TC2015-007701' .4, tttr' See 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.
DATES 10/20/2015
LOCATION OF CONSTRUCTION(Street address or Description): WASHINGTON
PURPOSE OF CONSTRUCTION: ADA RAMP REPLACMENT AND STREET RESURFACING.
DESCRIPTION OF CONSTRUCTION: TRAFFIC CONTROL FOR CIP 2012-07B WASHINGTON ST IMPR.
DIMENSION OF INSTALLATION OR REMOVAL: 143.500 SF
APPROXIMATE TIME WHEN WORK WILL BEGIN: 10/22/2015 TIME OF COMPLETION: 12/7/2015
ESTIMATED CONSTRUCTION COST: $491.520.00 (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 2012-07B 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, 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
(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 regulations of the City of and
to pay for any additional replacement necessary as the result of this work. I) M., 3A,.'e
I8natie.o(APplicant or Agent
GRANITE CONSTRUCTION - KYLE /
GRIJALVA 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 ATTN: 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: TC2015-0077
DATE ISSUED:
EXPIRAPN DATE:
BY:
WORK INSPECTED BY*:
PERMIT COMPLETION DATES:
*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: t1phl~q :t C2E .7n12.-
I Tract No: t1 Project Name:
Purpose of Construction (i.e.: Rough Grading, Offsite Street,
a
Description of Construction (i.e.: See Plan SetNO. 01234) 17 &t
M -R Pedt V
Dimension of Installation or Removal: i45QP :
Approximate Construction Start Date: ftW2'/2O15'<
Approximate Construction Completion Date I 12I7I2O15
Estimated Construction Cost $L491520
Estimated Construction Cost shall include the removal of all obstructions, materials, and debris, back-filling, compaction and
placing permanent resurfacing and or replacing improvements I
Contact Name: Y G'nj i!LIPhone Number I
Name of Applicant/Owner
Applicant Address 30OO M tj &f- 5TJ
Applicant Telephone Number: [OIi . •;'
Applicant E-mail Address:Fj
Name of Contractor:
Contractor Address 38OOO '
Contractor Telephone Number 6675750b 4
Contractor State License Number r89
Contractor City Business License Number Out I
Contractor E-mail Address Fyle ?ivageinc orn
A COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED'
ADnlicant or Contractor General Liability Insurance ComDanv:
ApDlicant or contractor General Liability Insurance Policy Number:
Office Use Only:
inspection Fee:
Permit Fee:
As-Built
Deposit:
Dust Control'
Deposit:
Credit
Amount:
TOTAL FEE DUE: •
I ifluPIt :r •kllg?q - FnrrnQ X AnnhIrtInfl
Office Use Only:
Assigned Permit Number 70-2D/6-0 6 77
Approval Date:
•
Expiration
Date: •
Issue
Date:
Administrative Authority:
P
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10 DRUMS CLOSED
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NOTES:
1. IN HEAVY PEDESTRIAN AREAS THE
ADJACENT LANE MAY NEED TO BE
CLOSED TO MAINTAIN PEDESTRIAN
TRAFFIC.
LEGEND
O CONES/DRUMS
TYPE III BARRICADE
SIGNS
EZZ WORK AREA
51
Mid Block Right Lane Closure
NOT TO SCALE
Optional +
Optional
1+
Optional
36 Work Area Traffic Control Handbook
Mid Block Closure of Two Lanes
NOT TO SCALE