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3593NOTE:_- 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 DATE: 12/17/2001 LOCATION OF CONSTRUCTION 53 240 AVENIDA RUBIO (Street address or Description of Location) Subdivision Improvement Permit— Class III Minor Improvement Permit Class IV PURPOSE OF CONSTRUCTION TN.kTAT.T, ANn MATNTATU A Sketch (attach construction plans if appropriate) ONE INCH DOMESTIC WATER SF.RVTf:F, T.TNLr DESCRIPTION OF CONSTRUCTION SEE ATTACKED SPECIAL CONDITIONS DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN .APPROXIMATE TIME OF COMPLETIONNTVE-'y DAXQ ESTIMATED CONSTRUCTION COST $ 1 1 nn nn (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 f`tlia'tI D0 AQV 1 nSR rnAr..RVT t.A rA Q?1 1A Inn g fi§ a Name of Applicant (please print) Business Address Telephone No. SAME AS ABOVE Name of Contractor and Job Foreman .t Contractor's License No. 1, Business Address Telephone No. City Business License No. Applicant's Insurance Company Policy Number A 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 $ 0.00 Permit Fee 0.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 0.00 Receipt No. Received by Date Recorded by 3593 PERMIT VALIDATION PERMIT NO. 3593 DATE APPROVED 12/17/2001 EXPIRATION DATE Al 41'a 0002 DATEyISSUED gy P i s 4$ r Administrative Authority Telephone: (760) 777-7075� NOTE -- With propet validation this form �� &,�LRtencroachment permit CITY OF LA QUINTA• APPLICATION FOR PERMIT VOF PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)111:� For the construction of public or private curbs. - and other like public works improvements in Connection w th AlPam. sidn"U11. �9 lom sewers. voter mains eetiofs with INOR IMPROVEMEMM&WAPPROVED SUBDIVISIONS DATE: Subdivision improvement Permit —Class III LOCATION OF CONSTRUCTION L/0 !�//"-7 ` r ��Mina Improvement Permit Class IV ISiraet aaoreu or Oeteriptun of Loeatuel PURPOSE OF CONSTRUCTION M=ALL AIVD /nAINTAI V A N E I N of DESCRIPTION OF CONSTRUCTION rl A"ly_17 �Tnv rr L1A/h� DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION. IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attach laartstruction plans it appropriate) W; 1 % 2001 APPROXIMATE TIME OF COMPLETION-N/All_TY c94.1S HAY ESTIMATED CONSTRUCTION COSTS —1140.00 Ilnctuding removal of all obstruction. materials. and debris backtl ' � 1 ' Un paction and Iilrq. torn• Placing permanent resurfacing and/or replacing improvements$ In consideration of the granting of this permit. the applicant hereby agrees to: Incenlnlly. defend and taw the City. its allthorued aselnt. ofllcers. representativas ens ovolO yeea. hemMe� I•o1n and apintt am and •. penalties. Ira0occu 01 Ipas /etYltlfl' from dalnls O t:OrA aaiOA and Nnlfl� out OI ally Heiden(. leis or Oarow 10 ptnom Or p/OWA% NGUI n the Or omllrring a• a protanate result of any work ol"Maeelt udder tole pef11111 VM@d GWIMMt 10 this applicalioll. Notify the Adnllnntrative Authority at 1e82, tw.nty.foilr 1241 hews iw advance of the plow aphoon wore vwli be tuned. La tolly Quints lh all applieaate Gty f2rdinanep, the tenea and conolisms of the puma, and all aWksool idles and •t0lilatlom of the Gtv of V Cu�nta ano to pay for any additional replacsnlent neseawy as the raids of flab ovW46 COACHELIA V Sig tors of Applicant or A x �o S • WATER DISTRICT. P. 0. Box 1058 COACHELIA, 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 Pohcy Numoer b— �v, 3T13 IZ 03101 1//3 /OL .v_ CALLE 6-A.C. 232 Q 2 E!3f3—_on 3 P34. N 7333-N462 163 � 23104 35 IY a A21622505 0TT-574-3 ai 73=06! 3 l61 0 249 236 340 347 53-063 QI • a 160 162 Ji 248 O 257 339 O 34B t7-100 a 37-127 :Q N „ 37-093 01 O 1 CHIHUAHUA 1 434 A 437 473 Q1 47B 53-M 432 4" 73-080 • 53-125 43l O 440 ' 0] 1 163 247 9 -A 238 339 P O 349 430 41l 53=120 -. 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N O �� P U �� W 'A 4 N 0 I- I� �Itl �I � Y �IJ �I• �I� ul 41� ul ul5 oP �I� �I� uI� I L. -� 116547) �� 6•D.LP.-91 6• p - 0 t155671 u �u Io13 YYYO•NW1•oIel_ T2�23 14 1 P�NI 16 17 18 19 20 2t 22 23 24 13 14 /S 16 17 18 19 20 2124 12 I1 IT _ I� 10 9 18 7 6 S IV ♦ 3 2 1 IP 12 ♦ 11 TIY 10 .IP 9 yY 8 {py IM1 7 Ip 6 Spy 41yy� ul+ 3 1G 2yYj{11 k 1 (yyut tiIP 4IP uIN PIS +Iy UIM1. uIJ u`� ule' 1— 4 YID I" to �I IN 13 14 15 16 17 18 19 20 21 22 23 24 n 12 11 10 9 8 7 6 S 4 3 2 1 r ul� �IW SIN NI= I� 11, K n gD572) 6.O.LP.-90 cH572) L AIVAP-100 6• dP.-9 Y V !�I� 13 14 1S 16 17 IB_19 20 21 i22. 23 24 1ro 2 11 10p� 9 B1/ 7 �T� 6 I 4 3 2 1 JJ 1NuLO l� vlb 01� uliD WIV� IPI 1U� `^li IWN wl•' 1 I>� 13 I 14 1, 15 $ 16 �1�.. 17 !8 19 I� 20 to 2l I 22 411t1 23 W 24 12yu lY 111y� ,ypl• W IOy .y.11lY Y 9 Pl M e Yl� W 7 Yl W 6 lyl� S I� 4y - I+ 3 Vl� 2 -11!I'-. �1I $IWI: wIN $la j1V im IO ><leI� $I� 3 It 15 16 17 • 19 20 2! 22 2 24 1 11 t09 8 7 4 3 2 1J WI .16 I �1i �1V �1g �1• JlW u� �1 ICIi oi I 1 I J �+11; 119-20 7 Y U J J J 13 13l 15 16 17 18 21 22 23 24 12 11 IG 9 8 7 16W3 4 3 2 J 1 bl$I �IW $I• Flu El. 1 f0 9 8 ��7 6 S 4 3 2 1 i� I� wI� 12 4 S 6 7 8 19 20 21 22 231 24 -)III 11 10 9 • 7 11 4 3 • 1 1IP I# Im I� 4 I ICI CIE Im IN ,o 13 14 13 16 17 18 19 20 21 22 23 IE 11 10 9 8 7 4 II LA I-V IN iiTIWIN lial 151,0q-411 ilel Ill lit 4 12 — 4 SPECIAL CONDITIONS --PERMIT NO. 3593 --- COACHELLA VALLEY WATER DISTRICT --- 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. 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. 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 am. to 5:30 p.m. Saturday 8:00 am. to 5:00 p.m. May l st to September 30: Monday -Friday 6:00 am 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. 3593 Paget of4 SPECIAL CONDITIONS --PERMIT NO.3593 --- COACHELLA VALLEY WATER DISTRICT --- 8. Pursuant to Section 14.16.290 of the La Quinta Municipal Code (Ordinance 10 § I (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 - Permit No. 3593 Page 2 of 4 r r s'• r r SPECIAL CONDITIONS --PERMIT NO.3593 --- COACHELLA VALLEY WATER DISTRICT--- 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. 3593 Page 3 of 4 SPECIAL CONDITIONS, -PERMIT NO.3593 --- COACHELLA VALLEY WATER DISTRICT--- 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 '/2" 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 and maintenance of one (1) one inch (1") domestic water service line. This service is located at 53-240 Avenida Rubio. 19. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. Special Conditions - Permit No. 3593 Page 4 of 4 '*, �.. r �� . . ,. �� �. r ..