7086Finance Revenue Code E-1
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.
Subdivision Improvement Permit - Class III
Minor Improvement Permit Class IV
DATE:April 9, 2007
LOCATION OF CONSTRUCTION (Street address or Description): Santerra TM 32225; Madison Street and 58' Avenue
PURPOSE OF CONSTRUCTION: Install (1) 18" stub -out connection
DESCRIPTION OF CONSTRUCTION:. See attached plans
DIMENSION OFINSTALLATION OR REMOVAL: See attached plans
APPROXIMATE TIME WHEN WORK WILL BEGIN:Will Call TIME OF COMPLETION:One month from start
ESTIMATED CONSTRUCTION COST: $60,000.00 (Including removal of all obstruction, materials, and debris, backfilling,
compaction and placing permanent resurfacing and/or replacing improvements)
COMMENTS: CAA t, rv,4 PRE--Cv� Lido SdPxhlr ?'FC,?
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-
7075.
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.
Signature of Applficant4dr Agent
CVWD - Carol Pfannkuche P.O. Box 1058 Coachella, CA 92236 (760) 398-2651 ext 3521
Name of Applicant (please print) Business Address Telephone No.
Same as above
Name of Contractor and Job Foreman. Business Address Telephone No.
NA NA
Contractor's License No. City Business License No.
Self -Insured NA
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit - Class III
Minor Improvement Permit - Class IV
Inspection Fee
Permit Fee
As -Built Deposit
Cash Deposit -Surety. Bond,
if required
TOTAL.
SNo Fee
$0
$0
$0
SNo Fee
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
See attached schedule
PERMIT NO.7086
DATE APPROVED: 34 lo, zoo-7
EXPIRATI4O DATE: AA /a ,
BY: Scr-'� _
Administrative Authority
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PUBLIC WORKS DEPARTMENT
APPLICATION FOR PERMIT
Date: krt 1 5
M.
ITract No: At37-2L Project Name: Sarite rry
vicinity:_ Modi6o►-t Cl1')d 5 ", nt
Purpose of Construction (Ex: Rough Grading,Offsite Street etc.)
I !g't c.4C'�hr,;ccl�`c
of
Dimension of
ion (Ex: See Plan Set No. 01234)
or Removal• & d - �p o
Approximate Construction Start Date: An I ZGO�
Approximate Construction Completion Dat : 0
Estimated Construction Cost: $ W w 060 . o
Fstimated Constntctibn Cost shall include the removal of all obstructions, materials, and debris, back -filling, compaction and
placing permanent, resurfacing and or replacing improvements
vJ AT E q Ihone Number:
`f
�STRIG�
COACHELLA VALLEY WATER DISTRICT
CAROL PFANNKUCHE
Development Services Technician
P.O. Box 1058
Coachella, CA 92236
75-525 Hovley Lane East
Palm Desert, CA 92260
(760)398-2651
(760) 398-2661
Ext: 3521
Fax: (760) 391-9638
► A COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED A
Applicant or Contractor General Liability Insurance Company:
Applicant or Contractor General Liability Insurance Policy Number:
Office Use Only:
Inspection Fee:
,^h
Permit Fee:
As -Built
Deposit:
Dust Control
Deposit:
45
Credit
Amount-------- -
Office Use Only:
Assigned Permit Number. Q
Approval Date: o
Expiration
Date:
Issue
Date:
Admi nisuative-Authority.• -
?Q0�
TOTAL FEE DUE:
V-A
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1. t
11 -A ", N't - e - , * 'k I k
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--,--3 C>A yS
N
ROAD
w�E Wow
S 500 FT
NO SCALE
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I Al
-- - - - -- ----- --- -- ---- WORRAREA------------------
- -- ------ - ---------- -
WORK AREA WORK AREA
Nr END
ROAD WORK
020.2 r' .
END 220 FT
ROAD WORK
C30A(CA)
500 FT
ROAD
` G AHEAD
p
NOTES: 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH 2O06 CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES (M.U.T.C.D.)
2. TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAY BE REQUIRED TO FACILITATE PUBLIC SAFETY AND TRAFFIC FLOW IF
DEEMED NECESSARY BY CITY OF LA QUINTA REPRESENTATIVE.
3. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL (SIGNS, BARRICADES AND DELINEATORS) AND MAINTAIN SAME IN ACCORDANCE WITH
TRAFFIC CONTROL PLANS.
4. CONTRACTOR SHALL MAINTAIN A MINIMUM 10 '(12' TYP.) TRAFFIC LANE WIDTH ATALL TIMES AND A MINIMUM 2' BETWEEN THE EDGE OF CUT AND THE NEAREST TRAFFIC LANE.
5. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINED AT ALL TIMES.
6. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. AT END OF THE WORK HOURS, THE ROAD SHALL BE CLEAR OF DEBRIS AND RETURNED TO NORMAL.
7. FLAGGERS SHALL CONFORM TO SPECIFICATIONS ON SHEET 3
Install Mter Line
AVE. 58
55
scow Based onSWndad
Desert Pipeline Inc. WA
Top Barricades, Inc. ( 00)852-TOPS Ron Ffi
N eld
1 of 3 5/31 07 To Be Issued on Approvaill
m
s
N'
w TsDELINEATORS WILL NEED TO
BE MOVE TO OTHER SIDE AFTER
NO SCALE THE FIRST HALF IS COMPLETED
TO COMPLETE THE CROSSING
62Dd
ROAD WORK
fP A Z//500 FT
O�S&• p 500 FT
GG`Q`S
W20-4
' 500 FT j L ,
W2D-1
Rm
--ram --------------------------------------------------------------
WORKAREA
00 FT
NOTES: 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH 2O06 CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES (M.U.T.C.D.)
2. TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAY BE REQUIRED TO FACILITATE PUBLIC SAFETYAND TRAFFIC FLOW IF
DEEMED NECESSARY BY CITY OF LA QUINTA REPRESENTATIVE.
3. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL (SIGNS, BARRICADESAND DELINEATORS)AND MAINTAIN SAME IN ACCORDANCE WITH
TRAFFIC CONTROL PLANS.
4. CONTRACTOR SHALL MAINTAIN A MINIMUM 10 '(12' TYR) TRAFFIC LANE WIDTH AT ALL TIMES AND A MINIMUM T BETWEEN THE EDGE OF CUT AND THE NEAREST TRAFFIC LANE.
5. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINED AT ALL TIMES.
6. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. AT END OF THE WORK HOURS, THE ROAD SHALL BE CLEAR OF DEBRIS AND RETURNED TO NORMAL.
7. FLAGGERS SHALL CONFORM TO SPECIFICATIONS ON SHEET 3
W20.1
EN D
ROAD WDRK
Install Water lane
a
AVE. 58
55
Pdme contraaor eases on eWano
Desert Pipeline Inc.. N/A
Tmft cmtd Design by Phm Pmpamd 4
Tops N Barricades, Inc. (800)852-TOPS Ron Fifield
DO Pemd Number
2 of 3 5/31/07 To Be Issued on Approval
I i i
Flagger Requirements
A. Minimum Requirements
1. Receive and communicate specific instructions clearly, firmly, and courteously;
2. Move & maneuver quickly;
3. Provide clear and positive guidance;
4. Understand and apply safe traffic control practices;
5. Recognize dangerous. traffic situations insufficient time to avoid injury.
B. Flagger Safety Apparel
1. Background
a. Fluorescent orange -red, or
b. Fluorescent yellow -green
2. Retroreflective.material (Orange, yellow, white, silver, yellow -green, or fluorescent
version.
3. Material shall be visible at 1000 fl
4. Apparel sball'be designed to identify the wearer as a person
5. Law enforcement personnel should adhere to the same standard
C. Hand -Signaling Devices
1. Stop/Slow paddle octagonal in shape with minimum 18" width and 6" letters. Must
have white legend on red background.
D. Directing Traffic
1. Only three (3) sign.als are required.
STOP SLOW
E. Flagger Communications
1. If work area is too long for relay (2 fl.aggers can't see each other)
a. One flagger given the responsibility to coordinate
b. Use Radios or
C. Field phones
F. Flagger warning signs must be removed or covered when flagging is finished, when work is not going to
start immediately, or when work is completed.
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