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Home My WebLink About18.7.2 Caltrans Permit City of Fontana · ' CALIFORNIA ' FAX COMMUNICATIONS FROM FAX, NUMBER (909) 350-6618 PLEASE DELIVER THE FOLLOWING PAGES TO: Company: Name: Fax Number:~,~ - t/Z ~ ~ Phone Number: From: Phone Number: Tot. I Number of Pages: Da~e: ~ ~ '~ Time: (includin~ cove~ s~e~) cc: FAX CHARGE IS: ~3.00 1ST PAGE (EXCLUDING COVER SHEET) $1.50 THEREAFTER. PLEASE MAKE CHECK PAYABLE TO THE CITY OF FONTANA IN THE AMOUNT OF ~ PLEASE MAIL TO: CITY OF FONTANA, P.O. BOX 519, FONTANA, CA 92334 FROM: Name CompanylRrm Addrese Phone No. NOTE: Please return Thie cover sheet with Payment (Account No. 010-031 6-2300) 8353 SIERRA AVENUE (P.O. BOX.'518) · FONTANA CALIFORNIA 92334-0818 · (714) 350-7600 SISTER CITY- YAMLOOPS, B.C. CANADA . ' ~lft recycled paper PERMIT NO. 08-91-N-UT-2303 CO/RTE/PM 08-$Bd-10-32.11 CALTRANS PERMITS 247 W. Third Street San Bernardino, CA 92402 100% COMPLETION NO~ICE work on Permit No. 08-91-N-UT-2303 has been completed. A final inspection meeting was held on Permittee Representative Date DEPARTNEMT OF TRANSPORTATI~ (~LTRA I PePre1, ~ DN:M-P2Q~ (Rev 1/90) 08--91 UT-2303 DtstlColRtelPM 08-SB~-10-32,~1 ~n co~l~anoe ~h (o~ec~ one): Dste X Your application of DECEMBER 17, 1991 July 13, 1992 Fee Paid Deposit __Utility Notice No. of $EXEMPT $ XXXX ~unt Agreement No. of $XXXX BondC0mpany R/W Contract No. of XXXX 8ondNuff0er city of Forttans XXXX 8353 Sierra Ave. Forttans, CA 92337 (714) 350-7610 , PEEMITTEE and subject to the following, PERHISSION IS HEREBY G~TED to= Have installed and thereafter own and amaintain 54" steel casing with V.C.P. sewer line' under and across Route 10 at Cypress as per plans date stamped December 17, 1991 and/or as directed by the State~s Representative. A PRE-JOB MEETING WITH THE ASSIGNED STATE~S REPRESENTATIVE, SO8~ COLLINS {714)383-SgB4, IS REQUIRED PRIOR TO ST~T OF ~Y WO~ ~DER THIS PE~ITI IN ADDITION, THE ATTACHED PRECONSTRUCTION MEETING AGRE~ENT S~LL BE SIGNED ~D RET~ED PRIOR TO STATING WO~ ~DER THIS PE~ITI PAIL~E TO DO SO ~Y RESET IN PETIT C~CEL~TION ~D RESUBMITTAL ~Y BE REQUIRED. F~THER INFO~TION ~Y BE ATTAINED BY THE ~ FIELD SUPERVISOR F~ COR~VA (714)383-6922. ~L WO~ S~LL BE PERFOXED IN ACCO~ANCE WITH THE C~ENT DEPONENT OF T~SPORTATION ST~D~D SPECIFICATIONS, ST~D~ P~S ~D DEPONENT OF T~SPORTATION ENCROAC~ENT PETIT ~ILITY PROVISION DATED ~LY 1987. "AB-BgILT" P~S ~a RSQgIRBD gPON COHPLBTZON OF ~L WO~, THE "AS-BOILT" P~8 MO8T BB CERTIFIED (Aa-BOILT P~8 FOR RO~WAY GEOMBTRIC8 ~ BELOW F~T~EB) A8 8OCH BY A REGIaT~ED CIVIL THE ATTACHED PAGES ARE MADE PART OF THIS PERMIT The following attachments are also Included as pert of this permit (Check in addttio~ to fee the permittee will be billed applicable) actual coats for: j~ Yes General Provisions __ Yes _~_ No Review __Yes....~X NO Utility Maintenance Provla~o~s Yes X No Inspection __Yes.J. NO Special Provisions i Yes Field t4ork __YeSX NO Excavation permit required prior to beginning Nork: (If any CaLlPans effort expendecl) X Yes N.A. The information tn the onvirormentat dectwrentation haa been reviewed and considered prior to approval of this permit. This berratt is void uaql. esa the Nork is ccepteted before NAY 31, 199~ This permit Is to be strictly construed and no other Nork other then specifically mentioned Is hereby authorized. No project Nork shall be coemenced until all other necessary permits and onvtrormentat clearances have been obtained. U t i L i t i es APPROVED: Collins Garcta 91-2303 KEYHOLE. District Director CDH N NG, P.E. Assistant Dial tot Permit Engineer PAGE.3: ATTACHED TO AND ~E PANT OF PERMIT NO. 08-9 N-UT-2303 Motwithstanding General Provision No. 3, your contractor will be r~luirsd to apply Zor and obtain · permit prior to starting work. Psrmittee's work shall be subordinate~ to any operations which the State m~y conduct# and shall not fielay, nor iatsrfere with ths State Zoroes or Btate's contractor. YOUR ATTENTION IS DIRECTED TO STANDARD SPECIFICATIONS SECTION 7-1.11 PRESERVATION OF PROPERTY AND BUSINESS AND PROFESSIONS CODE, SECTION 8771. PERMITTEE SHALL PHYSICALLY INSPECT THE WORKSITE AND LOCATE SURVEY MONUMENTS ~ PRIOR TO WORK COMMENCEMENT. MONUMENTS SHALL BE REFERENCED OR RESET IN ACCORDANCE WITH BUSINESS AND PROFESSIONS CODE. Permittee shall be responsible for arranging the services of a qualified traffic control contractor to provide any needed traffic control. The permittee shall arrange a meeting between his field representative, traffic control contractor, CALTRANS representative and the CHP at least two (2) weeks prior to start of any work covered under this permit to arrange date and time of starting work and determine appropriate methods of handling traffic during the installations. AT LEAST 3 WORKING DAYS NOTICE SHALL BE GIVEN TO THE CALTRANS REPRESENTATIVE AND THE CHP, PRIOR TO THE MEETING TO ALLOW TIME TO MAKE ARRANGEMENTS TO ATTEND THE MEETING. Work under this permit shall not commence until all traffic control plans have been approved by the State. In addition, if time extension is necessary, a request for time extension should be made a minimum of two (2) weeks prior to completion date stated on the face of the permit. If work has not been started before the completion date, permit may be voided and resubmittal may be required. PERMITTEE SHALL CONTACT STATE'S REPRESENTATIVE FOR FINAL INSPECTION AND APPROVAL OF COMPLETED WORK. PERMIT NO. 08-91-N-UT-2303 CO/RTE/PM 08-SBd-10-32.11 PRECONSTRUCTION MEETING AGREEMENT I, _, acting as an authorized agent for the permittee, CITY OF FONTANA , hereby agree to personally accomplish or have another designated party arrange for and attend a pro-construction meeting with authorized State representative SUSAN COLLINS , as specified on this permit. Such meeting shall be held two (2) days or more prior to planned start of work on this project. Authorized State representative shall have complete authority to determine whether permit conditions, either implied or written, have been complied with. State representative may then allow permit work to proceed as appropriate. Pre-construction Meeting Record below must be signed by both State representative and permittee before permit work may start. This agreement, or a copy thereof, shall be mailed back to the Calftans Permit Office at 247 W 3rd Street, San Bernardino, CA 92402, prior to construotion. Failure to 4o so may result in the suspension of work and/or fielay in the release of bonus. a copy shall also be kept at the Job site at 811 times when work is in progress. It is the permittee's responsibility to insure that the State representative is notified of work completion and that the attached Completion Notice is mailed to the Caltrans Permit office. Signature Date Print or Type Name Position or Title PRECONSTRUCTION MEETING RECORD State Representative Date Permittee Representative Date Date Work May Begin Date PERMIT NO. 08-91-N-UT-2303 CO/RTE/PM 08-SBd-10-32.11 CALTRANS PERMITS 247 W. Third Street San Bernardino, CA 92402 100% COMPLETION NOTICE Work on Permit No. 08-91-N-UT-2303 has been completed. A final inspection meeting was held on Permittee Representative Date PERMIT NO. 08-91-N-UT-2303 CO/RTE/PM 08-SBd-10-32.11 NOTIFICATION TO CLOSE ONE OR MORE TRAFFIC LANES This Notice must be approved by the State Inspector and filed in Public Affairs Office 4S-HOURS prior to lane closure. This form may be faxed to the Public Affairs Office. Send to: Gary P. Regan Public Affairs- Operations (714) 383-4632 FAX - (714) 383-6822 DATE PERMIT INSPECTOR'S SIGNATURE: PERMIT INSPECTOR: SUSAN COLLINS PHONE: (714]383-5954 LENGTH OF LANE CLOSURE NO. OF DAYS__ LESS THAN A DAY CLOSING LANE(S) NUMBER DIRECTION AND HOURS OF THE LANE CLOSURE START TIME COMPLETION TIME DESCRIBE THE TYPE OF WORK THAT WILL BE PERFORMED DURING THE CLOSURE: DATE PERMIT NO. CO-RTE-PM CALTRANS - PERMITS ATTN: 247 W. Third Street San Bernardino, CA 92408 NOTIFICATION OF N[EETI~G A MEETING HAS BEEN SCHEDULED: DATE: DAY: Time: ADDRESS: WITH THE FOLLOWING PERSONS: NAME.' CO~[PANY: ENCROAC~q~r~NT PEtiT GENERAL PROVISION~ 1. Authol'it~ Each Encroachment Per- 9. Con~lctt=g permits If a prior UtllitiesaresubJecttotheprovisionsof tar 3 of DIvision 1, commencing with. ' posed work, the new permittee must Code (CVCI. Section 660, etseq, of the Streets and arrange for any necessary' removal 15. Csreofl:Y~s,,-,,~ Iftheworkcontem- Highways Code (SHC). or relocation with the prior permittee. plated in any Encroachment Permit five (5) days' notic~ The~se General Pro- issued shall, whenever required by law, Depax'~menf. issued hereunder ar~ revocable or sub- Public Utilit ies Comm ission (pI. IC) af log to its former condition as nearly as Ject to modffication or abrogation al the State of California, CAL-OSHA, or may be possible any portion of the any time, without prejudice, however, any other public agency having Juris- State highway facility which has been to prior rights, including those eviden- diettoy_ Failure to comp[y with the law, excavated or otherwise disturbed by cod by Joint use agreements, franchise as noted above, will invalidate the permitt~c The permittee shall maln- agreements for operating purposee in 11. Provisions for Pedestxtans; Where underanypermit. lfthehighwaylsnat any permit. timeshallpede~triansbcdtvertedonto 17. permits for Record Onlyl If occup& 4. Acceptslice Of Provlsloo2 It is a portion of the street used for tion of highway right-of-way is under the designated Department raprosen- 12. Pr~tection of Traffic Adequate pro- are intended to be created by the iial start of work, When work has been of the traveling public Warning signs, rights .~hall be fully protected, interrupted formore than five(5)work- lights and safety devices and other Encroachment Permits issued in such ing day~ an additional 24-hour measures required for the public casesshallhavedesignatedacrossthe notification is required before restart- safety, shall conform to the require- face thereof 'Notice and Record Ingworkuntessapre-arrangedagree- ments of the Manual of Traffic PurpoaesOnly'.(DistrictOfficeofRlght ment has been made with the C.ontrols issued by the Department of Way must give approval for this Department's representative. Unless Traffic control for day or nighttime designatioxt) otherwise specified, all work shall be lane closures shall be in conformance 18. Clean Up itli~of-Wayx Upon corn- performed on weekdays and during with Department Slandard Plans for plotIon of the work, all brush. timber, normal working hours of the Depart- TrafficControISystsres, Nothinglnthe scraps, material, etc, shall be entirely 6. Standards of Coxast~xctiom All work to impose on permittee any duty, or left in as presentable a condition as performed within the highway shall standard of care, greater than or dif- existed before work started, conform to recognized standards of ferentthanthedutyorstandardofcare 19. Costoflrork' Unie~sothenvtsestated ment Standar~i Specifications, Stan- 13. Mhs~'~nm Interfexenco with Traf- agreernent all ccats incurred for work dard Plans and Manual on High and fie~ Allworkshallbeplannedandcar- withlog the State fight-of-way put- LOw Risk Facilities Within Highway ried out so that there will be the least suant to this Encroachxnent Permit Rights-of-Way and any Special Pxo- possible inconvenience to the travel- shall be berne by the permittee. and 7. Inspection and Approval by t~s to place property attired fiaggez~s) to lndemnfficatlon or contribution from Deparnnent~ All work shall be subject stop and warn conventional hi~way the State for such work. io monitoring, respection. and traffic Traffic shall not be unreason- 20. ActnslCostBm(s_s When the permit- approval by the Department. The per- ablydelaYed,Flagiilngproceduresshali tee is to be billed actual costs (as and acceptance of the work tions to Flaggers pamphlet and/or such costs will be at the current hourly 8. Keep Perm~ ou ths Work Site The Manual of Traffic Controls for reteestabltshedbytheDepartmentfor lhereof shall be kept at the site of the Zones issued by the Department 21. 8obn2t Plato For installation of all work and must be shown to any rap- 14. 8toragaofEquipmsntandMaterlslm undergroundfacllltles, andallsufface law enforcement officer on demand, ralllng('[~13e Ill between any [ane carry- the permittee shall furnish five (5} sets WORK SHALL BE SUSPENDED IF ing public traffic and any obstacle, of plans showing location and con- PROVIDED. within twelve lest i12] of ihe lank application Thix'W (301 days after STATE QF CAUFORNIA · DEPARTMENT OF TRA/' '~RTA"~ON FREEWAY CLOSURE NOTIFICA~,/.N 8-A- 451 (NEW 3/92) DATE Thle notification must be epproved end signed by the Calttwns' contat;t before it can be ALL dosurns must receive a lane closure number from ~e Caltrmns Ban Bemardlno Dispatch, (714) 38~4500, at least 48 hours in advance of slardng Ibis projecL Please fax a copy of the completed informalion to Ihe Public Affairs Offic~ at FAX (714) 38,1-6822, UNIT CALTRANS CONTACT WORK PHONE # R~,MPS [] [] EN NoE O CFI'Y & INTERSECTING ROADS DA~ T~ME WORK TO BE DONE DETOUR AVAILA~4LE? ROUTE CITY & INTERSEC'RNG ROAOS DATES TIME WORK TO BE DONE DETOUR AVAILABLE? ROUTE ~rFY i rNTERSECTING ROADS /ORK TO 8E DONE ; DLrrQUR AVNLABL~/ ROUTE