldat aq Apoauoo pae Ll!psat kom kagl oe mo pan �(Iataldmw ail !pigs paAIOAal aagm gou!l ,(uadotd to inwAg lie Jo aulualaan oql ao tg!xa ga!gm gaomnuom A*Atna lie 'aopomisuoa }o 8amulloq to aoneneaxa of Loud :9LN3[n1(1N0Nl A3AMS Z j Maofwd elotno e°I}o'dt!O}o wMS' tp" aoaotoltatut to (slap apnloatd of motol etu!n0 e-l;o 4!O to atslS aql gtlm patea!ptooa aq hogs 4JoA% llmtad g!qt }o pouad aql 8aunp eats e!qi. al tanpaoa kom ela!no e-1 to 410 to emto;tls);o ale1S aql galgm aongtado (ag o7 palaulPtogng ail !legs tNbm pasodwd ail L :}(EOM 3J tlNIQll000 j SPECIAL CONDITIONS --PERMIT NO. 3369 --- CVWD --- 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. CVWD, hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and erosion control. All areas shall be kept watered down daily including weekends. 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 1st 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 lst 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. 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 Perniittee's responsibility to appropriately detour and barricade all construction sites. Special Conditions - Permit No. 3369 Page 1 of 4 ,,. SPECIAL CONDITIONS --PERMIT NO. 3369 --- CVWD --- 8. 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), 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. Special Conditions - Pennit No. 3369 Page 2 of 4 • SPECIAL CONDITIONS --PERMIT NO. 3369 --- CVWD --- F. 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. G. 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. H. 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. 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. Special Conditions - Permit No. 3369 Page 3 of 4 SPECIAL CONDITIONS --PERMIT NO. 3369 --- CVWD --- C. Permanent pavement replacement shall be installed using a City approved 3/4" max medium asphalt concrete as the base course lift and a City approved '/z" max medium finish course lift for capping. Asphalt concrete mix design shall be approved by the City prior to its placement. D. Cold -Mill and Overlay - The existing pavement which was properly protected in place during the trenching operation located adjacent to the trench sawcut shall be cold -milled to a depth of 0.10 feet with butt joint created next to the existing unmilled pavement surface. The cold - milled area and base asphalt concrete in the trench area shall be overlaid with a City approved C2-AR-4000 asphalt concrete mix. The width of the cold milling area shall be as follows: • For longitudinal trenches located in a parking lane: two (2) feet outside the sawcut removal lines. • For longitudinal trenches located in a traffic lane: two (2) feet outside the sawcut removal lines, or to the lane line striping, whichever is greater. • For transverse trenches across existing street: two (2) feet outside the sawcut removal lines. E. If grinding and capping operations are not performed in the same day as base paving operations, the base course lift of 3/4" 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. F. 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 permanently stabilize any and all soil that was disturbed as a result of work performed under this permit with an approved dust control treatment. Soil stabilization shall be done immediately after completing the operation. 17. 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. 18. This permit allows for the installation of a 1-8" water stub out in Avenida Montezuma as shown on CVWD drawing #s 23384 & 23385. 19. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. Special Conditions - Permit No. 3369 Page 4 of 4 NOTE: With'oper validation th+�orm constitutes an CITY OF LA QUINTA e�icroachment 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 s Subdivision Improvement Permit— Class III DATE: 1—i7—Q1 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Tract 2840.9 - Avenida Montezuma (Street address or Description of Location) PURPOSE OF CONSTRUCTION Domestic Water Service Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 8" stub out — 8" tee 3-8" Rate valves & 2-8" to 6"" reducers See attached conditions DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION,' IF NEEDED 10 x 10 APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE.TIME OF COMPLETION 4-10-01 ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) Inconsideration 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 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 $ Permit .Fee -0- Penalty Cash Deposit -Surety Bond if required TOTAL: $ _0— Receipt No. Received by Date 6 PERMIT VALIDATION PERMIT NO., 3369 DATE APPROVED 1-17-01 EXPIRATION DATE 4-25-01 DATE ISSUED 1.47-01 By (/mil J( Administrative Authority Recorded by 11 Telephone: (760) 777-7075 The following General and Special Provisions are attached to and made a part of Permit No. GENERAL PROVISIONS The following shall always apply: - ENROACHME T 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. 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 oboes 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 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 cost as specified above. PROTECTION OF TRAFFIC: AU excavations and work areas shall be properly lighted and barricaded as deemed necessary by the City Engineer or La Quints City Public Works inspectors. Suitable detours and demur signs shall be placed and maintained for the duration of the project. The City shall be nodfied.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 sbaU be replaced in land. In the event it becomes necessary to remove or cut existing drainage structures, City of La Quints 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 tight 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 exec" 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 Quints roads, it shall be the responsibility of the permince (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 following shall apply when indicated: No Permittee shall notify the City at (619)777-7075 at least 48 hours in advance of starting construction. ®RZUTILITY 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 UTTIITY 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 le" than and in conformance with City of La Quints Road Improvement Standards and Specifications, Ordinance 0461. R'S PARKWAY GRADING: Area between the property Ube and top of the proposed concrete curb shall be graded to a dope of i/4 inch to one foot (I). R6 GRADE- CHECKING: City of La Quints 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 (__�het) 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 L Quints Standard 1207. 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. SIGHT CLEARANCE Sight clearance of 600 feet in all directions shall be assured and maintained at all times., CS R10 SOIL STERE IZEW The area to be surfaced shall be treated with soil sterilizer. Rate of application shall cotnmply with.the manufacturer's specifications. R11 COORDINATE WORK: The proposed work shall be subordinated to any operation which the State of California or City of La Quints may conduct in'this area during the period of this permit. Work shall be coordinated with the State or City of La Quints forces to preclude delay or interference with State of City of La Quints projects. R 12 SURVEY MONUI►lEN'IS: Prior to excavation or beginning of construction, all survey monuments which exist on the centerline of all streets or property lines when involved shall b'e 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. R 1 PAVEHg.NP' CITITING: 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 beat facilitate the general flow traffic. Prior to final paving operations, say damage to pavement straight edges shall be corrected. R14 LitMJT 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 wort site. 1� BACIff'ILL 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 Quints 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 road or gravel. R16 BACKFILL SAND: Backfill shall be. approved transit -mix and or equivalent and shall be'placed in lifts of not greater than throe feet (3) and vibrated using vibrotamper or equivalent equipment. Alternste methods may be substituted, but in any Caro, a relative compaction of 95 percent &ball be attained with the structural section of the roadway. R17 BACKFILL PLACEI► 014T: Backfill shall be applied. in layers of not more than 50 percent of the total depth of the crouch before flooding or a maximum of five-foot (5) lifts where trenches are of excessive depths. Caro 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 then 90 percent or equivalent to the surrounding groin, whichever is the greater compaction. Where ponding or flooding is used for 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 testa 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 teat &ball 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 testa 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 SC400 &hall be placed on a prepared subgrade. The SC400 temporary paving shall be placed after r maximum of 3000 linear feet of trench has been excavated and backfill operations completed, but in co 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 incbea (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. R2"2 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. �DR23 STREET RESTWING: Where street striping is still visible on streets to be excavated, such striping @ball be replaced upon completion of permanent. repairs. R24 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quints road right of way shall be accomplished by a licensed, bonded and insured tree service, and bandied 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 boles 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: 3369 --- CVWD --- 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. CVWD, hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and erosion control. All areas shall be kept watered down daily including weekends. 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 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. 3369 . Page 1 of 4 FN SPECIAL CONDITIONS -=PERMIT NO. 3369 --- CVWD --- 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 (S SPWC), 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. Special Conditions - Pemut No. 3369 Page 2 of 4 SPECIAL CONDITIONS --PERMIT NO. 3369 --- CVWD --- F. 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. G. 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. H. 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. 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 cannot 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. Special Conditions - Permit No. 3369 Page 3 of 4 SPECIAL CONDITIONS --PERMIT NO. 3369 --- CVWD --- C. Permanent pavement replacement shall be installed using a City approved 3/4" max medium asphalt concrete as the base course lift and a City approved '/z" max medium finish course lift for capping. Asphalt concrete mix design shall be approved by the City prior to its placement. D. Cold -Mill and Overlay - The existing pavement which was properly protected in place during the trenching operation located adjacent to the trench sawcut shall be cold -milled to a depth of 0.10 feet with butt joint created next to the existing unmilled pavement surface. The cold - milled area and base asphalt concrete in the trench area shall be overlaid with a City approved C2-AR-4000 asphalt concrete mix. The width of the cold milling area shall be as follows: • For longitudinal trenches located in a parking lane: two (2) feet outside the sawcut removal lines. • For longitudinal trenches located in a traffic lane: two (2) feet outside the sawcut removal lines, or to the lane line striping, whichever is greater. • For transverse trenches across existing street: two (2) feet outside the sawcut removal lines. E. If grinding and capping operations are. not performed in the same day as base paving operations, the base course lift of 3/4" 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. F. 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 permanently stabilize any and all soil that was disturbed as a result of work performed under this permit with an approved dust control treatment. Soil stabilization shall be done immediately after completing the operation. 17. 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. 18. This permit allows for the installation of a 1-8" water stub out in Avenida Montezuma as shown on CVWD drawing #s 23384 & 23385. 19. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. Special Conditions - Permit No. 3369 Page 4 of 4 A rim 0 NOTE: With proper validation this form constitutes an encroachment permit CITY OF LA OUINTA 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: I Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION a Nfnrl4Pn IStrest address or Description of Locatlonl P(MPOSE OF CONSTRUCTION DESCRIPTION QF, CONST CTION rr n I— n DIMENSION OF INSTALLATION OR REMOVAL ' SIZE OF EXCAVATION, IF NEEDED - & - A- WT APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ X hQ10 - --- (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: Sketch (attach construction plans if appropriate) �Jel✓ aAAMed C IA eyra t)",�,5 ;338y-,4 a3a,F5 Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all pe happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this nalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or pro peity application. Notify the Administrative Authority at least twenty -lour 1241 hours in advance of the time when work will be started. Comply with all applicable City Ordinances, the terms and conditions of th permit and all applicable as and egulations of the City of La Ouinta and to pay for any additional replacement necessary as the res t of this work. ignature of AppficaAt or Agent 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 $ `,j Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: S Receipt No. Received by Date PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: (6191 564.2246 Recorded by