3761r^
NOTE:
rWith 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 I I
DATE: 0=bi+1= 1A IM1 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 46-300 DW= Pal= ice$
(Street address or Description of Location)
PURPOS OF CONSTRUCTION Sketch (attach construction plans if appropriate)
ImAita =�� a " C==Zic t:y= ccr V1p
,,,,,,,DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
6ft x Oft
SIZE OF EXCAVATION, IF NEEDED
\\APPROXIMATE TIME WHEN WORK WILL BEGIN ��►��%�
_ r'APPROXIMATE TIME OF COMPLETION 11M/02
ESTIMATED CONSTRUCTION COST $ WTT%
(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
CV1.1) P.0.2= 1058 0=h-_11a, t, 760.398.2651 x 505
Name of Applicant (please print) Business Address Telephone No.
mT3 ar; aboVJ
Name of Contractor and Job Foreman Business Address Telephone No.
RA
Contractor's License No.
ilk
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: $
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 3761
DATE APPROVED 0&-c'3' 1C* 2002
EXPIRATION DATEJrnuary 300, 200i
DATE ISSUED
By
A.033tZn4dmZiis�t;rat ti��v�e authority
Telephone: (760) 777-7075
PERMIT NO. 3761
CV WD
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, Inc., hereinafter referred to as "Permittee", shall be responsible for providing continuous dust
and erosion control.
3. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more
frequently if required.
4. Pursuant to Section 6.08.050 of the La Quinta Municipal Code (Ordinance 18 § 1, 1982), throughout
the work site, the Permittee shall comply with City regulated work hours. Operation and maintenance
of equipment within one-half mile of human occupancy shall be performed only during the following time
periods:
October 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 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.
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
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 - Penanit No3761_ Page t of 4
PERMIT NO. 3761
CV WD
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 two (2) travel lane of paved surface shall be
maintained 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 rdmainder of the project.
Special Conditions - Permit No3761_ Page 2 of 4
PERMIT NO.3761
CV WD
E. In subsequent lengths of trench, the frequency of compaction tests shall equal one per each lift of
backfill, per 300 linear feet of open trench, at randomly selected locations within the open length
of trench.
F. The depth of the randomly selected compaction tests shall also be randomly selected except that
where multiple tests are required in a given length of trench, the tests shall be no closer than three
feet (vertically) from each other.
G. If any compaction test fails, previously placed backfill (in the same length of open trench or
previous lengths of trench) which is represented by the failing test (as determined by the City
Inspector), shall be tested for compliance with compaction requirements.
H. All costs incurred due to the conditions above shall be borne by the Permittee. Copies of all test
results shall be furnished to the City Inspector.
12. All excavations within City of La Quinta right-of-way shall be backfilled, and temporarily paved if within
the existing travel way, at the end of every workday as directed by and to the satisfaction of the City
Engineer for the protection of the public. Lengths of open trench shall not greatly exceed that which
can not be backfilled in the same day. Excavated trenches shall not be allowed open overnight, however,
Permittee may leave a length of excavated trench, not to exceed twenty (20) feet in length, open
overnight at a point where construction will begin the next day, provided that this length of trench is
completely covered by steel plating.
13. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to its
original condition.
14. Access and egress to all local properties shall be maintained at all times.
15. Pursuant to Section 14.16.375 of the La Quinta Municipal Code (Ordinance 1.0 § 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 No3761_ Page 3 of 4
PERMIT NO.3761
CV WD
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 saw cut 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 (3) feet outside the sawcut removal
lines.
For longitudinal trenches located in a traffic lane: two (3) 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 or any existing detour 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. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time.
19. The permittee shall indemnify, hold harmless and assume the defense of the City from all damages, delay
costs, costs or expenses in law or equity that may arise out of work under this permit.
Special Conditions - Permit No3761_ Page 4 of 4
The following General and Special Provisions are attached to and made a part of Permit NO761
GENERAL PROVISIONS
The following shall always apply:
F.NROACENENI ON PRIVATE PROPERTY: This permit authorizes work to be accomplisbed wid" City oils Quinta rigbt of ,
way ONLY:Whenever construction ixtends 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 CONSIRUCAON EQUIPMENT. Cleated tracklaying concoction equipment shall not be permitted to operate on
any paved surface unless fined with smooth -faced street pads.. All mechanical outriggers shall be fitted with rubber street sboa to
protect the paving during excavations. Rubberiired equipmeot.only shall be used in backftll operations in paved areas. U the. existing
pavement is scarred, spalled, or broken during the term of this contract, or if the pavement is marred. City of L Quints sball request
that these portions of road be resurfaced over thew entire width. Resurfacing shall conaistof one cost of two inches (2') of A.C.
surfacing plus appropriate seal cost as specified above.
PRO7ECTION OF 73LAMQ 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 oodfied•24 hours in advance of any traffic detours or delineations.
CARE OF DRAINAGE MUC URFS: Any drainage structure including corrugated metal pipe, concrete pipe, peel, 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 Le 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 C2XANUP: Any surplus material resulting from excavation and backfdl operatioms shah be removed from Ibe Yight
of way. All paved surfaces shall be broomed clean of earth and other objectionable materials immediately after backfill turd Compaction,
Existing gutter line and'draioage ditches Thal W replaced to their original standard or better. All excess material shall ba.d cooed
Prior to paving. Water teaker. shall be used, as required, to sprialde the job site ta keep down dust conditions and eba11 be used
immediately after backU.
DE -WATER OPERATIONS: If de- watering operations are required and pumps are forcing water on City of L Quince roads, it shall
be the responsibility of the permince (contractor) to control this water and to provide off-street barricades when necessary..
CLOSING SJREM: 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 sweet for any length of time, permutes shall contact this office m tai obo she necessary per•m.Mon.
_
SPECIAL PROVISIONS
The following shall apply
760.777.7097
Rd NOTIFICATION: permitter @ball notify the City at OMqV3Q= at least 48 hours in advance of starting conswuetiou.
RZ UTILITY CLEARANCEe. (Substructures) Prior to making any excavation within the City. of La Quints, right of way
authorized by permit, the permittee @ball contact all concerned utility companies reladve.to the location of existing
substructures. Damage to existing aubatructures resulting from operations conducted under this permit anall be the sole
responsibility of the permits=.
R3 ITIIUTY CLEARANCE: '(Surface Structures) No work shall be done under this permit until all utilities are clear of the -
proposed work site. The perminee shall notify all concerned utility companies of the proposed worts,
,R4 PAVEMENT WIDENING: Area between the proposed concrete guner line. and the existing road pavement shall.be surfaced
with inches of A.C. paving placed on inches of class aggregate subbase course baying an'R-
value of not leas than abd in conformance with City of La Quints Road Improvement Standards mod
Specifications, Ordinance 1461.
R'5 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb @ball be graded to a dope of
1 /4 inch go one foot (I
R6 GRADE. CHECKING: City of La Quints @ball check grades upon receipt of plan and profile and/or grades an 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.. Depreased curb, matching concrete •gutter and
concrete driveway approach shall be constructed in conformance with City of La Quints Standard
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 2 112 inches of A.C. paving placed on of Clow aggregate base.
Driveway construction shall conform to attached drawing.
R9 SIGHT CLEARANCE: Sight clearance of 600 feet in all directions shall be &sent" end maintained at all times,
RIO SOIL S JM.IZER: The area to be surfaced shall be treated with soil steriliser. Rate of application shall eommply wilt.the•
manufacturer's specifications.
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NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCR
For the construction of public or Private curbs, driveways, paves
and other .like public works improvements in connection with MINOR
DATE: /
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION J
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLAT
SIZE OF EXCAVATIO..N, IF N'ECpEb. ,P' � 44 Y
APPROXIMATE
�9'lots, sewers, water mains
APPROVED SUBDIVISIONS
n .Improvement Permit — Class I I I
nor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
APPROXIMATE••TIME QF COMPLETION f•.., , .,'. '' UUI I D LUUL�
ESTIMATED 00*NST'RUCTIQN COST $
(Including r•Qmoval:,bf all 4b`struction,'materials;,tind•debris, b6rkfilling, com-
paldiori-.and 'placing permanent resurfacing 4 d/Qr.• replacing Improvements) 1r. WORKS
In1 consid4r•Ption of the granting of this permit, the. appli)<ant- hereby agrees to:
jni3emnify.,'defend and save the City, its apthorized age}ts, officers, representatives and employees, harmless from and against any and.all
penalties• liabilities or loss resulting from `oainis.-or• court action and arising out of any accident, loss or damage to persons or property
hpopening or occurring as a proximate result. of any work undertaken under the permit granted pursuant to this application.
i Notify the Administrative Authority at least tw46y'-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 rugs and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of. this work. �-_-
icant 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 $ II PERMIT VALIDATION
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by
Date
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Recorded by II Telephone: (760) 777-7075
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