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ENC2021-0071 AY 12-2-2021 12-2-2022           Date: __________________________________ Tract No: _________________ Project Name: ________________________________ Vicinity:_______________________________________________________________ Purpose of Construction (i.e.: Rough Grading, Offsite Street, etc.)_________________ ______________________________________________________________________ Description of Construction (i.e.: See Plan Set No. 01234) _______________________ Dimension of Installation or Removal: _______________________________________ Approximate Construction Start Date: _______________________________________ Approximate Construction Completion Date: _________________________________ Estimated Construction Cost: $ ____________________________________________ 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: _____________________________Phone Number: ________________ Name of Applicant/Owner: ________________________________________________ Applicant Address: ______________________________________________________ Applicant Telephone Number: _____________________________________________ Applicant E-mail Address: ________________________________________________ Name of Contractor: _____________________________________________________ Contractor Address: _____________________________________________________ Contractor Telephone Number: ____________________________________________ Contractor State License Number: __________________________________________ Contractor City Business License Number: ___________________________________ Contractor E-mail Address: T Drive/Checklists – Forms & Applications/Application for Permit posted 8-26-09 : Inspection Fee: __________________________________________ Permit Fee: __________________________________________ As-Built Deposit:___________________________________ Dust Control Deposit: ___________________________________ Credit Amount: __________________________________  : Ź       Ż Applicant or Contractor General Liability Insurance Company: ______________________________________________________________________ Applicant or Contractor General Liability Insurance Policy Number: ______________________________________________________________________ : Assigned Permit Number: __________________________________________ Approval Date: __________________________________________ Expiration Date:______________________________________ Issue Date: _____________________________________ Administrative Authority: _________________________________________ N/A IRONMAN 70.3 Indian Wells La Quinta City of La Quinta No construction. Race e event taking place on Sunday, December 5th 2021 Road Closures due to cycling portion of IRONMAN 70.3 Indian Wells La Quinta Traffic Control equipment staged on December 4th and fully deployed December 5th December 4th December 5th NA Sabrina Houston 760-703-1200 IRONMAN 9330 Scranton Rd STE 150 San Diego CA 92121 760-703-1200 sabrina.houston@ironman.com Coast Hills, INC DBA Southern California Barricades 5930 Lakeshore Dr , Cypress, CA 90630 714-676-8460 CA LIC #786758 C31 jim@scbarricades.com Excelsure Insurance Services CA000023885-05  78495 Calle Tampico La Quinta, CA 92253 760.777.7000  RE: Encroachment Permits – Compliance with Insurance Requirements Per Engineering Bulletin #97-04 please provide proof of the insurance items and endorsement certificates below: ޭ General Liability – $1M per occurrence / $2M general aggregate ޭ General Liability – Additional Insured Endorsement (for ongoing and completed operations) ޭGeneral Liability – Primary / Non-contributory Endorsement ޭAutomobile Liability – $1M combined single limit ޭWorkers’ Compensation – Statutory Limits / Employer’s Liability $1M per accident or disease ޭWorkers’ Compensation – Waiver of Subrogation Endorsement PERMIT NO. ENC2021-0071 Ironman 70.3 Indian Wells La Quinta / Traffic Control / Various Streets; See Attached Traffic Control Plan (No asphalt or earthwork permitted) The following permit conditions shall apply: 1. Jim Sprinkel with Southern California Barricades shall be available during the event by cellular phone at (714) 676-8460. 2. 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. 3. This permit or copy of it shall be on the work site (usually the job trailer) for inspection during the actual work performed. 4. The permittee must maintain proper stopping and sight distances for the vehicular traffic users using the public right of way. 5. The City of La Quinta reserves the right to require modifications of the work be made at permittee’s sole cost for proper sight distance requirements per guidelines in the AASHTO “A Policy on Geometric Design of Highways and Streets, 5 th Edition” or latest, in the installation of all appurtenances abutting and within the public street right-of-way. 6. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more frequently, if required. 7. The Applicant or Contractor shall furnish the City satisfactory evidence of insurance in the amounts provided in the Engineering Bulletin #97-04 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 and endorsements shall be submitted to the City. Each policy shall name the City as an additional insured. 8. Pursuant to Section 14.16.250 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), at residential streets, advance warning signs and traffic control shall be installed and maintained in accordance 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). On Collectors to Arterial Streets, the permittee must submit a traffic control plan which shall be from or 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). Traffic Control plans not from the CA MUTCD or the WATCH shall be signed and stamped by a civil or traffic engineer registered in the State of California. It shall be the Permittee's responsibility to appropriately detour and barricade all construction sites. 9. If public traffic lanes are required to be closed, this permit is not valid until the permittee submits, to the Public Works Department, a traffic control plan for review and approval prior to start of construction or parking on the paved R/W. PERMIT NO. ENC2021-0071 Ironman 70.3 Indian Wells La Quinta / Traffic Control / Various Streets; See Attached Traffic Control Plan (No asphalt or earthwork permitted) 10. 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. 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. The permittee shall not encroach upon private property without prior written approval (submit to the Design and Development Department, attention to the Associate Engineer) of the private land owner whom is being encroached upon. 14. All landscaping, irrigation, decorative rock, decorative concrete, sidewalk, lighting, etc., shall be replaced to its original condition. 15. Access and egress to all local properties shall be maintained at all times. 16. 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. 17. 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. 18. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. 19. 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.