4293=, w
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 III
DATE: 12-09-04 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION ***ANNUAL BLANKET PERMIT***
VARIOUS LOCATIONS WITHIN THE CITY.
(Street address or Description of Location)
ROUTINE MAINTENANCE FOR SERVICE
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
AND REPAIRS ENTERING MANHOLES.
DESCRIPTION OF CONSTRUCTION MAINTAIN AND REPAIR OF 'IMtC14dd1$:,,.
EPISTING FABILITIES.
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 01-01-05
APPROXIMATE TIME OF COMPLETION 12-31-05
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
a;"
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�thiVwork.
ff `f
Signature of Applicant or Agent
VERI20N 295 N. SUNRISE WAY, PALM SPB,iNGS, CA 92262 760-1364-1715
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
488385 A,B,C7 and CIO
Contractor's License No.
AMERICAN ROME ASSURANCE
City Business License No.
RMGL 480-63-31
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 $
Permit Fee _
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ NO FEE
Received by Date
TERED
4293
PERMIT VALIDATION
PERMIT NO. 4293
DATE APPROVED 01--01-05—
EXPIRATION DATE 12-31-05
DATE ISSUED
i
Administrative Authority
Recorded by 11 Telephone: (760) 777-7075
FROM (THU) 12. 9' 04 14:03/ST. 14:02/NO. 4860068233 P 2
- — - APPLICAT10N FOA ►ERMr
PUBLIC WORKS CONSTRUCTION
Fc, -me conrtrucu cam of public of private curls. drillways. palm m u. si - partial IlOtsti Ste. eater
a •d other like public works improvements in connection with MINOR IMPROVElEe%-rS and
12 / 0 9 / 04 Subdivision te94tt671MC hrtfit — ��Jn lu
DATE m 4v r U:s>Qv.sssent iew-stt= w IV
LOCA'°'ION OF CONSTRUCTION ***ANNUAL BLANKET PERMIT***
VARIOUS LOCATIONS WITHIN CITY_L
IStron igddresa or Description of Lowtiani
of Ino^cc nC rf%m4 rotICTIn1N ROUTINE MAINTENANCE FORi c=r12='+ 02111125 1f appvprivte)
I
DIMEMSION OF INSTALLATION OR REMOVAL
SIZE ;)F EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN. 11 L/ 11 LJ 1in_
"PROXIMATE TIME OF COMPLETION a� J1 VJ
ESTI ATED CONSTRUCTION COSTS
0riclui(ing removal of all obstruction, matarlals, and debris, badtfillinp, cons-
paetlo and placing permanent rasurfacing and/or replacing Improvements)
In consideration of the granting of this permit, the applicant hereby agrees to.
nele—Ov, defend end aria the City. Its authorized agents. officai , nprowntstiw and ernOses1w. ttoa act mina aqf and a0
.senalties. liabilities or toes resulting from dairro or court action and arising out of eery acim o - lion or decor tea maw or p-v nv
-opening or occurring a a proximate rawlt of any wort undertelan under the permit 0-80=9 iv>ot w 1111k
Votity the Administrative Authority at leant twenty-four (24) hours In advsnee of the parse so tot sail !e a=si .
:omply with all applicable City Ordinance, the tempts end aaonditlona f the permit and ad apo�te ratan and noiiriinas sf 60 CAI Of
V Write and to pay for any additional replacement neeessvy as the tultltof this wort-
, 4&;4,
Si4naturs of AppfiqV_ zr Agns
V'LRIZON 295 N. SUNRISE WAY PALM SRPINGS. CA 92262 760-864-1,.1
Name. of Applicant (please print) Business Address TeSara �-
Name of Contractor and Job Foreman Business Address
Contr)ectors License No. City
v ,r<: �,,,,. ►�o,r►e. Ass ��.w�e R M G t� 4 8 4 63 z3 L—
Appli..:ant's Insurance Company ro`cy'lacanc w
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
Inspe Zion Fee
Perm::=t Fee
Penal .y
Cash :)*posit•Surety Bond
it req sired
. TOTAL:
S
Racept No.
Recaived by Date
Reco•ded by
KRJOT VALOATI X*
Lk
PERMIT NC_ ?-,::It I —
DATE APPF:,b
0
EXPIRAT;C%:ATE t Z/`.
DATE ISSU: s
FROM (WED) 1. 5' 05 13:47/ST. 13:42/NO. 4860068450 P 2
RIGHT-OF-WAY
CERTIFICATE OF INSURANCE AND ENDORSEMENT
REQUIREMENTS
DESCRI ION OF CONTRACT:
TYPE OF INSURANCE: Commercial General Liability Insurance,. including: premises. d
Operations; Blanket Broad Form Contractural; Contractors Protective; Completed Operations
and Pr•ducts; Broad Form Property Damage; "XCU"; Personal Injury; Extended or Broad Porn+
Liability Endorsement.
r
Covera!3e shall be for not less than $1,000,000.
THIS I:S TO CERTIFY that the policies.of insurance listed below have been issued py the
company named below in conformance with the requirements set forth in District's'Contrac;t
Documents, and that said policies are now in force.
f
Said company will give at least 30 days advance written notice by registered mail to
Distrii=t, prior to any material change or cancellation of said policies.
This certificate or verification of insurance is not an insurance policy and doe+3 not
amend,) extend or alter the coverage afforded by policies listed herein. Notwith:3tanding:
any relquirement, term or condition of any contract or other document with respec= to
which (this certificate or verification of insurance may be issued or may pertain,, the
insurance afforded by the policies described herein is subject to all the terms,
exclusions and conditions of such policies.
Polih:y Effective Expiration Limits of Liability
Numbrer Date Date Bodily Injury &. Property D! majLee
ENDORSEMENT REQUIREMENTS:
District and its employees are included as additional insureds under these polices but
only rhile acting in their capacity as such and only as respects operations of t:.ie
original named insured, its subcontractors, agents, and employees in the perforr,:ance of
the above -referenced contract.
This Indorsement shall not operate to increase the insurance Company's total limits of
liability under the above listed policies.
The in
company hereby waives its rights of subrogation against the named
additional insureds'.
I
Endorsements �7must nbennprovided
Lby insurer on company forr(m�s,./�.,^'^ < 1
INS UR 'D: e_f l L C/l'llMM CG flrh� Zn(. ADDRESS ��� T t� l.Y ` S_� ��OU1ff �z`S Plii 1L.J.P�
Phone (g94 2,[) Person to Contact Rn r hP 62- c n
INSUReR.* � r� (. un M-Q A5Sl/7'Gtn C-e ADDRESS .b t 1y1-� �� . , f�Y (� Y f G rwa;
Phone !No. ,;k1R_1;JQ- 1 ;Jf--4- Person to Contact Denni <, Xr1r_C 4 { 1
I
AGENT -! 1 G cm &, r i-e 17SS1/Y/,Cry G'C' ADDRESS ko P, n e Oi
Phone INo.A)ya-'�-7J70-)';;?Ir4 Person to Contact 12gon,_5 2�0./SL1 a l
DATE : I Ila. it)Lk „ ALI
Authorized RepresoMtativkla NOTARIZED Signature
NOTIC�-.: No substitution or revision to this certificate and endorsement will bey'
accepj ed. If the insurance called for is provided by more than one Company, a F(eparate
certificate, using this format, shall be provided for each company.
CVn-783a
(Rev. 6/0aI
FROM (WED) 1. 5' 05 13:48/ST. 13:42/NO. 4860068450 P 3
RIGHT-OF-WAY
CERTIFICATE OF INSURANCE AND ENDORSEMENT
REQUIREMENTS
I
DESCiIPTION OF CONTRACT:
TYPEiOF INSURANCE: Commercial Automobile Liability
i
Cove 'page' includes owned, hired and nonowned automobiles and shall be for not :.ess that
$1,000,000.
THIS! IS TO CERTIFY that the policies of insurance listed below have been issued by tti=
company named below in conformance with the requirements set forth in Districe:'s contract
Documents, and that said policies are now in force.
Saidi company will give at least 30 days advance written notice by registered i;.1ail to
Disti-:ict, prior to any material change or cancellation of said policies.
i
Thiel certificate or verification of insurance is not an insurance policy and does noC
amend, extend or alter the coverage afforded by policies listed herein. Notw;.thstandILng
any ;requirement, term or condition of any contract or other document with respect to
whic;.i this certificate or verification of insurance may be issued or may perthin, the
ins rance afforded by the policies described herein is subject to all the terms,
exc1isions and conditions of such policies.
Pol.Licy• Effective Expiration Limits of Liability
Number Date Date Bodily Iniury s Property Damage
ce.jao�oy �I30�pS llowj°cob;n�c�' Sin ���
ENDoksEMENT REQUIREMENTS: C 5
DistIrict and its employees are included as additional insureds under these policies bat
only' while acting in their capacity as such and only as respects operations o:'. the
original named insured, its subcontractors, agents, and employees in the performance Df
the I;bove-referenced contract.
This endorsement shall not operate to increase the insurance Company's total :.imits of
liabiility under the above listed policies.
The insurance company hereby waives its rights of subrogation against the named
additional insureds.
I
Endorsements must be provided by insurer on company
forms.
INSURED: ( ADDRESS J-�- nfC S . (F I GC ;JZ Oh C,
Phone No.-Cffy3-U 3p Person to Contact r-C Q
INSOROR : P&YVX 1 ( (a () i- ani e os;S,- /r& n [ -P ADDRESS t-0 P�
Phone No.F:' - 0- lo'�s�Person to contact {er(1i fi n--)arfShrkL I
AGEIIT: C-e ADDRESS KC) P, rye LS4-. n Y n Y ' UC
Phone No. - - i Person to Contact -y�1�� n ✓Y)Cc��h u _
DATE: ��A ►I� Y
i Authorized Rep sentative's NOTARIZED Signature
NOTlICE: No substitution or revision to this certificate and endorsement will be
accepted. If the insurance called for is provided by more than one company, a separate
certificate, using this format, shall be provided for each company.
CVWD-783b (Rev. 4,/02)
FROM (WED) 1. 5' 05 13:48/ST. 13:42/NO. 486006B450 P 4
• I Klufll -�Jt -VIH1 '
CERTIFICATE OF INSURANCE AND ENDORSEMENT
DES c�If1IPTION OF cUrri'xAvT:
TYPEOF INSURANCE: Worker's Compensation Insurance/Employers Liability
Comp'Lies in all respects with the Worker's Compensation laws of the State of 0.'aliforn:ia.
THIS IS TO CERTIFY that the policies of insurance listed below have been issuMtd by this
compi;ny named below in conformance with the requirements set forth in District:'s Cont.,:act
Documents, and that said policies are now in force.
Saidl Company will give at least 30 days advance written notice by registered 6tail to
District, prior to any material change or cancellation of said policies.
This certificate or verification of insurance is not an insurance policy and acres not'
amend, extend or alter the coverage afforded by policies listed herein. Notwi.thatand:.ng
any :,requirement, term or condition of any contract or other document with res-ect to
which this certificate or verification of insurance may be issued or may pert:.in, the
exclir insuance afforded by the policies described herein is subject to all the terns,
isions and conditions of such policies.,
I •
Statutory
Po1licy Effective Expiration Limits of Liability
Nurttber Date Date As Required By Law
• ENDO#.S EMENT :
This [endorsement shall not operate to increase the insurance Company's total 14Mita of
liability under the above listed policies.
The insurance company hereby waives its rights of subrogation against the name-
addi5ional insureds.
INS7ED: V/ 1 imlml I-(L7 '. F ADDRES l { 5' pe)I I . �14 I'
Phone No.��S- iQ (43d Person to Contact Kfl('J, 2 I
IN=.*OR: it ran , ADDRESS kn C;
Phone NO. _&Z,- 33tQ - person to Contact C) I S
AGENT• �1 i C(A n �(, ias V`CQn< ADDRESS :0 lk�i flP_ S} . (1 Y Yl U 4QQ�
Phone' No .: i JoZ - ) - QR- Person to Contact (r [ S, r1'lr f Cj3 I 1
DATE i 9 I � j I_ �sAy( IVV Id..�d�Il l
�T Authorized Repreeektative-a NOTARIZED SignatWIe
NOTIOE: No substitution or revision to this certificate and endorsement will be
accepted. If the insurance called for is provided by more than one company, a aeparat•:
certificate, using this format, shall be provided for each company.
CVWD-783c
FROM (WED) 1. 5' 05 13:47/ST. 13:42/NO. 4860068450 P 1
Rietwork Engineering & Planning - West
29S N_ Sunrise Way. Palm Springs Fax 760-32S-2S36
i
TO: ANTHUN,I COUKUSSI Fronx RODE RT JONE'S
Fax: (7 be 1 17.7 - -7 I S K Phone: (700 .l 1104.1715
Phan: OLDi 7 i 7-- 70 M Date: (- 5 - a5
Ree Pages: L+
❑ Urgmd ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Rei:yde
'VERIUM INSURANCE FORMS
I
Verizon Special Conditions for Annual Blanket Permit 2005
Verizon / Various City Projects / Within the City of La Quinta
For the standard annual blanket permit conditions, the following shall apply:
The permittee shall obtain a unique blanket permit number 2 week's prior performing work. The unique
blanket permit number can be obtained by calling the Assistant Engineer I at 777-1089.
2. Annual blanket permit numbers are valid only for existing facility maintenance, connections, or repairs.
For all other type of work, the permittee must apply for anencroachment permit with the City of La
Quinta.
3. All prime or sub contractors working under any annual blanket permit must have the following
documents on file at the Public Works Department 2 weeks prior to start of construction:
a. General Liability Insurance Company and Policy Number
b. City Business License
c. Contractors State License Number
4. 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.
Emergency work does not apply to this permit.
6. Annual blanket permits are not valid for work within the Public Right of Way on any Arterial street (i.e.
any public street with more than 2lanes). The permittee must apply for an encroachment permit (see
online application form).
7. Verizon, hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and
erosion control.
8. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more
frequently, if required.
9. If a lane closure occurs within the Public Right of Way, Verizon must submit an approved traffic
control plan at least 2 weeks prior to start of.construction or parking on the paved R/W.
10. On any arterial roadway affected by work within a blanket permit, Verizon is required to provide an
informative message board (approved by the City Engineer) informing the commuters using the affected
roadways of possible traffic delays, time of construction, and if possible alternate routes: The message
board shall be provided for the commuters 48 hours prior to the start of traffic delays.
11. The permittee shall haul all offsite debris to a certified landfill. Prior to hauling debris, the permittee
shall inform the City (Inspection staff or 777-7089) of the name and location of the certified dump site.
Special Conditions Page 1 of 5
Verizon Suecial Conditions for Annual Blanket Permit 2005
Verizon / Various City Projects / Within the City of La Quinta
12. The permittee must obtain City approval and shall place temporary no parking signs along any parking
area disrupted by construction work. The signs shall be placed along the area 48hrs prior to the start of
closing the area, and removed immediately after the construction completion date.
13. Prior to excavating in native soils, the owner of the project 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 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.
14. 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 public street with more than 2 lanes) before 8:00 a.m.
15. 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.
16. Pursuant to Section 14.16A 10 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.
17. 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.
Special Conditions Page 2 of 5
Verizon Special Conditions for Annual Blanket Permit 2005
Verizon / Various City Projects / Within the City of La Quinta
18. 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.
19. 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.
20. All grading shall conform to Chapter 8..80 of the City of La Quinta Municipal Code, which can be
obtained at the City or on line at la-quinta.org.
21. 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:
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.
Special Conditions Page 3 of 5
Verizon Special Conditions for Annual Blanket Permit 2005
Verizon / Various City Projects / Within the City of La Quinta
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 location's 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.
22. 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.
.23. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to its
original condition.
24. Access and egress to all local properties shall be maintained at all times.
25. 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 Y2" max medium finish course lift for
capping. Asphalt concrete. mix design shall be approved by the City prior to its placement.
Special Conditions Page 4 of 5
Verizon Special Conditions for Annual Blanket Permit 2005
Verizon / Various City Projects / Within the City of La Quinta
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 urlmilled 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/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.
26. 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.
27. 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.
28. The City of La Quinta reserves the right to revoke; suspend or void this permit at any time.
29. 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.
30. 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 blanket
permit number from the City to perform the required restoration work.
Special Conditions Page 5 of 5
FROM (TUE) 3. 8' 05 8:37/ST. 8:37/NO. 4860068079 P 2
i
-e�
�, SL
NOTE. �L� 9✓
With prooer validation
&Is"form constitutes an '
encroachment; permit CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the; construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers,: water ma: ns
and oth :r like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SLI�BDIVISIOIJS
DATE: 12-09-04
Subdivision Improvement Permit — Clads I I I
Minor Improvement Permit Clads IV
LOCATION OF CONSTRUCTION ***ANNUAL BLANKET PERMT***
VARIOUS LOCATIONS WITHIN THE CITY.
(Street address cr Description of Location)
PURPOSE OPi CONSTRUCTION ROUTINE MAINTENANCE FOR SERVICE
. Sketch (attach construction plans i' appropria':e)
AND REPAIRS AND• ENTERING MANHOLES
DESCRIPTIO'14 OF CONSTRUCTION MAINTAIN AND REPAIR OF /�
EXISTING FACILITIES. �!7M 11,4kvey
DIMENSION il)F INSTALLATION OR REMOVAL IAtrgk &4AIROLC d,tf .J�FFE'es4A/ 5T
S�0 f6f C.4AF4 C L: iSk'
SIZE OF EXC4VATION, IF NEEDED AW A14E S,� A4yT1m�-
QXL fE TIME WHEN WORK WILL BEGIN 01-01-05 _ A��'Q .& At A SPfr�F_ 4F k;=� --
APPROXIMM.-E TIME OF COMPLETION! 12-31-05
ESTIMATED �,,',ONSTRUCTION COST $ _
(Including rerf,oval of all obstruction, materials, and debris, backfilling, com-
paction and pilacing permanent resurfacing and/or replacing improvements)
In consideratiyn of the granting of this permit, the applicant hereby agrees to:
i
Indemnifj;-, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and agaiist any and:ill
penalties,' liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persi+ns or prop(rty
happeninq or occurring as a proximate result of any work undertaken under the permit granted pursuant to this applicat ;)n.
Notify th!: Administrative Authority at least twenty-four (24) hours In advance of the time when work will be started.
i
Comply vrith all applicable City Ordinances, the terms and conditions of the permit and all applica a rules and regulations- of the City of
La Quinta and to pay for any additional replacement necessary as the result of ' work.
Signature of A pli nt or Agent
VERIZON 295 N. SUNRISE WAY, PALM SPRINGS, CA 92262 760-864-17I.5
Name of Appli:ant (please print) Business Address Telephone No.
Name of Co
ctor and Job Foreman
488385.; A,B,C7 and C10
Business Address
Telepht;pe No
Contractor's Lcense No. City Business License No. I '
AXLERI(:AN HOME ASSURANCE RMGL 480-63-31
Applicant's Insurance Company Policy Number ;
�-rEES: Subdi';rision Improvement Permit — Class I II ,
Public improvements: 3% of estimated construction costs
Pril�ate improvements: 3% of estimated construction costs
Minr,r''ImnrnvomPnt permit — rlacc IV: CPp attar.hP.rl zr.hPdijlP 4
FROM (TUE) 3. 8' 05 8:37/ST. 8:37/NO. 4860068079 P 1
*/.
r� PUBLIC WD°°ORKS.F=NG�INIEERI:JG
ANTHONY COIJAROSSI, F E.
ASSISTANT eVGINEER I
P.O. BOX 1504 DIRECT (760) 777 7089
8-495 CALLE TAMPICO FAX' '' (760) 777 7155
QUINTA. CA 92247-1504 EMAIL: zcol,�-ossiio)la7quir; a.ory
i
•PUBLIC WORKS jENGINEERI JG
HARVEY Di:::TWEILER
• INSPE':•TOR
P.O. BOX 1504
•
8-495 CALLE TAMPICO CELL (760) 535 -9463
FAX 1760I 77; -7155
LA
FROM
(TUE) 3. 8' 05 8: 38/ST. 8:37/NO. 4860068079 P 3
G5
38
Work Area Traffic Control Handbook
y Closing of Right Lane
19
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48 Work Area Traffic Control Handbook Work Area Traffic Control Handbook
Closure of Bike Lane
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=
MINIMUM RECOMMENDED DELINEATOR
AND SIGN PLACEMENT
SIGN SPACING
TRAFFIC SPEED"
TAPER
DELINEATOR
SPACING
(Advance of Taper.
LENGTH
(Taper)
(Tangent)
& Between Signs)
Each Lane
25 MPH (40 Krtyh)
150 R.(50m)
25 FL (8m) ,
50 FL If 5m)
150 Ft (50m)
30 MPH (45 Krryh)
200 R (60m)
30 Ft (9m)
60 FL (I am)
200 R. (60m)
35 MPH (50 KrtVh)
250 R (75m)
35 FL (11 m)
_ 70 Ft (21 m)
250 FL (75m)
40 MPH (60 Knvb)
350 R (11 Om)
40 FL (12m)
80 R (24m)
350 Ft (11 Om)
-45 MPH QO KffA)
550 R (170m)
45 FL (14m)
90 FL (27m).
550 R. (170m)
*50 MPH (80 Knvb)
600 R (180m)
50 R (15m)
100 Ft (30m)
600 FL If 80m)
'55
1�
50 Ft (15m)
100 Ft (30m)
1000 FL (300m)
KMnPHH+(85
NOTES: - "See Section 8 for high speed situations.
- Distances shown in parenthesis are approximate.
`•85th Percentile speed
or as directed by the Engineer.
—CHART
B —
PARKING
LANE OR SHOULDER
MINIMUM
MAXIMUM
MAXIMUM
SIGN SPACING
TRAFFIC SPEED,**
TAPER
DELINEATOR
SPACING
(Advance of
LENGTH
(Taper)
(Tangent)
Taper & Between
Each Lane
Signs
25 MPH (40 KrMi)
50 R (15m)
25 Ft (8m)
50 Ft (15m)
50 Ft (15m)
30 MPH (45 KrrVh)
66 R (18m)
25 FL (8m)
50 Ft (15m)
66 R (18m) '
35 MPH (50 KnYh)
83 R (21 m)
25 FL (8m)
50 Ft (15m)
B3 R (21 m)
40 MPH (60 KRVh)
116 R (24m)
25 R. (8m)
50 FL (15m)
116 R (24m)
•45 MPH (70 KrO)
183 R (27m)
25 FL (8m) -
50 FL (15m)
183 R (27m)
•50 MPH (80 KrrVh)
200 R (30m)
25 Ft (8m)
50 FL (15m)
200 Ft (30m)
'55 MPH+(85
333 R (30m)
25 FL (8m)
50 FL (15m)
333 R (30m)
KrO
NOTES: -'See Section 8 for high speed situations.
- Distances shown in parenthesis are approximate. '
••85th Percentilespeed or as directed by the Engineer.
Verizon Special Conditions for Annual Blanket Permit 2005
Verizon / Various City Projects / Within the City. of La Quinta
For the standard annual blanket permit conditions, the following shall apply:
The permittee shall obtain a unique blanket permit number 2 week's prior performing work. The unique
blanket permit number can be obtained by calling the Assistant Engineer I at 777-7089.
2. Annual blanket permit numbers are valid only for existing facility maintenance, connections, or repairs.
For all other type of work, the permittee must apply for an encroachment permit with the City of La
Quinta.
3. All prime or sub contractors working under any annual blanket permit must have the following
documents on file at the Public Works Department 2 weeks prior to start of construction:
a. General Liability Insurance Company and Policy Number
b. City Business License
c. Contractors State License Number
4. 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.
5. Emergency work does not apply to this permit.
6. Annual blanket permits are not valid for work within the Public Right of Way on any Arterial street (i.e.
any public street with more than 2 lanes). The permittee must apply for an encroachment permit (see
online application form).
7. Verizon, hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and
erosion control.
8. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more
. frequently, if required.
9. If a lane closure occurs within the Public Right of Way, Verizon must submit an approved traffic
control plan at least 2 weeks prior to start of construction or parking on the paved R/W.
10. On any arterial roadway affected by work within a blanket permit, Verizon is required to provide an
informative message board (approved by the City Engineer) informing the commuters using the affected
roadways of possible traffic delays, time of construction, and if possible alternate routes. The message
board shall be provided for the commuters 48 hours prior to the start of traffic delays.
11. The permittee shall haul all offsite debris to a certified landfill. Prior to hauling debris, the permittee
shall inform the City (Inspection staff or 777-7089) of the name and location of the certified dump site.
Special Conditions Page 1 of 5
Verizon Special Conditions for Annual Blanket Permit 2005
Verizon / Various City Projects / Within the City of La Quinta
12. The permittee must obtain City approval and shall place temporary no parking signs along any parking
area disrupted by construction work. The signs shall be placed along the area 48hrs prior to the start of
closing the area, and removed immediately after the construction completion date.
13. Prior to excavating in native soils, the owner of the project 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 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.
14. 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.
Note: Construction work (including setting up traffic control devices) is not permitted on any Arterial
street (ie any public street with more than 2 lanes) before 8:00 a.m.
15. 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.
16. 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.
17. 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.
Special Conditions Page 2 of 5
Verizon Special Conditions for Annual Blanket Permit 2005
Verizon / Various City Projects / Within the City of La Quinta
18. 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.
19. 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.
20. All grading shall conform to Chapter 8.80 of the.City of La Quinta Municipal Code, which can be
obtained at the City or on line at la-quinta.org.
21. 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:
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.
Special Conditions I Page 3 of 5
Verizon Special Conditions for Annual Blanket Permit 2005
Verizon / Various City Projects / Within the City of La Quinta
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.
22. 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.
23. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to its
original condition.
24. Access and egress to all local properties shall be maintained at all times.
25. 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 3/4" max medium
asphalt concrete as the base course lift and a City approved'/2" max medium finish course lift for
capping. Asphalt concrete mix design shall be approved by the City prior to its placement.
Special Conditions Page 4 of 5
a
Verizon Special Conditions for Annual Blanket Permit 2005
Verizon / Various City Projects / Within the City of La Quinta .
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.
26. 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.
27. 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.
28. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time.
29. 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.
30. 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 blanket
permit number from the City to perform the required restoration work.
Special Conditions Page 5 of 5
DAILY CONSTRUCTION
REPORT -.�..��
DATE�� //1Pi0. /Q—D7!6S
WEATHER
Project f
Job No. _ TEMPERATURE
Client
Contractor
WIND
Project ] it
HUMIDITY
DAY
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Brite .
Cle
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Rain
Snow
To 32
32-50
50-70
70-85
85 u
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Mo er
High
Report No.
Dry
Moder
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FORCE
Name of Contractor
FAZVERAGE9ELD
iJ.., yt�l��c, J,�,L . •
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Manual
�
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VISITORS
Time
Representing
Representing
Remarks
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REPORT
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150-70
70-85
85 u
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Report No.
Dry
JMotlJHurnid
FORCE
FVERAGEELD
Name of Contractor
Non -Manual
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2. Field Office Page l of Pages
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WEATHER
TEMPERATURE
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HUMIDITY
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Clear
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Report No.
Dry
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AVERAGE FIELD FORCE
Name of Contractor
Non -Manual
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VISITORS
Time
Representing
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DAY
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32-50
50-70
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Report No.
Dry
Moder
Humid .
FORCE
FAVERAGE9ELD
Name of Contractor
Non -Manual
Manual
Remarks
Representing
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nsuluunon: i. rrojecr manager
2. Field Office Page I of Pages
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4.. Client By: _ / Title Inspector
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Job No.
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DAILY CONSTRUCTION
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WEATHER
TEMPERATURE
WIND
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DAY
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Clear
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Rain
Snow
To 32
32-50
50-70
70-85
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Report No.
Dry
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Humid
FORCE
FAVERAGI�IELD
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DAILY CONSTRUCTION
REPORT
DATE67-n2,5
WEATHER
Project Sg)
Job No. — TEMPERATURE
Client
Contractor _ ,�,L'. WIND
Project Mgr
HUMIDITY
DAV
te .
FTo
Clear
Overcast Rain
Snow
32
32-50
50-70 70-85
85 up
Still
Moder
High Report No.
Humid
Dry
Moder
AVERAGE FIELD FORCE
Name of Contractor
Non -Manual
Manual
Remarks
VISITORS
Time
11—
Representing
Representing
Remarks
EQUIPMENT AT THE SITE
CONSTRUCTION
Distribution: 1. Project Manager
2. Field Office
3. File
4. Client
F:\pwdept\staff\fuller\inspections\DailyConst
Page I of Pages
By: / Title Inspector
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DAILY CONSTRUCTION
REPORT
DATE Q�
WEATHER
ProjectL(2CKr
Job No. _ TEMPERATURE
Client
Contractor �1L�-' G' WIND
Project Mgr ✓ T
HUMIDITY
DAY
S
M
T
TH
F
S
['7
Brite
Clear
Overcast
Rain
Snow
To 32
32-50
50-70
70-85
85 u
Still
Moder
High
Report No.
Dry
Moder
Humid
FORCE
FAVERAGEIELD
Name of Contractor
P-el' IX414e
Non -Manual
Manual
3
Remarks
VISITORS
Time
Representing
Representing
Remarks
CONSTRUCTION
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2. Field Office Page 1 of Pages
3. File
4. Client By: / Title Inspector
F:\pwdept\stafRfullerUnspections\DailyConst
DAILY CONSTRUCTION
REPORT
DATE�� - oI %— D s
Project f WEATHER
Job No. _ TEMPERATURE
Client
Contractor /^,C WIND
Project Mgr ✓
HUMIDITY
DA'f
S I M I T tW I TH F S
Brite
Clear
Overcast
Rain
Snow
To 32
32- 0
50-70
70-85
85 u
Still
Moder
High
Report No.
Dry
Moder
Humid
FORCE
FELD
Name of Contractor
IJ pitpe-
Non -Manual
Manual
Remarks
Representing
Representing
Remarks
CONSTRUCTION
JWAVAAM• -7t�
�..VA 1 4Z T. M
PITAKA GIN
2. Field Office Page I of Pages
3. File
4. Client By: / Title Inspector
F:\pwdept\staff\fu llerV nspections\DailyConst
Project
Job No.
Client
Contractor To
Project Mgr
DAILY CONSTRUCTION
REPORT
WEATHER
TEMPERATURE
WIND
HUMIDITY
DATE
DAY
S M T W TH FM
Brite
Clear
Overcast
Rain
Snow
To 32
32-50
50-70
70-85
85 up
Still
Moder
High
Report No.
Dry
Moder
Humid
FORCE
FAVERAGE'FIELD
Name of Contractor
Non -Manual
Manual
Remarks
Representing
Representing
Remarks
AT THE
TRUCTION ACTIVITIES
��au �uuuvu. i. rwicct rvianager
2. Field Office
3. File
4. Client
By�x Title
Page I of Pages
Inspector
F:\pwdept\staff\fullerVnspections\DailyConst
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