4263NOTE:
With proper validation
this form constitutes an
encroachment permit
t
61
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of- public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class I I I
DATE: 10/19/0!A Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Avenue( 52 - The Hideaway TM 29894
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Stm npd r-orerskte on ImIlAnd
DESCRIPTION OF CONSTRUCTION • p.R tai.An nAt No. 117114095
DIMENSION OF INSTALLATION OR REMOVAL SAA nl-nf*a
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN Thom enn+nv%Ia1-dnxx
of 'I:.rknil ieono ilmnxntrp�pn>t-rt
APPROXIMATE TIME OF COMPLETION') — pfte-c start, dal-
ESTIMATED CONSTRUCTION COST $ 33,500.00
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Sketch (attach construction plans if appropriate)
ENTERED
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 andiall applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of tFiiswork.
X..(i�_.
Signature of Applicant or Agent
Kim Fincher - ND La Quinta Partners 81100 Ave 53 La Quints 760-535-9443
Name of Applicant (please print) Business Address Telephone No.
Archuleta Concrete Palm Desert, CA 760-275--8193
Name of Contractor and Job Foreman Business Address Telephone No.
4-1 F2._ 0(_(+ 0 .) o ray
Contractor's License No. City Business License No.
�11
( -- ".j c i ,-_ 5 ;x'• " f. % 7 Z. DPI (� <
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class II I
Public improvements: 3% of estimated'construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ . 01 0 • � �
Permit Fee ! ` .),
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No
Received by
Date
f, � 4263
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE I I
DATE ISSUED` `'f `2'1
1.1
By
Administrative Authority
Recorded by II Telephone: (760) 777-7075
APPLICATION FOR PERMIT
Date:
Location of Construction:
rN
Purpose of Construction: ,`� S
Description of Construction:. Set a 5z+ �J a. C) Lj d '�
Dimension of Installation or Removal:
Approximate Construction Start Date: S
Approximate Construction Completion Date:
Estimated Construction Cost: $ 33.500
Estimated Construction Cost shall include the removal of all obstructions, materials, and debris, back -filling, compaction and
placing permanent resurfacing and or replacing improvements
Contact Name: ► l- Phone Number:
Name of Applicant: F 4 t Z, D
Applicant Address: -10 J .rc 53
Applicant Telephone Number:
Name of Contractor: a �x
Contractor Address:
Contractor Telephone Number: S
Contractor State License .Number: a
Contractor City Business License Number:
► A COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED
Applicant or Contractor General Liability Insurance Company:
Applicancor Contractor General Liability Insurance Policy Number:
Office Use Only:
Inspection Fee: . f O l u
Permit Fee:
1D0; o .7
As -Built
Deposit:
Dust Control
Deposit:
Credit
Amount:
TOTAL: FEE DUE:
Office Use Only:
Assigned Permit Number.
Approval Date:
Expiration
Date:
Issue
Date:
Administrative Authority:
10/05/2004 10:34
7603458223
ARCHULETA CONCRETE
PAGE 01
,A
Date: 30-Sep-04
PROPOSAL e . 574JC
suBmiTTED To: Kim Fincher
PROJECT NAME:
LOCATION:
ARCHULETA CONCRETE
79-607 Country Club Ste 1
Bermuda Dunes, CA 92201
(760)•346.8722 Fair 345-8223
Lic. No 672066
The Hldeway. .
La Quinta, CA
CONTRACT
Job No.
SCOPE OF WORK: stamp Concrete Median
Unit Ext.
ITEMS DESCRIPTION AMT. Unit Price
Color Concrete Stamp Median 6154 SF $ 5.20
plsf $ 32,000.80
$ -
s -
Barricades 1 EA $1,500.00
ea $ 1,600.00
-
S -
S -
S
Notes
DETAIL STIPULATIONS:
1) Grade to be Within .1 (One Tenth of One Foot)
2) Builder to thoroughly wet area during ALL operations
3) Addltlonal Move -Ins to be $1,100.00 ea
4) Subgrade to be Free of Rocks Initials: /
Contractor Sub Contractor
Page 1 of 2
PERMIT NO.4263
Hideaway / Stamped Median Concrete / TM 29894
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. Provide a 2'x2' mock-up of a cast -in -place colored stamped pattern concrete for approval prior to
installation in the median nose.
ND La Quinta Patners, (Kim Fincher)., hereinafter referred to as"Permittee", shall be responsible for
providing continuous dust and erosion control.
4. This permit or copy of it shall be on the work site for inspection during the actual work performed.
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 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 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.
7. 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.
8. Pursuant to Section 14.16.11.0 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.
Special Conditions Page 1 of 3
IP t
PERMIT NO.4263
Hideaway / Stamped Median Concrete / TM 29894
�. 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.
10. 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.
11. 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.
12. 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 to 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:
Backfill or excavation is not in the scope of work of this permit.
13. 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.
Page 2 of 3
Special Conditions
PERMIT NO.4263
Hideaway / Stamped Median Concrete / TM 29894
1-4. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to its
original condition:
15. Access and egress to all local .properties shall be maintained at all times.
16. 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:
Asphalt construction is not anticipated in this permit. Please apply for an additional permit if asphalt
construction is required. .
17. 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.
18. 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.
19. The City of La Quinta reserves the .right to revoke, suspend or void this permit at any time.
20. 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.
21. 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 3 of 3