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4255NOTE; With proper�balidation .v , 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 DATE: 10/5/04 Minor Improvement Permit Class IV Jefferson St. N/0 Ave 54 and Madison St LOCATION OF CONSTRUCTION S/O Ave 54 (Street address or Description of Location) PURPOSE OF CONSTRUCTION Provide telephone facilities Sketch (attach construction plans if ap propriate) ppropriate) DESCRIPTION OF CONSTRUCTION splice pit N10 Ave. 54 on Jefferson & conduit placement S/O Ave. 54 can Madison DIMENSION OF INSTALLATION OR REMOVAL 5XV Pnl lCe ni & 350 V wide trench for conduit: SIZE OF EXCAVATION, IF NEEDED V pride 36"deev APPROXIMATE TIME WHEN WORK WILL BEGIN 11/1/04 APPROXIMATE TIME OF COMPLETION 511105 �• ^^� 2005 i ESTIMATED CONSTRUCTION COST $ 6000.00 t I''', (Including removal of all obstruction, materials, and debris, backfilling, com- CITY OF LAQUINTA paction and placing permanent resurfacing and/or replacing improvements) FINA G 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 happeninogtl occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. i,totfy; 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. Sigri Cure of Applicant or Agent Verizon 295 N. Sunrise Wray Palm Springs. CA 92262 (760) 864--171.5 Name of Applicant (please print) Business Address Telephone No. INFORM CITY 2 WEEKS PRIOR TO START Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I II Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs • r Minor. Improvement Permit — Class IV: See attached schedule Inspection Fee $ 180.00 Oi0. Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by Recorded by $ 280.00 Date 4255 PERMIT VALIDATION PERMIT NO. 11 4255 DATE APPROVED 10/5104 EXPIRATION DATE 10/5/05 DATE ISSUED )� �( Administrative Authority r Telephone: (760) 777-7075 a. v PERMIT NO.4255 Verizon/Manhole Entering & Trenching Phone Conduit/On Jefferson & Madison 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. Verizon, hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and erosion control. 3. The permittee shall not encroach upon private property without prior written approval (submit to the Public Works Department, attention to the Assistant Engineer 1) of the private land owner whom is being encroached upon. 4. Prior to performing construction work or closing any lanes, the permittee shall call the City at (760) 777-7089 at least 48hrs prior to work and request an appointment for a preconstruction meeting with the City Inspection staff. 5. Prior to excavating in native undisturbed soils, the permittee shall, have employed by proposal contract an archaeological observer for the site excavations within.native undisturbed soils. A copy.of the contract must be submitted to the Public Works Department and attention this to Anthony Colarossi, Assistant Engineer I. If the archaeologist determines the site note to be required to be observed, please submit a letter signed by the archaeologist stating their determination. 6. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more frequently, if required. 7. 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. Note: Construction work (including setting up traffic control devices) is not permitted on any Arterial street (ie any 4 lane street) before 8:00 a.m. Special Conditions Page 1 of 5 PERMIT NO.4255 Verizon/Manhole Entering & Trenching Phone Conduit/On Jefferson & Madison 8. Work within 500 feet of a signalized intersection shall be performed 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. . 9. 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. 10. 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. 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 lanes of paved surface shall be maintained at all times. 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. 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), 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: Special Conditions Page 2 of 5 PERMIT NO.4255 Verizon/Manhole Entering & Trenching Phone Conduit/On Jefferson & Madison 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 appropriate moisture content for compaction. The appropriate moisture content range shall be established at the onset of the. project and ensured prior to use of the materials through progress testing on the stockpiles. C. The first length of trench backfilled shall be backfilled in the presence of the City Inspector. Compaction shall be tested at random depths at approximate three-foot vertical intervals as backfill is placed to ensure the effectiveness of the compaction methods and to establish the depth of lift that can be compacted. D. If lifts greater than one foot are attempted in this trial length of trench, compaction tests shall be taken within the lifts to ensure that the full depth of the lift is compacted. Upon satisfactory completion of this portion of trench, the City Inspector shall establish the maximum lift thickness to be compacted for the remainder of the project. E. In subsequent lengths of trench, the frequency of compaction tests shall equal one per each lift of backfill, per 300 linear feet of open trench, at randomly selected locations within the open length of trench. 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. 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, 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. 15. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to its original condition. Special Conditions Page 3 of 5 PERMIT NO.4255 Verizon/Manhole Entering & Trenching Phone Conduit/On Jefferson & Madison 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 conform to the following conditions: A. Existing asphalt concrete pavement shall be sawcut one (1) foot beyond trench edges. Edges shall be straight and clean. B. Permanent pavement replacement structural section, within all trenches, shall be 1" thicker than existing of asphalt concrete over the same existing thickness of crushed aggregate base or crushed miscellaneous base, meeting the requirements of Sections 200-2.2 and 200-2.4 of the Standard Specifications for Public Works Construction. The replaced pavement and base material shall be compacted to 95% relative compaction and respectively tested, for each 300 linear feet of trench. Verify exact structural replacement section thicknesses with the City prior to installation. C. Permanent pavement replacement shall be installed using a City approved 1/4" 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: three (3) feet outside the sawcut removal lines. • For longitudinal trenches located in a traffic lane: three (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 1/4" 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. Special Conditions Page 4 of 5 PERMIT NO.4255 Verizon/Manhole Entering & Trenching Phone Conduit/On Jefferson & Madison 18. 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. 19. 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. 20. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. 21. 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. 22. If it is the intent of the permittee to cut the pavement and have it restored by a third party, the permittee shall postpone cutting the pavement until the intended third party has acquired a permit from the City to perform the required restoration work. Special Conditions Page 5 of 5 City of La Quinta The following General and Special Provisions are attached to and made a part of Permit Number 4255 The following shall always apply: ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes work to be accomplished within the City of La Quinta's 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. TRACK -LAYING CONSTRUCTION EQUIPMENT: Cleated track -laying construction equipment shall not be permitted to operate on any paved surface unless fitted with smoother -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 operation 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 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 coat 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 City of La Quinta Public Works Inspectors. Suitable detours and detour signs shall be placed and maintained for the duration of the project. The City shall be notified twenty-four hours (24) in advance of any traffic detours or delineation. CARE OF DRAINAGE STRUCTURES: Any drainage structure to include corrugated metal pipe, concrete pipe, steel culvert and concrete structures encountered during excavation which necessitate removal shall be replaced in kind. In the event it becomes necessary to remove or cut existing drainage structures, City of La Quinta shall be notified prior to commencement of this work. Drainage structures and open drains shall be kept free of debris at all times for proper drainage. RIGHT-OF-WAY CLEANUP: Any surplus 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 OPERTATIONS: If de -watering operations are required and pumps are forcing water on City of La Quinta 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, permittee shall contact this office to obtain the necessary permission. SPECIAL PROVISIONS The following shall apply when indicated: ® R1 NOTIFICATION: Permittee shall be notified the City at (760) 777 - 7097 at least forty-eight hours (48) in advance of starting construction. ® R2 UTILITY CLEARANCE: (Substructures) Prior to making any excavations 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 UTILITY 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 ( ** N/A ** ) inches of A.C. paving placed on ( ** N/A ** ) inches of ( ** N/A ** ) aggregate sub -base course having n "R" value of not less than ( ** N/A **) and in conformance with the City of La Quinta Road Improvement Standards and Specifications, Ordinance #461.. ® R5 PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall be graded to a slope of one-fourth inch ('/d") to one foot (1'). ❑ R6 GRADE CHECKING: City of La Quinta shall check grades upon receipt of plan and profile and/or grades as established by a licensed engineer. ❑ R7 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter (** N/A") feet shall be removed. Curb and/or curb and gutter shall be saw cut prior to removal. Depressed curb, matching concrete gutter and concrete driveway approach shall be constructed in conformance with City of La Quinta Standard #207. ❑ 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 two and a half inches (2 1/2') of A.C. paving on (** N/A **) of class (** N/A ** ) aggregate base. ® R9 SIGHT CLEARANCE: Sight Clearance of six -hundred feet (600') in all directions shall be assured and maintained at all times. ❑ R10 SOIL STERILIZER: The area to be surfaced shall be treated with soil strerilizer. Rate of application shall comply with the manufacturers specifications. � City of La Quinta t ® R11 COORDINATg WORK: The proposed work shall be subordinated to any operation, whicFi the State of California or City of La Quinta may conduct in this area during the period of this permit. Work shall be coordinated with the State or City of La Quinta forces to preclude delay or interference with State or City of La Quinta projects. ® R12 'SURVEY MONUMENTS: Prior to excavation or beginning of construction, all survey monuments which exist on the centerline of all streets or property lines when included shall be completely tied out so they may be readily and correctly, 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 clearance. ® R13 PAVEMENT CUTTING: Pavement will be mechanically saw cut 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 or 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 one -thousand feet (1000') 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. ® R15 BACKFILL MATERIAL: Backfill shall be free of brush, roots or other organic substance detrimental to its use for purposes of producing and adequately consolidated backfill. Ant 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 on lifts not greater than three feet (3') and vibrated using vibrostamper or equivalent equipment. Alternate methods may be substituted, but in any case, a relative compaction of ninety-five percent (95%) shall be maintained with the structural section of the roadway. ❑ R17 BACKFILL PLACEMENT: Backfill shall be applied in layers of not more than fifty percent (50%) of the total depth of the trench before flooding or a maximum of five feet (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 not be less than ninety percent (90%) 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 continuos. ❑ R18 COMPACTION TESTS: If so required by the inspector, compaction test shall be made at intervals of not more than one - thousand (1000') feet and a maximum of one (1) test on each road. One (1) copy of each test shall be forwarded tot 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 tests shall be made as outlined in Sections 6.3.001 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 two inches (2") of SC-800 shall be placed on a prepared sub -grade. The SC-800 temporary paving shall be placed after a maximum of.three-thousand linear feet (3000') or 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. ❑ R21 PERMANENT PAVEMENT REPAIR: After backfill and compaction have been completed, a temporary patch consisting of two inches (2") of SC-800 shall be placed immediately. A permanent patch of ( 3 ) inches of A.0 surfacing placed on a ( 6 ) inch ( crushed ) aggregate base shall be placed no later than ( 5 ) days after completion of temporary road repair. ❑ R22 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. ® R23 STREET RESTRIPING: Where street striping is still visible on street to be excavated, such striping shall be replaced upon completion of permanent repairs. ❑ R24 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quinta road right-of-way shall be accomplished by a licensed, bonded and insured tree service, and handled safely without interference or hazard to the traveling public. It shall be the responsibility of the permitte 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 it becomes necessary to restrict traffic, the work shall be restricted to a maximum of five -hundred feet (500') at any one time. Adequate signs, 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 ninety percent (90%) or equivalent tot 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. FROM (TUE) 10. -5' 04 7: 59/ST. 7:58/NO. 4860068607. P 3 ---------------- ------------ - ----- ----- -- ___ _ __--- -- — _-- -- --_ • --- — _... I �------------------- --- �---------����T�Qd12RS=�LIk..D�-�j�2.'A.3 — '�' . ' �-L-I -- -- -• - - _ 1 1 t I 1 I ! / 1 i i .-. . . . . . ''-� CA•775 •=-T' - Verizon C1 l AREA STA C DIVISION: INLAND VALLEYS EXCH.: Lk QU/N!A W.C.:IffS'43 WO NO.: SPOG I G ' ; ! r - ' T— TAX DST: CONTROL NUMBER: TITLE: J EFFER So Sn K/Q �1f64 uE S DATE: REV. DATE: GALE: - -L -- DRWN ENG `. APRVD ° PRIN RKS OF FROM U 10 5 04 8 00/ST /N 006 0 ;•(T E) 7:58. O. 486 86 7, .P 4. 3 l! ~ r ILI n u bi m o F6 it P. K' •• � l7 .a m F ti ;oo7:i �y. 6(jn(lO2 A goy E ... 17iQ 1?JY c LEGEND +w� 50 Ft (1�) 7sa Ff. wi t270) I. A Flashing Arrow, sign shall be Traffic Cone or Delineator used for each lane closed. .02. Two lane closure signs (C-20) shall be used on the approach to o lane closure with T Sign speeds of 45 mph (70 Km /h) or greater. NOTE: This chart based 12_foot on (4m) wide lanes. For lone widths greater than 12 feet (4m), use the Direction of Travel following formulae: ( Not- a pavement marking) Toper formula: Q Flashing Arrow Sign (Where Required) Required) Refer to Poe 5 L S x W for speeds of 45 mph or more. L " S x W for speeds of 70 Km/h to sel(Where Type I . or T q II or more. L ' Y. ype . 60 for speeds of 40 mph or less. Nigh Level Warning Device (Flogtree) - L'- Mf for speeds of 60 Km Wh ere: 150 /h or less. Barricade (For Excavation Only) Refer to Page 9 for Details L - Minimum length of toper. S e Numerical value of posted on Type I TYPe IC or Type TII speed limit prior to work irElf teli7 •speed. u>< NORTHw^M . it ARROW PONT , un W Width of olfsetyap ANFlogger i•e.: 80 Km/h and 6m lone: L 80 x 2 ( /3)6 0 320 meters i.e.: 40 mph and 19' lone. L e 19 x 402 WORKSYTE 'TRAFFIC CONTROL PLAN SINGLE LANE CLOSURE ( LEFT LANE ) 0 FA See Chart "A' S14 Chart -A LEGENQ • Traffic Cone or Delineator T Sign Direction of Travel ( Not a pavement marking ) Flashing Arrow Sign (Where Required) Refer to Page 5 to select Type A, Type 1 . or Type II . Y High Level Warning Device (Flogtree) ~ Barricade (For Excavation Only) Refer t.Q.Pnq:a c ... type i , Type li • or Type X Flogger OVV G.�SEE W uG •p� • RIN N TAPER 1\0 FORMULAE /n Chart "A• S4s Ctwrt "A' 150' 43m MINIMUM RECOMMENDED CHART A — OOJNEATOR AND SIGN PLACEMENT TRAFFIC SPEED TAPER LENGTH (1) (�^) DM94CATOR SPACn10 SIGN SPACINO(S) (m) (�Y.O.f. Of ICyb 24 MPM (m) • B.t.un Sync) (n1) 30 MPH (IS) 123 Ft. (SS) 0 Ft. (8) 300 Ft (90) 31 MPM (50) 245 ►t. (71) 35 Ft. ((11(90) ) ) 300 ►t300 Ft (90) •4S MPH (70) 40 . .50 S40 FL (teS) 45 FL (14) 140 Ft. le 653+MPM (e5) 1000 Ft. 50 Ft. (15 6 Ft. (185) (303 SO Ft. (15,11) 750 Ft. (Y30) 1. A Flashing Arrow sign sholl be used for each lone closed. 02. Two lone closure signs (C-20) shall be used on the approach to o lane closure with speeds of 45 mph (70 Km/h) or greater. NOTE: This short based on 12—foot (4m) wide lanes. For lone widths greater than 12 feet (4m), use the rollowing formulae: Toper formula: L S x W for speeds of 45 mph or more. L S x '3 W for speeds of 70 Km/h or more. L ' WS' for speeds of 40 mph or less. - 60 L m WSSO for speeds of 60 Km/h or less. Where: L - Minimum length of taper. S - Numerical value of posted ii&i Or 85 percentile speed. W. ►Kdth of offset. I.e.: 50 mph and 19' lone; L rCNORM wmf A 1M MD ft MROw PdM7 50 x 19 � 950 feel A" A 1r,q -a.... 0.L 2. e 150 - 144 meters CURB OR E.P. i WORKS17E TRAFFIC CONTROL PLAN -- SINGLE LANE CLOSURE 0 CURB OR E.P. Meoion or Divioing One -- -- -- �-� — (3m) 10 ( — — _ _ — —_-•-- — V� O� r CURB OR E.P. e 5 To or L J 1 .4b 54e Chart 'A' tOpSee Chart 'A- 30m WORK G� AREA o� 0 � q- iryZ Q� G�V C: SCHDEART A - MIN4UM. RECOMMET(DED LINEATOR AND SIGN PLACEIIFNT � TRAFFIC. PEED O ( �) TAPER LENCTN (L) OEUNEATOR SPACING S ON SPACINC(S) ,P (m) • 8.1-- 5'r., (m) - 2S MPH125 Ft. � 30 MPH (4S) 100 Ft. (40) 2s Ft. (e) 300 FL. (90).:. 3S MPH (50) 245 Ft. (S3) 30 rl' (9) 300 Ft. (90) o 'p�u^ 40 MPH 6 320 rt. (7S) 40 Ft. 35 Ft. (I t) 300 FL (90) (tes) 45 r1. 3 Ft. 100 •SO N 600 t. (14) Soo Ft. (1e5 • TroNic Cone or •SS`MPM (es) 1000 FL Oelineotor NOTE: This chart based on 12-foot (4m) wide lanes. 1, A Flashing Arrow sign t30S) SO rt. (ts) 7Ja Ft. (230) W Sign For lone widths greater than 12 feet (4m), ° gt shall be used for each lone closed. use the following formutoe: 2. Two lone closure signs (C-20) shall be used on the approach Direction of Travel Toper formula: to o lone closure with speeds of 45 mph (70 Km/h)or 0 ( Not a pavement marking) L S x W for /) greater. speeds of 45 mph or more. - ,p L ' S x � W for speeds of 70 Km W 0 Flashing Arrow Sign (Where Required) /h or more. rn Refer to Poge 5 to select 7 L • INS o Type I or T �e A for speeds of 40 mph or less. o Type II . 60 rn m it K1gfi'"CeGei warning Device (Flaglree) Where: 150 - "" ' T2bs or-60 Km/h or less. 0% 0 L Minimum length of toper. --] ~• Borricode (For Excavation Only) S Numerical value of posted Refer to Page 9 for Details on speed limit prior to work or Type I . Type IC . or Tvt+w_Ttr 85. I... .. -... -._. - ... _... - .� W w Width of offset "::. �TM t •tr i•e.: 80 Km/h and 6m lone: L . 4MD µ A&Ao• �r MlORKS TRAFFIC Cl>r(TgOL P Flogger 80 x (2/3)6 320 meters EDGE OF GUITER CLOSURE -- LAN i.e.: 40 mph and 19' lane: 19 x 402 L � �„ - 507 lest FROM :'..,:j.TUE) 10. .5' 04 8c59/ST.8:59GN.0. 4860068610.P "2 . Work Area Traffic Control Handbook 39 Closing of Left Lane and Closing of Center of Street CIS OR C23—\ C13 OR C14 — 9 v I V I 1 I I 1101:1. (1,.Dm, I I vn� w1E I DI _: fl: yDI I .. .. DI of IDI iL�SNING O IARROW SIGN D NUNN O I C3n0 pD I nn I I I I I 1 I 1 I I I I I I I I I I C13 OR C14 BARRICADES DELINEATOR �— See Chart A 4 V fl C20 OR WI C1 a OR C23 I., I Z U. F rjrj Y1 4 Q u Cd 40 U. O I FROM (TUE) 10. 5' 04 7:59/ST. 7:5$/NO. 4860068607 P 3 ji- ------------ ------ !mac _ � _�-,.>__._�..� �_. .s. __� 1_- - -----_---- __ '--.----- _-._ •-- -_-_— _-- _45 ------------_ -_� _----__--------==_=1�'L _— ---_ _--_ __ --_- _- ____-. -_ - __� Nl7' --- _-- --- - ____ --_--_- _ �_-------------------ice --- -7.- -----�-_-- _� _ _ --_ -- - - --- - _--= -- _ OFC C11 AREA STA C . ---__ =E: -� -INLAND VALLEYS EXCH.: LR' Q U I A �'A 3 wo No.: 8PQSQs I G. ,�-T_CONTROL NUMBER:_77EFFE R S w oA Sr ni/Q �fEi�1 L��REV. DATE: `'GALE: DAWN ENG APRVD PRIN (��ING RNS OF FROM (TUE) 10. - 5' 04 S.: OO/ST.. 7:5.8/WO. 4860068.607 P 4. 15— f . . . . . . oLL ..-. - .... ._ ,rL!oo r,o to ... �i. See mart A' 10. AIM. (3m) • i T =+ • i • _� �� - ave cnerf W - See A Flashing Arrow sign shall be used for each lane closed. •?. Two lone closure • Troffic Cone or Delineator signs (C-20) shalt be used on the approach to o lone closure with speeds of 45 mph (70 Km�) T Sign or greater, NOTE: This chart based on 12-foot (4m) wide lanes, For lone widths•grecter -- Direction o/ Travel than 12 feet (4m), use the following formulae: ( Not- o pavement marking) Toper formula: 0 Flashing Arrow Sign (Where Required) Refer L - S x W for speeds of 45 mph or more. L . S x W for speeds Pat to Poe 5 to select Type A, Type I of 70 Km/h or more. Y . or II . L 60 for speeds of 40 mph or less. Migh Level Warning Device (Flogtree) - L'- W_for speeds of 60 Km Wh ere: 550 /h or less- -' Sorricade (For Excavation Only) Refer to Poge 9 for L , Minimum length of toper. S ' Numerical value of Details on Type I Ty9a II or Typj posted Peed limit prior to work Pr _. „� ytrleliiue speed. woe.rc NORTH WIN A -Wf1aW Width o1 offset, AND AN ARROW PONT :.e.: 80 9gar Km/h and 6m lone: L a 80 z (2/3)6 • 320 meters i.e.: 40 mPh and 19' lone; L 19 x 402 WORKS17E -TRAFFIC CONTROL pLAN SINGLE LANE CLOSURE ( LEFT LANE ) x No C O 0 co 0 0 m a v in 0 CO rn 0 0 rn OD ON 0 0 i�G�7\G SEE B9 4 of a.a.w)A .ia CURB OR E.P. y1 1 TAPER �P FORMULAE S piC90 ��G S SS Soo or L Chart 'A" See Chart "A' Su Chart 'A' S iS0' 4lfm G \V SM Chart "A' � i EMD • Traffic Cone or Delineator T Sign Direction of Troves ( Not a pavement .marking ) Flashing Arrow Sign (Where Required) Refer to Pogo 5 to select Type A, Type 1 . or Type II . Y High Level Warning Device (Fiogtree) Barricade (For Excavation Only) Refp.f.t0_Pngq_C �YPe I . Type it or Type III . Flogger - ......... -- MINIMUM RECOMMENDED DELINEATOR AND SIGN PLACEMENT ( TRAFTIC SPEED TAPER IfNOTN (L) DELRIEATOR SPAC)NO SIGN spAclNc(s) �) (m) (A-t. *I r.,. 21 MPN (^�) r e.t~ &4") (T) 30 MPN �4g) (� rt. 123 Ft.(40) n rt. (a) 300 Ft. (90) 33 MPH (y0) (�) JO Ft. (9) 300 Ft. (90) 245 /t. (75) 35 rt. (11) 300 Ft. s0 (90) 1e3 •43 MPH (70) SQ FL .S0 ( ) 45 Ft. 14) 340 Ft. to 055+MPM (65) so 1000 Ft. (305) Ft. (15 rL (leg) (10) 750 Ft. (230) 1. A Flashing Arrow sign shall be used for each lone closed. 82. Two lone closure signs (C-20) shall be used on the approach to o lone closure with speeds of 45 mph (70 Km/h) or greater. NOTE: This choft based on 12—loot (4m) wide tones. For lone widths greater than 12 feet (4m), use the following formulae: Toper formula: L • S x W for speeds of 45 mph or more. L S x' 's W for speeds of 70 Km/h or more. L for speeds of 40 mph or less. 60� L n 51 for speeds of 60 Km/h or less. Where: L • Minimum length of toper. S , Numerical value of posted tu 85 percentile speed. W • Width of offset. .aa.1t Marn4 111w A nr i.e.: 50 mph and 19' lone; L 50 x 19 95 AND AN Aftnow pam? . 0 feet l: e.:.. 6n w n A,. WORKSITE TRAMC CONTROL PLAN SINGLE LANE CLOSURE (RICI(T_t an.! K �1 0 CURB OR E.P. --------Af�T-EET' � Meyionor OiviJin9 Line — — — 10' (min.) — — — — -- -- -- � � • p G G/ � S 1 � CURB OR E./Oc, To er LSea Chart 'A' 100' 30rn See Chart 'A• WORKAREAG ,� SSG a• p.•y.a; O • Traffic Cone or Delineator tr Sign , . Direction of Travel ( Not o pavement marking ) Flashing Arrow Sign (Where Required) Refer to Page 5 to select Type A, Type I , or Type I1 v Irrr-Level W ining Device (Flogtree) Barricade (For Excavation Only) Refer to Page 9 for Details on Type I , Type lC , or TVne_m Flogger MINIMUM RECOMMENDED -CH OW NEATIOR TRAFFIC TRAFFIC SPEED PLACEMENT TAPER LENOTM (L) (Krrt/N) DELINEAAr0 Sa'(ACINQLA .P 25 YPM ( ep) ; (m) (m) l•o.w,e. or ram.. • e.1— S•v�.. (m) " 30 MPH (eS) t25 rt. 125 Ft. '(e0) 25 rt. (SS) (a) 300 Ft- (90) . 35 MPH (50) 245 Ft. (7S). Ft' (9) 300 rt. (90) 40 YPM 35 Ft. 320 Ft, (t1) 300 FL (90) •e YPM -50 (70) s0 Ft. Se0 Ft. (185) 45 Ft. ' 1 (te) 3 F t00) Y M 600 1. Se0 Ft. (tes •53«YPM (es) 1000 FI t30S) 50 ft. (ts) 750 fl. (230) NOTE: This chart based on 12—foot (4m) wide tones. For lone widths 1; A Flashing Arrow gig,OD greater than 12 feet (4m), •2. Two tone closure sig(t:1120) aholdl be used ofor eachone l opprooch \\� use the following formuloe: to o lone closure with speeds of 45 m h 70 Km a or O Toper formula: P ( /) greater L . S it W for speeds of 45 mph or more. L OD L ' S x' '3 W for speeds .of 70 Km/h or more. 0% 0 L = for speeds of 40 mph or less. o rn 60 � ao — • 150 ti-,yTEb3-0)-66 Km/h or less. 0 Where: � L Minimum length of toper. ro S Numerical value of posted speed limit prior to work or W e Width of offset.,",-, ""^"� M0i4M rtM . •tr MD AM Mno. Poerr WIDRKSITE TRAFFIC CONTROL PLAN ... i.e.: 80 Km/h and 6m lone: L . 80 x (2/3)6. = 320 meters LEDGE OF CU TTER CLOSURE i.e.: 40 mph and 19' lane:.l . 19 x 4p2 cn 507 feet I FROM (TUE) 10. 5' 04 8:59/ST. 8:59/N.O. 4860068610 P 2 ' 2 ' 1_. I Work Area Traffic Control Handbook 39 Closing of Left Lane and Closing of Center of Street C13 OR C14 — I { I. I I 1 { to R. (3.em) I mt LAKE DD I . DI =_ I I y°I D O I ' D I { I iLA$M1R' •RROW E1m ®O 00. (. C30 { n I I I I I { I { { { { I 1 i I Z w —C13 OR C14 �— BARRICADES U. fCL DEUNEATOR �— See Chan A I 1� I ZT Q Z G IX ie S y I P ao S tj d LL V � E Q Cd d L C20 OR WI U. a CIO OR C23 0 FROM (TUE) 1 0. .5' 04 7: 59/ST.-, 7; 58/N0..4866068607 P .2 . APPLICATION' Fpq pERi1CT PUBLIC WORKS COIIQTqU�-trot (mil F`r t^e construction of public or private cu,_ And other Dice public works im �• oavesnarsts, _• - �� _. '• Proventents in connection with MINOR IMPAOVElEi� assd >bp� �"M A�'�YB OA'rE: 7—IL 05/04 Subd;v : LOCATION OF CONSTRUCTION JEFFERSON ST N/0 AVE 54 & MADISON Sk T S/0 q� 5 Coast to MinDrDe®m[ N 4 IStr" wdreu or Deecriptian Of Location) PUR':POSE OF CONSTRUCTION TO PROVIDE TELEPHON F CILITIESS e:7 MMMpA TA��ow, PTT Ulf) nor — ==r=%.o— a fit.) .1--%i't .31. i• - - SEE 2 DRAWINGS THAT ARE ATTACHED. DIM NSIONPF jNDSTA RLATC NF R REMOVAL 5cUi tr•r UT VERIZON WORK ORDER t' 0543-8.POOIGR SIZE�F EXCAVATION, IF NEED E® - APPTXIMATE TIME WHEN WORK WILL BEGIN APPR OIXIFAATE TIME OF ESTi ATED CONSTRUCTION COSTSMPLETIO O uncle irlg removal of all : �Qon On P+ctio' obsVtsction, materials, and debris, badcfilting, oom- and pladny permanent resurfacing and/or replacing bttproventanti) In colpideration of the !ranting of this Permit- ermi the applicant hereby agrees prove tbde+nnifyl dehnn} and "" the C't - is authorized ut wined swou oK �pneeersstivee•and iebititiea w toso or &r�'!� �tatQ atee! N;oh�n w occurring a e 1 xr4rrtO result o/peny evork undertakan u 8cdOn and der he a any it a or � � aw ski Administrative Au rider the permitft e 3m 1 h n iaest twenty-four 1211 tsoure N advance of the tires mom no w91 7 O i with all spay iota City Ordinanees" ds a coma and Conditions O! the t+ermit and actbw �� m+Inta and to pay far arty additional Mlacoment necessary p tfna remit th of thisrWt wort n �OrCef]ft hole -0m6mions. tt 00 ciy as VER IZON Signature of Appligr- 295 N. SUNRISE WAY PALM SPRINGS CA 92262 760-864-015 Name of Applignt (Please Print) K, i-�% C; Busineu Address Name f' Z week PY�:o r �- T�Oa® Jio o ICaniraetor artd b Foreman Business Address Tf1el .� ContraRpr's License No. City ss�sea Liost� >� "— Applicang's Insurance Compan FEES: c p ry hurrs� . ubdNision improvement Perm; —Class I f l Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs i^or Improvement Permit — Cia>s ly; &e, attsehed schedule Inspection' Fee s L0 0 J _ Permit Fee 100.00 PERSQT VAL CLAT)C Penalty ; PERMIT NC. Cash Deposit•Surery Bond if reQu;red DATE APPn:* sS3 TOTAL: s 80 L? EXPIRAT:C% J►TE Receipt--�" No. DAMISSU:: Received by, By Date __ Recorded by.' Telepl-.re —x) 77;.7,-- FROM,. :.(TUE) 10. :5' 04 8: 59/ST. 8:59/NO. 4860068610 P 1 I 208 NORTH WAY P/V.li13Pf MM GLXXWl1N 02M TM. proem �l;lv joweS ftm 74o-777. 7/--f'S '•�••� h.o.e.e 7Go - 7 7 7 - 70-8 Q Rees � Phonse 7w-. �G 4 - /7 %S G,L,e,r O c dto, i° a C] Ugwd Pw RVbUW O 11s6se Casa! R*Oy i0 measF., Recyc 0 Conunentu ..FROM.TUE) 10. .5' 04 7: 58/ST. 7:58%NO. 4860068607 P 1.... f • . •ii ftx ANTHONY COLAROM FMC _— 760-777-7155 VERIZON Netwp* Engineering & Planning —West 295 N. Sunrise Way Palm Springs, CA 92262 ROM ROBIN .CONES Pages: 7 Data 10/5/2004 Ron ; Phone: 760-864-1715 ---------------- L7 Argent For Rcwew ❑ Please ConPlease ReWy ❑ Please Recycle i DRAWING Z h� ENUE 54 ® RO4 I7COM9RUM N AHEAD IEF F LANE GL.DSED AHEAD I I � I 200' KOND VIDRK ■ a D GONS-MUL110N SPEED LIMIT I a 75 MPH o � FLASVH N 6 kZROW S\GN vr� ,+D' T � I • 1 • I COUSTRUCTI ON j AIZgPr (JtSfF 1 iRPcFFIG GONiROL FLAN { FDR TMFNGHltfb ON THE • PAST SIDE OF MADISON TRFNGii WILL U • 21 W I QE X %M LDNb *X 3' DEEP FLASHING AkIFOW SIGN • ■ 11>,NE GLfKED • ROAV WRY, NO SGl�LE • SFEER UMIT ENO UWgR0TION ■ 25 MPH .I 320' ■ DMUR A,1•IEAD 13201 ■ Kokv GON sTM.U6T10N AttEAV With proger.%ilidatjon 4 e' this form constitutes an CITY OF LA QUINTA encroachment permit � APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT). caw C�'`110F 'pFlb��s 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 10/5/04 Subdivision Improvement Permit —Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Jefferson St. \/O Ave 54 and Mzidison St S/0 Ave 54 (Street address or Description of Location) PURPOSE OF CONSTRUCTION provide telephone £:ici].ities Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION splice pit N0 Ave. Y4 Oil -Jefferson & conduit. alacement S/O Avr?. 54 on Madison DIMENSION OF INSTALLATION OR REMOVAL 5x5 ` s:o3-irP r_.f v 4 `. & 350 1' widetrenchfor conduit SIZE OF EXCAVATION, IF NEEDED 1 r wide 36rtdee APPROXIMATE TIME WHEN WORK WILL BEGIN 11/1/04 vx.om APPROXIMATE TIME OF COMPLETION---5/1/OSis ����ESTIMATED CONSTRUCTION COST$ 6000.00 (Including removal of all obstruction, materials, and debris, backfilling, com- LAgU1MTqpaction 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, li1bilities or loss resulting from claims or court action and arisirig out of any accident, loss or damage to persons or property happening"'r occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. N"oti•fy 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. " St,Wure of Applicant or Agent Verizon 295 N. Sunrise Way Palm Snrinps, CA 92262 (760) 864-1715 Name of Applicant (please print) Business Address Telephone No. INVORK CITY 2 WEEKS PRIOR TO START Name of Contractoe and Job Foreman Business Address Telephone No. Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class I I I Public improvements: 3% of estimated construction costs Q� Private improvements: 3% of estimated construction costs Minor. Improvement Permit — Class IV: See attached schedule a, 455 Inspection Fee $ 180.00 f II PERMIT VALIDATION 0.0 Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by $ 280.00 Date PERMIT NO. "4255 DATE APPROVED 10/5/04 EXPIRATION DATE 10/5/05 DATE ISSWED v Administrative Authority Recorded by 11 Telephone: (760) 777-7075 UU/ Z81 Z.UD WED WO VC.: VAA f aU fir 1173 Ull,y of lf' Ra rUu, R ICJ UUI/ uUL FINANCE W-� Revenue Code_____ P_U_ Bc)x 1504 LA QUINTA, CALIFORNIA 92247-150 78-495 CALLF. rAMPI(:0 LA QUINTA, CALIFORNIA 922,53 September 29, 2005 • Verizon Daniel Honeyfield U 295 North Sunrise Wa, *4,P Palm Springs Ca 02 C p �Par c Re: JEFFERSON STREET i SOUTH OF AVENUE 54 (760) 777.7000 FAX (760) 777-7101 w.0. D543 -$�OOI G� 22.10 54 AND MADISON STREET Encroachment permit 4255 will expire on 10105/2005. In order to avoid the issuance of a °Stop Work Order' please renew this permit with in the next 10 (ten) days. The renewal fee as per City Council Resolution states: Encroachment Permit— renewal of expired permit $900.00 Plus 10•0 of original fee for each year the permit has been expired . ORIGINAL PERMIT FEE 10.% EXPIRATION PENALTY FOR EACH YEAR PERMIT HAS BEEN EMPIRED $280-00 - •$28.00 $100.00 RENEWAL AMOUNT DUE: $128.00 7f;`you Have ariy guegions or need additional information, please call Jesse .fimenez, Counter Technician at (760)775-7075. .. Sincenrly, aul Goble, P.E. Senior Engineer City of la' Quinta Public Woii..s I Engineering Department " -� 3 ORAWIN(-) 7 NO Tf With proper validation 0 this form constitutes an : CITY OF LA QUINTA encroach mentpermii APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)` OF If$O�S 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: 10/5/U4 Minor Improvement Permit Class IV sef.ferscnn St. N/0 Ave 54 M:ta ie:disorr St LOCATION OF CONSTRUCTION S/O Ave 54 (Street address or Description of Location) PURPOSE OF CONSTRUCTION provide telephone facilities Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION sp ice Pit L' 0 Ave. 54 o:_ J'efYersor,, & Co:iduit- nlaceniei7m 5/0 Hva 54 n•- t•i:diec:t . F DIMENSION OF INSTALLATION OR REMOVAL 5x5 t -A Ire n_ 9 � & 350 11 wide trench for col-lu r SIZE OF EXCAVATION, IF NEEDED 1 t wide 36"deep APPROXIMATE TIME WHEN WORK WILL BEGIN 11/1/04' tH APPROXIMATE TIME OF COMPLETION 5/1/05ESTIMATED CONSTRUCTION COST$ 6000.00 `" 20t05 tJ' (Including removal of all obstruction, materials, and debris, backfilling, com- CITY OF LAgUINT paction and placing permanent resurfacing and/or replacing improvements) FIM 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, libilities or loss resulting from claims or court action and arising out or any accident, loss or damage to persons or property happening"•,'o! occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Nii;ify 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. SiVAure of Applicant or Agent Verizon 295 N.. Sunrise Vay Palm Springs, CA 92262 (760) 864-1715 Name of Applicant (please print) Business Address Telephone No. INFORM CITY 2 WEEKS PRIOR TO START 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- Suhdivisinn Imnrnvemont permit — rInct 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 $ 180.00100.00 _ I Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by Recorded by 280.00 Date 3 ° 4255 PERMIT VALIDATION PERMIT NO. 4155 DATE APPROVED 10/5/04 EXPIRATION DATE 10/5/05 DA.T,E ISSWED s Administrative Authority Telephone: (760) 777-7075