1710��• :, M � � � r rti i�S� 1 ...
*I
NOTE: ,•T.,A - ••• •: - '
:•�..-=With pr oper'validAion'
this form. con stitutes an
- _ .rt• '' ' , .CITY OF LA QUINTA
encroachment permit gr .
APPLICATION FOR PERMIT
PUBLIC', WORKS CONSTRUCTION (ENCROACHMENT)"
For,,the,' constructiion',�of public. or private. curbs, driveways, pavements, sidewalks, parking lots,, sewers, water mains
and other like public works! improvements in connection, h MINOR•IMPROVEMENTS and APPROVED SUBDIVISIONS
�, n` - - # ;�,• 'E Subdivision Improvement Permit = Class III
/ DATE: ` 4/1/93 + ` '� Minor Improvement Permit Class IV
y ,? t, '
LOCATION .OF,.CONSTRUCTION .tefU*001~S 6, ,the' whiteWatQlt River S> ortuwator'Channel "
(Street acl&esCcr Description of'Location)'4' Ria ��r` • ' r * + * '
. , y I�nitaliation" .of aloua ArAteetioa za .
PURPOSE OF. CONSTRUCTION Sketch construction plans if appropriate) '
to::Vreyetlt "erogii* -tai' bank `' ,A
DESCRIPTION OF CONSTRUCTION? 660" %of .doficteste slurs
` :cir-oC ctfan oin thio" R6: 'BAnk '6f ChaxinsZ ' - a ° " 9919 ATTAC i13b CONDT2I®NS -
`61MENSION OF�IN$TALL'ATIOIV OR REMOVALeaa` attaohed
SIZE OF EXCAVATION, IF'NEEDED aria' n>>1>Cach�sd
w � r
APPROXIMATE TIME,WHEN WORK WILL•, -BEGIN' "�►/1/9 l
APPROXIMATETIME OF'COMPLETION J "�k8131191'
Mss ESTIMATED`CONST,RUCTION COST $
} ,(Including removal,�of�,all�otistructio ��materlals and debris; backfilling, com
paction and placing permanent,resurfaciing�and/orje'plac�ng impr#vements►'
+_In^con sideration ofyihe granting of this permit 'the applicant hereby agrees to: w Kor
'. • a •I,ndemnify;'yaefend"and'.save,the City„its authorized agents, officers, representatives and employees, harmless from arid'against any - and all 's
w' penalties; liabilities'or lossresulting'from�'claims.or court•action and•arising out of'any accident, loss or damage to persons .or property
' •' happening'or occurrAg as�a'prozimate result 'of ;any work`undertaken under the permit, granted pursuant. to this application:
i r �' n _; � y.F ` , aN.. °` r r.• ii. � .t- , • .i,. ., a. •.t. - o' i . r� .
the;AdministratrveW. i4,Authority.�at leasi'twenty-fourx(24) hours advance ofithe 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 buinta,and to pay for any ad ditional`replacement necessary as the result of this "work.
'` .� ,, .fit+ _ 'r`'<� v � '. .}y~ +ro �,j'..` '..� r.� I. �• :K� � j•
Signature of Applicant or Agent i
s ,
Coachille • VAA1, i4;,Vater bigti cCr ':1?OBox.' 1058, Coaehalia �: +x. ' (619) 398--2661`
Name•of Applicant_(please, print)•PBusiness Address - Telephone No.
Name of Cdntractor.and-Job.Foreman ', t t Business Address 3 ' T,elephone No.
.. x t
Contracior`'s License No. <xR, �' ,� r S City Business License No.
Applicani's 'Insurance Company' ` �` .J Policy Number'
FEES:`' Subdivision Improvement'permit R Class"III ,j •• r•� . r. ''
a
Public•improvements: 3 o of estimated construction costs '
Private improvements: 3% of estimated'construction costs
Minor Improvement Permit — Class IV: See attached schedule” ,
Inspection Fee - $ PERMIT VALIDATION
Permit Fee . �II
1710
Penalty.
Cash Deposit -Surety Bond "
if required i
TOTAL: $ '0
Receipt No.
Received by Date
Recorded by
PERMIT NO.
DATE APPROVED 4/1/93
EXPIRATION DATE 8/31/93
DATE ISSUED t J
By \
Administrative Authority
TELEPHONE: (619) 564-2246
_...�... _.... ,r ......:.........., .
The following General and Special Provisions are attached to and made a part of Permit No.
GENERAL PROVISIONS
The following shall always apply:
ENCROACHMENT ON PRIVATE PROPERTY: This permit authorizes workto be accomplished within City of La Quints right of way
ONLY. Whenever construction extends within private propeny. it shall be the responsibility of the permittee lot his Contractors) to
secure permission from abutting property owners. Such authorization must be.secured by the Permtnee prior to starting work.
TRACKLAYING CONSTRUCTION EQUIPMENT: Cleated traddaying epr>arruction equipment shall not be permittedtooperste on any
Paved surface unless fitted with smooth -faced street pads. All mechanical outriggers shall be fitted with rubber street shoes to protect
the paving during excavations. Rubber -tired equipment only shall be used in backfill operations in paved areas: Mahe existing
Pavement is scarred, spilled, or broken during the term of this contract or tithe pavement is marred City of La Quints shall request
that these portions of road be resurfaced over their emirs width. Resurfacing shall' consist of one coat of two inches (2"1 of A.C.
surfsging plus appropriate seal coat as specified above. .
PROTECTION OF TRAFFIC: All excavations and work areas shall be properly lighted and barricaded as doomed necessary bythe City
Engineer or La Quints City Public Works Inspectors. Suitable detours a nd detour signs shall be placed and maintained for the duration
of the project. The City shall be notified 24 Hrs. in advance of any traffic detours or datinsaborta,
CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete Pipe steel Culvert and
concrete structures encountered during excavation which necessitate removal shall be replaced in kind. In the event.it becomes
necessary to remove or cut'existing drainage structures, City of La Quints shall be notified prior to commencement of this work
Drainage structures and open drains shall be kept free of debris at all times for proper drainage,
RIGHT OF WAY CLEANUP: Any surplus materiel resulting from,excavation and backfill operations shall be removed from the right of
way. All paved surfaces shall be broomed dean of earth and other objectionable materials immediately after baddill and compaction.
Existing gutter line and drainage ditches shall be replaced to their original standard or better. All excess materiel shell be removed
prior to paving. Water tanker shall be used, as required, to sprinkle the job site to keep down dust conditions and shall be used
immediately aher.baddill.
DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing water on City Of La Quints roads it shall be
the responsibility of the permittee (contractor) to control this water and to provide off-street barricades when necessary,
CLOSING STREETS: No street shall be closed. A minimum of one lane of traffic shall be maintained at all times to provide limited
access for the adjoining property owners and emergency vehicles. In the event it i s felt by the permittee that he must dose a street for
any length of time, permittee shall contact this office to obtain the necessary permission
SPECIAL PROVISIONS
The follwing shall apply ONLY when indicated:
R1 NOTIFICATION: Permittee shall notify the City at 564.2246 at Ieast.Whours in advance of starting construction.
R2 CASH DEPOSITS OR BONDS: A cash bond Oran approved surety bond in an amountof nottess than s
shall be furnished in the name of City of La Quints to coverall work involved in the restoration of the various La Quinta
roads and survey monuments. This bond shall be continuous until cancelled by the City Engineer. This bond must be
posted prior to commencement of any work on this project.
R3 LITY CLEARANCE: (Substructures) Priorto making any excavation within the City of La Quints fight at way authorized
by permit, the permittee shall contact all concerned utility companies relative to the location of existingsubstruetures.
Damage to existing substructures resulting from operations
of the permittee. cortdudted under this permit shall be the $olaretportsibility
UTILITY CLEARANCE:,(Surface structures) No work shall be done under this permit until all utilities are dear of the
proposed work she. The permittee shall notify all concerned utility companies of the proposed work
t R5 PAVEMENT WIDENING: Area between the proposed concrete gutter line and the existing road pavement shall be
surfaced with inches of A.C. paving placed on inches of class
having an "R"value of not less than aB9regate subbase course
and in conformance with City of La Quints Road Improvement Standards
• and,Speerfieations. Ordinance #481.
R6 PARKWAY GRADING: Area betweenthepropertylineandtopoftheProposedconcretecurbshall'begradedtoaslopeat
1/4 inch to one foot (1 �.
R7 GRADES & STAKES: City of La. Quints shall establish grades and stakes for the proposed concrete curb and gutter
construction.
RB GRADE CHECKING: City of La Quints shall chedtgradesupon receipt ofplan and Profile and/or grades asestabliahed by
a licensed engineer.
R9 CURB REMOVAL FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter ( ll be
feet►aha
removed. Curb and/or curb and gutter shall be saw cut prior to removal. Depressed curb, matching concreto )Shautter and
concrete driveway approach shall be constructed in conformance with City of La Quints Standard #207.
RIO DRIVEWAYS. A.C.: Driveways shall be constructed as not to alter existing drainage pattern. Surfacing between the
property line and the existing road paving shalt be 2-1/2 inches of A.C. paving placed on 1 -') of clan
aggregate base. Driveway construction shall conform to attached drawing.
R11 CULVERTS: A nehdiameter()culvenshall beinstalled with the mvenapproximately 1-1/2
inches below and in line with the existing flow line. Culvert installation shall conform to the attacneo drawing.
R1 SIGHT CLEARANCE: Sight clearance of 600 feet in either direction shall be assured and maintained.
R13 SOIL STERILIZER: The area to be surfaced shall be treated with soil sterilizer. Rate of application shall eomplywith the
manufacturer's specifications.
R� COORDINATE WORK: The proposed work shall be subordinated to any operation which the State.of California or
City of La Quints may conduct in this area during the period of this permit. Work shall be coordinated with the State or
City of La Quints forces to preclude delay or interference with State or City of La Quints projects.
SURVEY MONUMENTS: Prior to excavation or beginning of construction. all survey monuments which exist on the
centerline of all streets or property lines when involved shall be completely tied out so they may be readily and correctly
be replaced by a licensed civil engineer or surveyor at the experoe of the permittee. A complete set of notes showing the
ties to these monuments shalt be furnished to the City Engineer prior to the removal of anv monumems. This office snail
be notified upon completion of replacement of all survev monuments for proper project clears
nice
R16 SURVEY MONUMENTS: Prior to excavation or begknntnq of construction, ail survey monuments shall be tied alit by City
of La Quints and sunable payment or guarantee of payment shall be made as reimbursement for all tNOrlk involved.byCit
R17 PAVEMENT CUTTING: Pavement will be mechanically cut to a straight edge prior to excavation. all
of pavem$nt
cutting shell be approved through the office of the City Engineer. (Under no circ Method shall excavating O equipment
be used to excavate prior to cutting of pavement). Excavation material shall be placed in such a position as to best
facilitate the general flow of traffic. Prior to final paving operations, any damage to pavement straight edge shall be
corrected.
R18• PAVEMENT CUTTING: Pavement shall be saw cut prior to removal. Prior to final paving operations, any damage to
pavement straight edge shall be corrected.
R19 UMITOFEXCAVATIONS: Excavations shall belimnedto1.000lineal feet ofopentrenchbefore backfilloperations must
QiD
begin. All excavations shall be properly barricaded with lights ovsmlght, on weekends and holidaysforthe protecttonof
the traveling public. The Public Works inspector shall determine the suitability of excavation barricading in each case. No
excavation shall remain open for a period exceeding five 15) days. No excavation shall be made unless the construction
material is actually on the work site.
R20 BACKFILL MATERIAL Backfill shall be free otbrush. roots or other organic substance detrimenta.: *. .'-S use forpurpms
of producing an adequately consolidated backfill. Any material which the City of La Quints deems unsuitable (spongy or
saturated material) which is encountered during excavation shall riot be used for backfill, but shall be Supplemented or
replaced by an approved sand or gravel.
R21 BACKFILL SAND: Backfill shall be approved transit-mix sand Or equivalent and shall be placed in lifts of riot greaterthan
three feet (31 and vibrated using vibrotamper or equiva lent equipment. Alte mats methods may be substituted. but in any
case a relative compaction of 95 percent shall be attained within the structural section of the roadway.
R22 BACKFILL PLACEMENT: Backfill shall be applied in layers Of not more tnan 50 percent of the total depth of the the
before flooding or amaximum affive-foot 151 lifts where trenches aro of excessive depths. Care is to be exercWW that the
backfill material is not subjected to extreme swell by flooding operations. Backfill material shall be placed so that the
resulting compaction shall be not less than 90percent or equivelern to the surrounding ground, whichever isthe greater
compaction. Where ponding or flooding is used for a maximum settlement, adequate dikeswill be consvuctedto retain
the water. Where jetting is used. the jets shall be of sufficient length to reach the bottom of each
supply shall be continuous. :ager and the water
COMPACTION TESTS: If so required bythe inspector, compaction tests shall be made at intervals of not more than 1,000
feet and a minimum of one (1) test on each road. One 11) copy of each test shall be forwarded to the City Engineer for
approval end f iled prior to making permanent repairs. Compaction tests shall be made asoutlined in Section 6.3.01 of the
Standard Specifications, Division of Highways, State of California, dated January 1973.
24 COMPACTION TESTS: If so required by the inspector, companion testa shall be made for each crossing or Service line
One (1) copy of each test shall be forwarded to the City Engineer tat approval and filed prior to making permanent repairs.
Compaction tests shall be made as outlined in Section 6.3.01 of the Standard Specificatiohis
.Division of Higptways State
of California, dated January 1973.
R25 TEMPORARY PAVEMENT REPAIRS: After completion of backfill and compaction operations. a temporary patch
consisting of 2 inches of SC-800 shall be placed on a prepared subgrade. The SC-800 temporary paving shall be placed
after a maximum of 3.000 lineal feet of trench has been excavated and backfill operations completed. but in no case shall
� the placement of the temporary pavement exceed a five (5) day limit.
/RZ6 PERMANENT PAVEMENT REPAIR: After backfill and compaction operations have been completed, tem ora
ll // consisting of two inches (2") of SC-800 shall be placed immediately. A permanent patch of =inches Patch
surfacing placed on a �— inch class _base shall be placed no later than Irtches A.C.
temporary road repair. �, cowlDlTioh( NiJ 11 da Ysaftercpmpletlonof
R27 PAVEMENT REPAIR: F.A-S.: Upon completion of backfill and compaction. a temporary patch consisting of two inches (2-)
of cold mix paving 1SC-8001 shall be placed immediately. A permanent patch of three inches 13") of A.C. surfacing shall
be placed on six inches 16") concrete base as directed, but not later than fifteen 115) days after completion of temporary
P". Concrete base shall be of five-sack mix and shall conform to the City of La Quinta Road Improvement Standards
and Specifications. Ordinance 11461.
R28 FOG SEAL: A fog seal coat consisting of an application of asphaltic emulsion shall be applied over all path areas as
determined by the City Engineer.
R29 SEAL ARMOR COAT: A seal coat consisting of an application binder and screenings shall be applied on all patch areas
where such seal coats existed prior to issuance of this permit. Seal or armor coats shall be applied es specified in Section
37, Standard Specifications. State of California, Division of Highways, dated January 1973. Work of pavement repair to
be accomplished by a licensed contractor engaged in the business of pavement repair.
R30 STREET RESTRIPING: Where street striping Is still visible on streets to be excavated. such striping shall be replaced upon
Completion of permanent repairs.
R31 TREE RELOCATION OR REMOVAL: Tree relocation within the City of La Quints road right of way shall be accomplished
by a licensed. bonded and insured tree service. and handled safely without mterference or hazard to the traveling public.
It shall be the responsibility of the permittee to maintain the tree In a vigorous growing condition at its new location.
Trees to be removed shall be removed in sectionswhich can be handled safelywithout Interferenceor hazard to highway
traffic. The entire width of the tree stump shall be removed and disposed of so that no debris remains in view of the
highway. The stump hole shall be backfilled and thoroughly compacted as specified inthe following paragraph. Where It
becomes necessary to restrict traffic. the work shall be restricted to a maximum of 500 feet at any one time. Adequate
signs, flagmen and/or barricades shall be provided to protect the traveling public at all times.
Large holes resulting from tree removal shall be backfilled and compacted to not less than 90 percent or equivalent to the
surrounding ground. whichever is the greater compaction as determined by the Impact or field method. Compaction
tests shall comply with Section 6.3.01 of the Standard Specifications. Division of Highways. State of California. dated
January 1973.
R32 TREE TRIMMING:
a. Only the necessary trimming shall be accomplished to provide clearance of the facility for one calendar year.
All broken or weak sections within the trimming Shall be removed.
b. Where It becomes necessary to restrict traffic. the work shall be restricted to a maximum of 500feet at arty one time.
Adequate signs. flagmen, and/or barricades shall be provided to protect the traveling public at all times.
c. If tree trunks are partially outside of the City of La Quints road right of way, permittee shall make his own
arrangements with adjoining property owners for consent to the trimming in addition to the authorization provided
by this permit.
d. All tree trimming on EVERGREEN TREES, PALM TREES, and other ORNAMENTAL TREES shall be accomplished to
the satisfaction of the City Public Works Inspector.
a• Abutting property owners shall be contacted. in all instances. prior to trimming or topping trees.
f. Pruning shall, in all instance& be at the shoulder of the crotch to insure even, fast healing In all cuts of two Inches
(2") and Soon in W& Sealant shall be applied to 811 cut secttons as directed by the City Public Works Inspector.
SPECIAL CONDITIONS --PERMIT NO. 1710
--- CVWD ---
In
addition to the standard permit conditions; the following shall apply:
I.
All'work shall be performed in' accordance with the plans submitted by CVWD.
2.
This permit is only for work within the City of La Quinta and it's right-of-way.
Permittee/contractor shall acquire a permit from any other abutting agency and/or
jurisdiction, ie, Caltrans, City..of Indio etc.
3.
Permittee shall be responsible for providing continuous dust and erosion control.
4.
Streets shall be kept clean. They shall be -completely cleaned at the end of each
'working day and more frequently if required. .
5.
Contractor, shall comply with the local noise ordinance. Operation and
maintenance of equipment within one 'half mile of human occupancy shall. be
performed only during the following time periods:
October•lst 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 lst 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 including Sundays.'
6.
Permittee shall assume. responsibility for repair of.any pavement breakdown at the
haul road'access to any public or private street 'and for any damage'to,other City
streets or facilities.
7.
Advance warning signs -and traffic control shall be installed.and maintained in
Accordance with Cal Trans Standards. It shall be the permittee's responsibility
to detour and barricade this site.
8.
Permittee shall notify the City Engineering Dept. at 564-2246 at least 24 hours
:in advance of starting construction.'
9.
In advance of excavation, Contractor/permittee shall submit to the city for
acceptance 'a detailed plan, in accordance with Labor Code Section.6705, showing
..the design or shoring, bracing, sloping, or .other provisions to be made for
worker protection from the hazard of caving ground during the excavation of any
trench or trenches five feet or more in depth.
If such plan varies from the shoring system standards, the plan shall be prepared
by a registered civil or structural engineer. As a part of the plan, a note
shall be included stating that the registered civil or structural engineer
certified that the plan complies with the Cal OSHA Construction Safety Orders or
that, the plan is not less'effective than the* shoring, bracing, sloping, or other
provision of the Construction Safety Orders.
10.
If the work is to be performed by forces other than that of the utility company
the contracting company shall apply for an additional encroachment permit and pay
the appropriate fee.
11.
Minimum pavement replacement section shall:be 4" of 'A. C. over 6" of Class iI•
aggregate Base and to the satisfaction of`the,City Engineer.
12.
All landscaping and irrigation shall be replaced to its original condition.
13.
''Prior to`excavating, permittee shall contact Underground Service Alert at 1800- "
422-4133 and provide the city inspector with and "inquiry no.,,
Special Conditions - Permit No. 1710 Page I 2
.of
1 .^ �
• a
14.1 When work'is within 500' of a signalized intersection, the permittee shall notify
CalTrans Signal Dept. at (619).688-6845 48 hours prior to beginning work.
15. Street closures shall not be allowed_at any time, a minimum of one travel lane_
on paved surface shall be maintained at all times.
15. All -excavation at or near the travel way shall be.backfilled at the end of the
work day for the.protection of,the traveling public.-
17.,
ublic:17.- Ingress and egress,for all local properties shall be maintained at all times.
IE. Contractor shall provide sufficient survey information plotted in a format for
easy analysis for all the pavement that is to be removed and replaced plus
additional length and width to assess rideability. Scope of pavement replacement.
area and structural section shall be replaced to the satisfaction' of the City
Engineer.
.19. The city will determine the final limits of asphalt replacement.'
20. •Permittee shall, submit a written traffic control plan for approval prior to
commencing any .workwithin the travelway.
21. :All work shall be performed,per the latest edition of the Standard Specifications _
For Public Works Construction.
Serial Conditions - Permit No. 1710 Page 2 of 2
NOTE:
With proper validation
G
this, form constitutes an,,.
CITY OF. LA. 'QUINTA v
encroachment permit
APPLICATION FOR PERMIT
f ENCROACHMENT)i",.
PUBLIG WORKS CONSTRUCTION ( oFo�S -_
r
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
2 SubdivisioWImprovement Permit Class III
DATE: Minor. Improvement; Permit Class IV
LOCATION OF CONSTRUCTION 79 -,555 ��OBLUOFi
LDT: 'S 7RAC7o, D05fR-T CC -"8 Mil/ OM-rtS
(Street address or Description of Location)'
PURPOSE OF CONSTRUCTION /NSTALL AND 1TIAINTAINI FDUP_ Sketch lattach construction plans if appropriate)
k40U_SE L/FTEIZAL 770 rL =-WF—a SRIi LCE _
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
+
SIZE OF EXCAVATION, IF NEEDED' s
APPROXIMATE TIME WHEN WORK WILL BEGIN-
APPROXIMATE TIME.OF COMPLETION AJ/NF—TY C90) DAYS
ESTIMATED CONSTRUCTION COSTS SOD -°O
(Including removal of all obstruction, materials, and debris, backfilling, com
paction. and placing permanent resurfacing and/or replacing improvements)
s
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 e.
penalties, liabilities or Ioresulting from claims or court action -and arising our of any;.accident, loss or damage to persons or proarrtN
Ion
happening "or occurring 'as a proximate result of any work undertaken under the permit granteO pursuant to this=appliration.
Notify, the Administrative Authority at least twenty-four 1241 hours in advance of the time when -work will be siarted.
a _
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable. rules and regulations of the Cny' o:
La Quinta and to pay for•any additional replacement necessary as the result of'.this work.
}. Signature of Applicant or Agent
COACHELLA VALLEY WATER DISTRICT P. 0. Box 1058:-COACHELLA, CA. 92236 398-2651
Name of Applicant (please print) Business Address ' Telephone Na.
jName of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. r City Business. License No.*
Policy Number
Applicant's Insurance Company
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SPECIAL CONDITIONS --PERMIT NO XXXX
--- CVWD ---.
In addition to the standard permit conditions,Lthe following shall apply:
I All work shall be performed in accordance with the latest edition of the Standard
,Specifications For Public Works Construction.
2.. Permittee shall be responsible for providing continuous dust and erosion control.
3. Streets shall be kept clean. They shall be completely cleaned at the end of each
:,working day and more frequently if required.
4. 'Contractor shall comply with the local noise ordinance. 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 lst 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 including Sundays.
5. Permittee shall assume responsibility for repair of any pavement breakdown at the
haul road access to any public or private street and for any damage to other City
streets or facilities.
6. Permittee shall submit a traffic control plan to the Engineering Dept. for
approval prior to starting work. Advance warning signs and traffic control shall
be installed and maintained jn accordance with Cal Trans Standards. It shall be
the permittee's responsibility to detour.and barricade this site.
7. Street closures shall not be permitted. A minimum of one travel lane on paved
surface shall be maintained with flagmen at all times.
8. If the work is to be performed by forces other than that of the utility company
the 'contracting company shall apply for an additional encroachment permit and pay
the appropriate fee.
9. .Permanent pavement replacement section shall be 1` greater than existing, but not
less than 4" A,.C.-over*5" class,II A.B. which ever is greater-.
All landscaping irrigation decorative rock etc. shall be replaced to its original.
condition.'
11. Prior to excavating, the permittee shall contact underground•Service Alert at
1(800) 422-4133.
12. All work shall be coordinated with the City's contractor and others working
within the area as directed by and to the satisfaction of the'City Engineer.
13. 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.
Special Conditions -'Permit No. XXXX `- Page 1 of 2
14. When work is within 500, of a signalized intersection , the permittee shall
notify Riverside County Signal Dept. at (714) 275-6894 or Caltrans Signal Dept
at (619) 688-6845 as appropriate, 48hrs prior to beginning work.
15. In advance of excavation, _contractor/permittee shall submit to the city for
acceptance a detailed plan , in accordance with labor code section 6705, showing
the• design of shoring, bracing, sloping, or other provisions to be made for
worker protection from the hazard of caving ground during the excavation of any
trench greater than five feet in depth.
'If such plan varies from the shoring system standards, the plan shall be prepared
by a registered civil engineer. As part of the plan, a note shall be included
stating that the registered civil or structural engineer certifies that the plan
complies with the Cal OSHA Construction Safety Orders or that the plan is not
less effective than the Cal OSHA Construction Safety,Orders.
1
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Special Conditions - Permit No. XXXX Page 2 of 2
NOTE
With proper validation
this 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 mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
L73
Subdivision Improvement Permit — Class I II
DATE: Minor Improvement Permit Class IV
LOCATION OF'CONSTRUCTION ��. �� FYI SD S I a F_ E T—
12'I V E t2 ST7�f2/liI w,�-T Fit C✓ 14 1-4 b-4 ff c_
(Street address or Description of Location)
PU POSE OF CONSTRUCTION —L --IS LA L L—/4 -7 01Q C) F SL-Di°C Sketch (attach construction plans if appropriate)
T .0-T7QM TU PPEVE 7- r vzos/oe.l 0 t4 K_
DESCRIPTION OF CONSTRUCTION' l CO 1= I;F T 0 F SES RTTrf�ft 1✓� G�n1DITor.15
CCD lel Lit E T E_ .)QP DT'Fc 7'1 nfJ_r,e_l r�. ► - l
NAM
2-0-1 rtLI-41L 0E D-4E_C_".A74q1qEL-
DIMENSION OF INSTALLATION OR REMOVAL '�; F -E A-�ti FJ/)
-IP Axl-►�-lS -
f
SI7, E OF EXCAVATION, IF NEEDED S E F_ /4-7—rA-CJ-•I E.10
APPROXIMATE TIME WHEN WORK WILL BEGIN -A PL I ��3'
APPROXIMATE TIME OF COMPLETION A V (—UST -3 , / q a
ESTIMATED CONSTRUCTION COST $ IZZ CDO, 00(D
,,.(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: x
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 this work. j
Signature of Applicant or Agent
E l-L-Zot vii -LSF `I Ii,) AT }2 0 15 i �. • 10 o i3o )� ) L5 -a COAC"N ELLA - W8 z66/ EY- -1261-
Name of Applicant (please print) Business Address Telephone No.
T2 8C UF_T-E MIJF
Name of Contractor and Job Foreman Business Address' Telephone No.
�l
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —'Class III r
Public improvements: 3% of estimated construction costs y
Private improvements: 36/o of estimated construction costs
Minor Improvement. Permit — Class IV: See attached schedule E `
Inspection Fee $ i PERMIT -VALIDATION
Permit Fee
Al PERMIT NO: `
Penalty _
Cash Deposit -Surety Bond DATE APPROVED _ 3 E
if required
EXPIRATION DATE �3
TOTAL: $
DATE ISSUED
Receipt No.
Received by
Recorded by
Date
By ,
Administrative Authority
TELEPHONE: (619) 564-2246
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