3600M
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 I II
DATE: 011 Jn2 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION ANNUAL BLANKET PERMIT FOR VARIOUS LOCATIONS WITHIN THE CITY
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION ROUTINE MAINTENANCE FOR
SERVICE AND REPAIRS
DESCRIPTION OF CONSTRUCTION MAINTAIN AND REPAIR OF
EXISITNG FACILITIES
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
—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
Sketch (attach construction plans if appropriate)
SEE ATTACHED SPECIAL CONDITIONS
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 t is work.
4MA,440i�'
fio,�
Signature of Applicant or Agent J
VRR,T7nN 295 1NnRTIi STTtTRTSF WAY PATH SPRTNOS CA Q2769 76n 779 1610
Name of Applicant (please print) Business Address Telephone No.
SANY AS AAOVF
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:. $ 0.00
Receipt No.
Received by Date
3600
PERMIT VALIDATION
PERMIT N10500 3600
DATE APPROVED 1/9/02
EXPIRATION DATE 19ru /Q2
DATE ISSUED A�
By ,kle,679,�
1 Y �ministrative Authority
Recorded by
Telephone: (760) 777-7075
,_ 4
FROM ; + (WED) 1 2. 26 01 ' t 1 : 1 1/aT. 1 1 : 10/NO. 48600681 73 F 2
M,3 form constrtutas ar
encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMrrIgo
PUBLIC WORKS CONSTRUCTION (ENCROACHMNE ri
For the construction of public or private curbs, driveways, pavemerm, sidawafks. Mx sp 111_. se-aek taaftir aaisios
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SLSIDIVISICIc
DATE:— 12/26/01
LOCATION OF CONSTRUCTION VARIOUS
ANNUAL BLANKET PERMIT.
(Street address of Description of Location)
PURPOSE OF CONSTRUCTION
01`11ITTNC MAThITChIAMf`C 4. Ctn%1Tr`r nrnnTnc Sketch (artxi ;pja=ifapWopriztr1
DN1r,NfPfr 2F PPP)ffpU8Tl� I S=
DIMENSIgy F I�STA LAT(�N OR REMOVAL
NO MORE �I 8e L.F.
SIZE OF EXCAVATION, IF,NEEDED
Subdivision (mproeecssrz Pam: — Ckm III
Minuet Invr+areaeert2+Pwaait clan rV
TIONS WITHIN THE CITY OF LA QUINTA
APPROXIMATE TIME WHEN WORK WILL BEGIN nt in1 102
APPROXIMATE TIME OF COMPLETION 1Z131/02
ESTIMATED CONSTRUCTION COSTS
(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:
Indemnitv, defend and save the City, its authorized agents, officers, representatives and amp6orees, aarwI , , and spfirtR any and aO
penalties, liabilities or toss resulting from claims or court action and arising out of any accdetZ. Ise or drrtsape so persona or property
happening or Occurring as a proximate result of any work undertaken under the permit grsntad praamwaa o Vjrw bra.
Notify the Administrative Authority at least twenty-four 124) hours In advance Of the time sAan ercic a.7 be eared
Comply with all applicable City Ondinancas, the terms and conditions of the permit and all appt',rahie Hales and mgmAstiorts of the Cay of
La Quints and to pay for any additional replacement necessary as the result of this vw
r_
Signature of Applicant or Agent
�ERIZUL__295,N. SUNRISE WAY PALM SPRINGS CA 92262 760/778-3610
Name of Applicant (please print) Busines; Address Te*phone No -
Name of Contractor and Job Foreman Business Address Tdepsone No
Contractor's License No.
City Business Ljowme No.
Applicant's Insurance Company Policy Nu:nbc
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
Permit Fee / Q
Penalty
Cash Oeposit-Surety Bond
if required
TOTAL:
Receipt No.
Received by
Date
P£RSOT VALtpA/TFiON
PERMIT NO. -34 v
DATE APPROVED 2'
EXPIRATION DATE J 2 3 J e) 2
DATE ISSUED
By
ACrtutisn a eye
Recorded by
Telephcr.e: (760) 777-7175
GEC-26-21701 WED 10:15- TEL:760-777-7155 NAME:LA QUINTA PUBLIC WORKS P. 2
The following General and Special Provisions are attached to and made a part of Permit No.
GENERAL PROVISIONS
The following shall always apply:
ENROACHMENT 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 perminee 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 Le Quinta shall request
that these portions of road be resurfaced over their entire width. Resurfacing shall consist of one coat of two inches (2') of A.C.
surfacing plus appropriate seal cost as specified above.
PROTECTION OF TRAFFIC: All excavations and work areas shall be properly lighted and barricaded as deemed necessary by the
City Engineer or La Quints 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 Is 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 'right '
of way. All paved surfaces shall be broomed clean of earth and other objectionable materials immediately after backfill and'compaction.
Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess material shall be removed
prior to paving. Water tanker shall be used, as required, to sprinkle the job site to keep down dust conditions and shall be used
immediately after backfill.
DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing water on City of La 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
The following shall apply when indicated:
`4I NOTIFICATION: Perm ittee shall notify the City at (619)777-7075 at least 48 hours in advance of starting construction.
2 UTILITY CLEARANCE: (Substructures) Prior to making any excavation within the City of La Quints 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 LrfHJ Y CLEARANCE: (Surface Structures) No work shall be done under this permit until all utilities are clear of Ibe
proposed work site. The permittee shall notify all concerned utility companies of the proposed work.
R4 PAVEMENT WIDENING: Area between the proposed concrete gutter line and the existing road pavement shall be surfaced
with inches of A.C. paving placed on inches of class aggregate subbase course having an 'R'
value of not less than and in conformance with City of La Quints Road Improvement Standards and
Specifications, Ordinance #461.
®R 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 (1J.
R6 GRADE CHECKING: City of Le 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 (_feet) shall be
removed. Curb and/or curb and gutter shall be saw cut prior to removal. Depressed curb, matching concrete gutter aqd
concrete driveway approach shall be constructed in conformance with City of La Quints Standard #207.
R8 DRIVEWAYS: A.C. driveways shall be constructed as not to alter existing drainage pattern. Surfacing between the property
line and the existing road paving shall be 2 1/2 inches of A.C. paving placed on (�� of class aggregate base.
Driveway construction shall conform to attached drawing.
R9 SIGHT CLEARANCE: Sight clearance of 600 feet in all directions shall be assured and maintained at all times.
R10 SOIL SIT ULI7.ER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall commply with. the
manufacturer's specifications.
i
1 1 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 project".
R 1 SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the
centerline of all streets or property lines when involved shall be completely tied out so they may readily and correctly be
replaced by a licensed civil engineer or surveyor at the expense of the perminee. 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 PAVEMENT CUTTING: Pavement will be mechanically saw cut to a straight to a straight edge prior to excavation. Method
of pavement cutting shall be approved through the office of the City Engineer. (Under no circumstances shall excavating
equipment be used to excavate prior to cutting of pavement.) Excavation material shall be placed in such a position as to best
facilitate the general flow traffic. Prior to final paving operations, any damage to pavement straight edges shall be corrected.
R14 LIMIT OF EXCAVATIONS: Excavations shall be limited to 1000 linear feet of open trench before backfill operations must
begin. All excavations shall be properly barricaded with lights overnight, on weekends and holidays for the protection of the
traveling public. The Public Works Inspector shall determine the suitability of excavation barricading in each case. No
excavation shall remain open for a period exceeding five (5) days. No excavation shall be made unless the construction
material is actually on the work site.
1 BACKFILL MATERIAL: Backfill shall be free of brush, roots or other organic substance detrimental to its use for purposes .
of producing an adequately consolidated backfill. Any material which the City of La Quinta deems unsuitable (spongy or
saturated material) which is encountered during excavation shall not be used for backfill, but shall be supplemented or replaced
by an approved sand or gravel.
R16 BACKFILL SAND: Backfill shall be approved transit -mix sand or equivalent and shall be'placed in lifts of not greater than
three feet (3') and vibrated using vibrotamper or equivalent equipment. Alternate methods may be substituted, but in any case,
a relative compaction of 95 percent shall be attained with the structural section of the roadway.
R17 BACKFILL PLACEMENT: Backfill shall be applied. in layers of not more than 50 percent of the total depth of the trench
before flooding or a maximum of five-foot (5) lifts where trenches are of excessive depths. Care is to be exercised that the
backfill material is not subjected to extreme swell by flooding operations. Backfill material shall be placed so that the resulting
compaction shall be not less than 90 percent or equivalent to the surrounding ground, whichever is the greater compaction..
Where ponding or flooding is used for a maximum settlement, adequate dikes will be constructed to retain the water. Where
jetting is used, the jets shall be of sufficient length to reach the bottom of each layer and the water supply shall be continuous.
R18 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made at intervals of not more than 1000
feet and a minimum of one (1) test on each road: One (1) copy of each test shall be forwarded to the City Engineer for
approval and filed prior to making permanent repairs. Compaction tests shall be made as outlined in Section 6.3.01 of the
Standard Specifications, Division of Highways, State of California, dated January 1973.
1.9 COMPACTION TESTS: If so required by the inspector, compaction tests shall be made for each crossing or service line.
One (1) copy of each test shall be forwarded to the City Engineer for approval and filed prior to making permanent repairs.
Compaction tests shall be made as outlined in Section 6.3.01 of the Standard Specifications, Division of Highways, State of
California, dated January 1973,
20 TEMPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations, a temporary patch
consisting of 2 inches of SC-800 shall be placed on a prepared subgrade. TLe SC-800 temporary paving shall be placed after a
maximum of 3000 linear feet of trench has been excavated and backfill operations completed, but in no case shall the
placement of the temporary pavement exceed a five (5) day limit.
21 PERMANENT. PAVEMENT REPAIR: After backfill and compaction have be��eyy co plated, a temporary patch consisting of
two inches (2") of SC-800 shall be placed immediately. A permanent patch of y/4I inches A.C. surfacing placed on a
VA ?— inch Is, base shall be placed no later than days after completion of temporary road repair.
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.
2 3 STREET RESTRIPING: Where street striping is still visible on streets to be excavated, such striping shall be replaced upon
completion of permanent repairs.
RU 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
bole 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. Adequatesigns, flagmen and or
barricades shall be provided to protect the traveling public at all times.
Large holes resulting from tree removal shall be backfilled and compacted to not less than 90 percent or equivalent to the
surrounding ground, whichever is the greater compaction as determined by the impact or field method. Compaction tests shall
comply with Section 6.3.01 of the Standard Specifications, Division of Highways, State of California, dated January 1973.
GENERAL CONDITIONS -- PERMIT NO. 3600
--- VERIZON ---
BLANKET PERMIT - JANUARY 1 - DECEMBER 31, 2002
In addition to the standard permit conditions, the following shall apply:
1. Work authorized by this permit shall be limited to the maintenance and repairs of existing
underground equipment, installations, and facilities owned and operated by Verizon hereinafter
referred to as "Permittee". New equipment, installations, and facilities shall be authorized through
separate permit*, (see Note below). All work shall be performed by the Permittee.
*Note: New equipment, installations, and facilities constructed for single family home residential gas
services located on local residential streets shall be authorized by the Blanket Permit, provided all
construction is performed behind the existing curb and gutter or edge of pavement, and no cutting
of existing street pavement is required, or if street crossings are performed by a bore operation.
PRIOR TO COMMENCEMENT OF ALL WORK, the Permittee shall notify the City at least 48
hours in advance at (760) 777-7075, giving the location and description of the work to be performed,
the dates and times the work will occur, and the name of the foreman responsible for the work. A
work authorization number will be issued for each occurrence of work.. WORK PERFORMED
PRIOR TO CITY NOTIFICATION AND WITHOUT A WORK AUTHORIZATION
NUMBER IS PROHIBITED.
2. SEPARATE PERMITS ARE REQUIRED FOR ALL OF THE FOLLOWING:
A. Work within any major, primary, or secondary arterial street. Those streets include, but are not
limited to:
Eisenhower Drive, Washington Street, Adams Street, Dune Palms Road, Jefferson Street,
Madison Street, Monroe Street, Fred Waring Drive, Miles Avenue, Westward Ho Drive,
Avenue 48, Avenue 50, Avenue 52, Avenue 53, Avenue 54, Airport Boulevard, Avenue 58,
and Avenue 60.
B. Construction ofall new equipment, installations, and facilities, and realignments or changes to
existing facilities*, (see Note above).
C. Construction work performed by an outside contractor for the Permittee.
D. Construction work performed within 500 feet of any major intersection, see Condition #7.
3. 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.
4. Permittee shall be responsible for providing continuous dust and erosion control.
Special Conditions - Permit No. 3600 1 Page I of 3
GENERAL CONDITIONS -- PERMIT NO. 3600
--- VERIZON ---
BLANKET PERMIT - JANUARY 1 - DECEMBER 31, 2002
5. Streets shall be kept clean. They shall'be completely cleaned at the end of each working day and
more frequently if required.
6. 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 1 st 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.
7. Work performed within 500 feet of a major or signalized intersection is restricted between the hours
of 9 a.m. - 3 p.m. Traffic control shall be set up after 9 a.m. and removed before 3 p.m. The
Permittee shall contact the Riverside Country Traffic Signal Maintenance Department at (909) 275-
6894 if signal operation at the'intersection is to be altered in any way.
8. 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.
9. 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.
10. Pursuant to Section 14.16.290 of the La Quinta Municipal Code (Ordinance 10 § 1 (pait), 1982),
street closures shall not be permitted. A minimum of one travel lane of paved surface shall be
maintained with flagmen at all tunes.
11. 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.
Special Conditions - Permit No. 3600 Page 2 of 3
GENERAL CONDITIONS -- PERMIT NO. 3600
--- VERIZON ---
BLANKET PERMIT - JANUARY 1 - DECEMBER 31, 2002
12. Should additional work, materials, or modifications of the work be required in order to meet City
standards, safety requirements, signage requirements, or to fit actual field conditions, the work shall
be performed by the Permittee as directed by and to the satisfaction of the City Engineer at no cost
to the City of La Quinta.
13. Pursuant to Section 14.16.370 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982),
backfill compaction within street rights -of -way shall conform with Section 306-1.3 of the latest
edition of the Standard Specifications For Public Works Construction (SSPWC), and as required by
the Public Works Department.
14. 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, Pennittee 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.
15. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to
its original condition.
16. Access and egress to all local properties shall be maintained at all times.
17. 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 meet requirements of the' Public Works
Department.
18. Permittee shall notify the City of La Quinta Public Works Department a minimum of 48 hours prior
to commencement of any construction at (760) 777-7075.
19. 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.
20. 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.
21. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time.
Special Conditions - Permit No. 3600 Page 3 of 3