TC2015-0066See below for Finance Revenue Codes
01'
OF
S 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: 10/1/2015
LOCATION OF CONSTRUCTION (Street address or Description): WASHINGTON FROM CALLE TAMPICO TO AVE 52
PURPOSE OF CONSTRUCTION: TRAFFIC CONTROL FOR CORING AND STREET RESURFACING.
DESCRIPTION OF CONSTRUCTION: TRAFFIC CONTROL FOR CIP 2012-07B WASHINGTON ST IMPROV.
DIMENSION OF INSTALLATION OR REMOVAL: 143.500 SF
APPROXIMATE TIME WHEN WORK WILL BEGIN: 10/5/2015 TIME OF COMPLETION: 11/30/2015
ESTIMATED CONSTRUCTION COST: (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing
permanent resurfacing and/or replacing improvements)
COMMENTS: SEE PROJECT CONTRACT AND SPECIFICATIONS FOR CIP 2t01 FOR PERMIT CONDITIONS
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, toss 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
(24) hours prior to the anticipated inspection.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and reuIations of the City of and
to pay for any additional replacement necessary as the result of this work.
KYLE GRIJALVA - GRANITE
CONSTRUCTION 38000 MONROE STREET INDlO, CA 92201 (760)574-6113
Name of Applicant (please print) Business Address Telephone No.
GRANITE CONSTRUCTION COMPANY P 0 BOX 50085 ATFN: LEGAL DEPT WATSONVILLE, CA 95077-5085 (831)724-1011
Name of Contractor and Job Foreman Business Address Telephone No.
089 02501
Contractor's License No. City Business License No.
VALLEY FORGE IS CO GL 2074978689
Applicant's Insurance Company . Policy Number
Finance Revenue Code
TOTAL: $0.00
PERMIT NO: TC2015-0066
DATE ISSUED:
EXPIR DATE:
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.
Pate:
2oI2
O -7B
Pur di ,p p pgh-Gra Offsite Street, c)ti
scnption of Construcp(i c See Plan Set No 010 iQ ~en
PPg
Dirnerisionof.JnstalIatiOn drRemoc'al
Approximate Construction Start Date i5 -
Approximate Construction Completion Date 'L
Estimated Construction Cost $J52Ok
Estimated Construction Cost shall include the removal of all obstniction maccrials and debris back filling compaction and
placing pcinanëni and or repbcingimprovemcnts
Contact Name ¶JPhone Numbei Q57611t
Name of Applicant/Owner
Applicant Address F3O 7]1iiC Th
Applicant Telephone Number 6O57j4 1 TT
.... Applicant EmaiiAddress:D
U
Name of Contractor:
Contractor Address [3_OohoeiSkeei TdipA___________
Contractor Telephone Number
Contractor State License Number _____ 'I
Contractor City Business License Number___25j 17
contractor E-m.1 _____________________
RRENT I [UST-BE PROV
General.
Office_Use Only:
InspectionFee:
PermitFee:
As-Built
Deposit:
Dust Control
Deposit:
Ciddit.
Amoimt:
TOTAL FEE DUE:
I urlveltnecKltsts —I-orms;&#kpplicatlor
OfficeUseOnlyf
.
Assigned PëiinitNunibr. 1 C 201
ApprovalDatc: ;.r• -- . -
Expiration
Date:
•-
ininiativc Authority:
GRAnITE
To whom it may concern,
Granite Construction will plan to use the "Mid Block. Closure of TWO
Lane?' Traffic, Control Plan found on page 36 of the Work Area Traffic Control
Handbook (2012 Twelfth Edition) for conng operations on Washington Street
from Avenue 52 to Calle Tampico on 10/5/2015 - 10/6/2015.. The lanes closures
will beflipped when working.0n the inside #1 lane. 'Please see, .atthed plan.
Thank you,
Kyle Grijalva
Project .Enginer
Granite Construction Company
760-574-61.13
36 Work Area Traffic Control Handbook
- Optional
Opti onal
Optional
A