HomeMy WebLinkAboutAgr 2006-10-06 (CAL TRANS)
STATEOF'~~,,~'D4JUlIT OF TRANSPORTATION
F.NC..10ACIlMENT PERMIT
TR-0120
Permit No.
0406-NUM1712
DistlCo/Rte/PM
04-Mrn-131 V AR.
DIRECTOR OF PUBLIC WORKS
TOWN OF TIBURON
In compliance with (Check one):
D Your application August 30, 2006
Date
October 6, 2006
Fee Paid
Deposit
$
Payment Bond Amount (2)
D Utility Notice 0
Performance Bond Amount (1)
D Agreement No.
o
Bond Company
D R/W Contract
o
Bond Number (1)
Bond Number (2)
TO: I" Town of Tiburon
1505 Tiburon Boulevard
Tiburon, CA 94920
I
Attn:
L Phone:
Mr. Nicholas Nguyen
(415) 435-7388
-.J ' PERMITTEE
And subject to the followiU~P"'ION IS BUIY GRANTED to:
petfQnn~ and~tnjlifttol:lat1ee ofpennittee~$ ~xisting facili,ties, on State Highway 04-Mm-131, at various Post Miles, in the Town
ofT~;ti1~.cqUtlty.
Any work involving bona-fide emergency repairs on permittee's facilities shall be initiated with Caltrans District 4 Communications
Center at (510) 286-6359 to obtain an appropriate lane closure or work authorization number. Emergency is defined as without taking
proper immediate action, circumstance that may result in property damage, loss of human lives, or loss of essential services.
A minimum of one week prior to start of work under this permit, notice shall be given and advance approval of construction detail, operations,
public safety, and traffic control shall be obtained from State Representative Jack Free, P. O. Box 587, Petaluma, CA 94952, (707) 762-5540,
weekdays between 8:00 AM and 4:30 PM, holidays excluded.
All permitted work requires the permittee to apply for and obtain a work authorization number prior to start of work. See the attached
"Encroaclunent Permit Project Work Scheduling Procedures" and the attached "Permit Project Work Scheduling Request Form". Additional time
beyond the minimum seven-day advance notice required in the above paragraph may be required for obtaining the traffic control approval.
Immediately following completion of the work permitted herein, the permittee shall fill out and mail the Notice of Completion attached to
this permit.
The following attaclunents are also included as part of this permit (Check applicable):
[gJ Yes 0 No General Provisions
DYes [8J No Utility Maintenance Provisions
[gJ Yes 0 No Storm Water Special Provisions
o Yes [8J No A Cal-OSHA permit required prior to beginning work:
#
In addition to fee, the permittee will be billed actual
costs for:
DYes
DYes
[gJ Yes
[8J No
[8J No
Review
Inspection
Field Work
(If any Caltrans effort expended)
DYes
[gJ No
The information in the environmental documenmtion ,has been reviewed and considered prior to approval of this permit.
t
This permit is void unless the work is completed before ~. 31. 2~.
This permit is to be strictly construed and no other work other than specifically mentioned is hereby authorized.
No project work shall be commenced until all other necessary permits and environmental clearances have been obtained.
DAC APPROVED:
cc: JPeterson(2), JFree
DTM-BLoo
TMC-JRichardson
Marin County
BIJAN SARTIPI District Director
BY:
.C"~ '-
MI~itD. CONDIE, District Permit Engineer
Page 10f2
l'!Al\1TI: Town of Tiburon
PERMIT NO.: 0406-NUM1712
DATE: October 6,2006
When approved, traffic control performed under this permit shall be in accordance with the appropriate State Standard Plans T -10
through T-14. Where required by the plan, the use ofa flashing arrow-board is MANDATORY.
For shoulder closures, see attached State Standard Plan Sheet T-IO. For lane closures, see attached State Standard Plan Sheets T-ll
through T -13. Parking may be restricted, as needed.
Work is authorized from 9 AM to 3 PM, Monday through Friday, holidays excepted.
All utility work shall be performed in accordance with the related provisions contained in the Department of Transportation
"Encroachment Permits Utility and Tree Trimming Special Provisions" dated May 2006.
Trench backfill shall conform to Section 19-3.06 of the State's Standard Specifications and the current edition of the Standard Plans.
Tests for relative compaction of structure backfill material used in backfilling trenches may be made in accordance with Test Method
No. California 231 (Nuclear gauge). Any base, surfacing or pavement shall be replaced in kind, or as otherwise required by State's
representative.
No work is authorized on facilities crossing over or located within the State's access controlled right of way.
No excavation shall be left open overnight without permission from the State Representative.
Excavations made within the limits of the highway shall be backfilled before leaving the work for the night unless otherwise authorized
by State's representative. After backfilling the trench, temporary surfacing shall be placed if required by State's representative.
A copy of this permit shall be placed in all vehicles involved in doing this work. Permittee shall notify the State Representative before
doing any work under this permit.
All Permittee's personnel shall wear appropriate personal protective equipment, including hard hats and bright-colored vests, shirts or
jackets with retro-reflective material while on State highway right-of-way.
Where the edge of trench is within two feet (2 ft.) of existing curb and gutter or pavement edge, AC pavement between the trench and
curb or pavement edge shall be removed.
The attached "Street Trench Paving Detail" shall be used to restore pavement within the State right of way.
THIS PERMIT DOES NOT AUTHORIZE TREE TRIMMING OR TREE REMOVAL.
A monolithic pour of sidewalk and curb and gutter shall not be permitted.
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