TC2015-0005See below for Finance Revenue Codes
ENCROACHMENT PERMIT
PUBLIC WORKS CONSTRUCTION
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.
DATE: 3/17/2015
LOCATION OF CONSTRUCTION(Street address or Description): NON-ARTERIAL STREETS
PURPOSE OF CONSTRUCTION: FOR MAINTENANCE OF CVWD WATER AND SEWER FACILITIES WITHIN CITY OF LA QUINTA CITY LIMITS
DESCRIPTION OF CONSTRUCTION: CVWD 2015 ANNUAL BLANKET PERMIT
DIMENSION OF INSTALLATION OR REMOVAL:
APPROXIMATE TIME WHEN WORK WILL BEGIN: 1/1/2015 TIME OF COMPLETION: 12/31/2015
ESTIMATED CONSTRUCTION COST:SO.00 (Including removal of all obstruction, materials, and debris, backfilling, compaction and
placing permanent resurfacing and/or replacing improvements)
CITY OF LA QUINTA WILL INVOICE THE PERMI1TEE FOR TIME AND MATERIAL EXPENSE TO-BE DETERMINED
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 at (760) 777-7097. To
submit an inspection request, leave a message on the Inspection Request Hotline at (760) 777-7097 prior to 1:30 P.M. at least twenty-four
(24ours prior to the anticipated inspection.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of and
to pay for any additional replacenent necessary as the result of this work.
42!~
Signature of Applicant or Agent
CVWD - VALERIE LUNA P.O. BOX 1058 COACHELLA, CA 92236 (760)398-2651
Name of Applicant (please print) Business Address Telephone No.
CVWD P.O. BOX 1058 COACHELLA, CA 92236 (760)398-2651
Name of Contractor and Job Foreman Business Address
AEC266
Contractor's License No.
SELF INSURED
Applicant's Insurance Company
Finance Revenue Code
TOTAL: $0.00
Telephone No.
N/A
City Business License No.
SELF INSURED
Policy Number
PERMIT NO: TC2015-0005
DATE ISSUED:.
EXPIRA ION DATE
BY: .2 -
WORK INSPECTED BY*:
PERMIT COMPLETION DATE:
If the work is covered by a Subdivision Improvement Agreement,
Subdivider shall request final acceptance of improvements from the
City Council.
PUBLIC WORKS DEPARTMENT
APPLICATION FOR PERMIT
Date: January 21, 2015
Tract No: Project Name: Annual Blanket Permit
Vicinity:City of La Quinta Boundaries: Various Locations (non-arterial streets only)
Purpose of Construction (i.e.: Rough Grading, Offsite Street, etc.)________________
CVWD 2015 Annual Blanket Permit for maintenance of CVWD Water and Sewer Facilities
Description of Construction (i.e.: See Plan Set No. 01234) N/A
Dimension of Installation or Removal: N/A
Approximate Construction Start Date: 1/21/15
Approximate Construction Completion Date: 12/31/2015
Estimated Construction Cost: $ N/A
Estimated Construction Cost shall include the removal of all obstructions, materials, and debris, back-filling, compaction and
placing pennanent resurfacing and or replacing improvements
Contact Name: Valerie Luna Phone Number: (760) 398-2651
Name of Applicant/Owner: Coachella Valley Water District
Applicant Address: PC Box 1058 Coachella CA 92236
Applicant Telephone Number: (760) 98-2651 Ext. 3529
Applicant E-mail Address: Vluna@cvwd.org
Name of Contractor:
Contractor Address:
Contractor Telephone Number:
Contractor State License Number:
Contractor City Business License Number:
Contractor E-mail Address:
A COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED ,4
Applicant or Contracprneral Liability Insurance Company:
#rr - jI,I4.rC#'
Applicant or Contractor General Liability Insurance Policy Number:
Office Use Only:
Inspection Fee:
Permit Fee:
As-Built
Deposit
Dust Control
Deposit:
Credit
Amount:
TOTALFEEDhJE:
I IrijII :nAlI? - I-r,rmc X nrIutlflI
Office Use Only:
Assigned Permit NumberTC 2.0 1
Approval Date:
Expiration
Date:
Issue
Date:
Administrative Authority:
PERMIT NO. TC2015-0005
CVWD 2015 Annual Blanket Periiiit/ Maintenance of CVWD Facilities on Non
Arterial Streets/ Various Locations
The following encroachment permit conditions apply to the Coachella Valley Water District (CVWD)
except for emergency operations when immediate action is required for restoring service and/or
protecting public safety. If the emergency requires extended traffic control and/or lane closures, CVWD
or its sub-contractor shall pull a permit from the City the next business day.
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). Encroachment permits for work on an Arterial Roadway will require an
approved traffic control plan and appropriate insurance, and work will be performed in accordance with
the latest edition of the Standard Specifications for Public Works Construction (SSPWC).
For blanket permits, the following conditions apply:
1. CVWD shall obtain a unique blanket sub number at least 48 hours, but no more than one month prior to
performing work. The blanket sub number can be obtained by calling the Assistant Civil Engineer at
(760) 777-7047.
2. Work under this Annual Blanket Permit is limited to installing new routine lateral domestic water,
sanitation (sewer), irrigation and non-potable water connections, and to perform routine maintenance
upon existing facilities, including replacement or adjustment of valve box and manhole collars, within
the R/W of non-arterial streets, as defined in the City's General Plan, by CVWD or its approved sub-
contractors (see Section 4). For all other type of work, the permittee must apply for a separate
encroachment permit with the City of La Quinta.
3. The permittee may only work at night if approved by the City Manager. Night work may be halted if the
city receives complaints about the work.
4. All 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:
General Liability Insurance Company and Policy Number
City Business License
Contractors State License Number
The sub-contractor shall furnish the City satisfactory evidence of insurance in the amounts provided in
the Engineering Bulletin for Indemnification & Insurance Requirements. This insurance shall be kept
in full force and effect at all times by Applicant or Contractor during the prosecution of the permitted
work and updated Certificate of Liability Insurance shall be submitted to the City. Each policy shall
name the City as an additional insured.
5. All work shall be performed in accordance with the latest edition of the Standard Specifications for
Public Works Construction (SSPWC).
Special Conditions Page 1 of 3
PERMIT NO. TC2015-0005
CVWD 2015 Annual Blanket Permit/ Maintenance of CVWD Facilities on Non
Arterial Streets! Various Locations
CVWD, hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and
erosion control.
Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more
frequently, if required.
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 24 hours prior to the start
of closing the area, and removed immediately after the construction completion date.
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.
Unless authorized by the City Engineer, 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 City Traffic Signal Technician at (760) 250-0571 if signal
operation at the intersection is to be altered in any way.
Prior to-performing construction work and closing any lanes in the Public Right of Way, the permittee
shall call the City at (760) 777-7097 at least 24 hours prior to work and submit an inspection request.
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.
Traffic control plans will not be required to be submitted in advance. However, 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 the latest edition of the California
Manual of Uniform Traffic Control Devices (CA MUTCD) or the latest edition of the Work Area
Traffic Control Handbook (WATCH Manual). It shall be the Permittee's responsibility to appropriately
detour and barricade all construction sites.
Special Conditions Page 2 of 3
.4 .
PERMIT NO. TC2015-0005
CVWD 2015 Annual Blanket Permit! Maintenance of CVWD Facilities on Non
Arterial Streets/ Various Locations
A minimum of two (2) travel lanes (one in each direction) of paved surface shall be maintained at all
times. When work does not permit two travel lanes, one travel lane of paved surface and an appropriate
number of flagmen shall be maintained at all times. When planned work does not permit maintaining
vehicular travel, CVWD shall submit a street closure/detour/traffic control plan prepared under the
guidance of the latest edition of the California Manual of Uniform Traffic Control Devices (CA
MUTCD) or the latest edition of the Work Area Traffic Control Handbook (WATCH) to the City for
review and approval one week prior to starting construction.
Prior to excavating, if required, the Permittee shall contact Underground Service Alert it 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.
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.
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.
All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to its
original condition.
Access and egress to all local properties shall be maintained at all times.
Permanent asphalt pavement replacement within City right-of-way shall be completed no later than
seven (7) days after the completion of the work. Where CVWD has a developer installation agreement
for replacement of improvements within private right of way, CVWD shall provide a drivable surface
until such time as the developer can replace their improvements.
Permittee shall permanently stabilize any previously stabilized 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.
The City of La Quinta reserves the right to revoke, suspend or void this permit at anytime.
The permittee shall indemnify, hold harmless and assume the defense of the City from all damages,
delay costs, costs or expenses in law or equity that may arise out of work under this permit.
Special Conditions Page 3 of 3