City of Rancho Palos Verdes

2. Location of Work
4. Permittee/Owner
6. Address1
8. City
9. State
10. Zip
12. Phone Number
13. Cell Number
14. Email Address
16. Contractor

    1. Check the box if the contractor is the same as the permittee/owner.
18. Contractor
20. Address1
22. City
23. State
24. Zip
26. Type of Work

    1. Asphalt Work
    2. Cellular
    3. Curb Core
    4. Curb & Gutter

    1. Driveway Approach
    2. Dumpster
    3. Haul Route
    4. Mailbox

    1. Material/Equipment Staging
    2. Parkway Improvements
    3. Sewer Line/Lateral
    4. Sidewalk

    1. Special Event
    2. Trench Excavation
    3. Utility Work
    4. Other
28. Description of Work
30. If you selected "Dumpster", please select from the authorized commercial haulers below.

    1. California Waste Services (CWS)
    2. Consolidated/Republic Services
    3. EDCO Corporation
    4. Universal Waste Systems (UWS)
    5. Waste Management-L.A. (WM)
    6. West Coast Rolloff
32. City Business License Number
33. State Contractor's License Number
35. Certificate of Insurance
36. Additional Insured
38. NPDES Forms
39. For a copy of the NPDES requirements and forms, please click here.
    NPDES Regulations and Forms
41. Hold Harmless Form
42. For a copy of Hold Harmless form, please click here.
    Hold Harmless Form
44. Plans
46. Statement

    1. I or the entity on whose behalf this Permit is given, hold a currently valid California Contractor's License and a City of Rancho Palos Verdes Business License.
    2. I have received, read and understand and I agree to perform all work in accordance with the permit (see "General Guidelines" below), the document titled "Instructions for Encroachment Permit," American Public Works Association (A.P.W.A.) Standard Specifications for Public Works Construction, applicable Standards Plans, current California MUTCD manual and the City Municipal Code.

48. That in consideration of the granting of this permit, the City of Rancho Palos Verdes, City wherein the permit work is to be performed and any of their officers or employees thereof shall be saved harmless by the applicant from any liability or responsibility for any accident, loss or damage to persons or property, happening or occurring as the proximate result of any of the work undertaken under the terms of this application and the permit or permits which rnay be granted in response thereto, and that all of said liabilities are hereby assumed by the applicant It is further agreed that if any part of this installation interferes with the future use of the Right of Way by the general public, it must be removed or relocated, as designated by the Director of Public Works at the expense of the permittee/owner or his successor in interest. 

50. GENERAL REQUIREMENTS

    Call "DIG ALERT" at 1-800-227-2600 at least 72 hours prior to any construction.

    •    Encroachment Permit may require a minimum of 10 working days for FIRST submittal for Excavation, Haul Routes and/or Traffic Control Plans

    •    All Mock-ups shall be installed at least two weeks prior to any Public Hearing related to the proposed construction.

    •    All disturbed areas including, but not limited to, vegetation, trees, shrubs, landscaping, fences, sidewalks, driveways, curb & gutter, asphalt, pavement markings, traffic signs, street lights, traffic signals, and utilities, shall be restored to its original condition or better, as determined by the Public Works Director, and meet current Standards and Specifications for Public Works Construction.

    •    All work, unless otherwise specified, shall be done in accordance with the current edition of the STANDARD SPECIFICATIONS FOR PUBLIC WORKS CONSTRUCTION.

    •    Any staging of materials in the City Rights of Way requires prior approval.

    •    Haul Routes must be approved 48 Hours prior to coming into the City.

    •    The Permittee/Contractor must follow the latest National Pollutant Discharge Elimination System (NP DES) & Best Management Practices (BMP's) guidelines.

    •    Before work on any sewer line begins, a permit must be issued by the City of Rancho Palos Verdes Building and Safety Division in addition to this permit. For information on sewer permits call (310) 544-5244 and ask for Building and Safety.

    •    When permittee tunnels under existing curbs, gutters and sidewalks, the excavated trench shall be back filled with cement grout as described in the Standard Specifications.

    •    A.C. Pavement shall be saw-cut beyond edge of trench as specified by APWA Standards.

    •    Asphalt shall be placed in one-inch lifts or as directed by Department of Public Works Staff.

    •    When compaction or material tests are required, all costs are to be borne by the permittee.

    •    A one-sack sand slurry mixture may be required for compaction where excavation interferes with traffic flow or where work is within the roadway portion of an intersection.

    •    All excavations must be back filled or plated at the end of the workday. The City reserves the right to require the permittee to plate open trenches in lieu of back filling.

    •    Permanent pavement repairs shall be made within 25 calendar days after excavation work is completed. Inspector's approval is required before permanent repairs are made.

    •    Tree trunks shall be cut to within 4" of curb height. All tree trunks and roots shall be ground to a depth of 18" below grade by a mechanical stump grinder to the satisfaction of the Department of Public Work staff. All wood chips shall be removed, holes filled and compacted with topsoil.

    TRAFFIC CONTROL STANDARD REQUIREMENTS

    •    Traffic controls throughout permit construction shall conform to the current State of California MANUAL OF UNIFORM TRAFFIC CONTROL DEVICES (MUTCD) FOR USE IN PERFORMANCE OF WORK UPON HIGHWA VS. Permittee shall provide and maintain all such signs, lights, and devices. All barricades in use after sunset must have portable flashers.

    •    Traffic may be restricted only between the hours of 9:00 a.m. and 3:00 p.m. and subject to review of the Traffic Engineer.

    •    One lane of traffic in each direction shall be maintained at all times on all major and secondary highways.

    •    Pedestrian walkways must be maintained with safety fencing or barrier separation for adjacent excavation.

    •    The cost of any damage to traffic signal control devices shall be the permittee's responsibility and it shall be brought to the immediate attention of the inspector. The Permittee/Contractor shall be responsible for the replacement cost of any inductive loops in the ground (wire sensors for traffic signals) that are in conflict with or damaged by construction.

    DUMPSTER REQUIREMENTS -(MUST OBTAIN CONTAINER FROM LIST OF CURRENT APPROVED VENDORS)

    •    Keep the street clean from debris at all times.

    •    Do not block/obstruct traffic motorist line of sight in any direction.

    •    Dumpster shall not infringe on any driveway approach, Fire Hydrant, Emergency facility, or utility cabinet.

    •    Dumpsters must have cones, delineators, reflectors and reflectorized tape at corners.

    CURB AND GUTTER, DRIVEWAY APPROACH, SIDEWALK and CURB CORE REQUIREMENTS.

    •    City's trench standards shall be used.

    •    Remove any/all markings following construction.

    •    Remove and Replace curb and gutter at the edge of the asphalt and haul materials to a recycling center. Provide Load Ticket to the Inspector. (Do not cut Asphalt in the street unless directed to do so by the Department of Public Works staff).

    •    Install monolithic section of curb and gutter.

    •    Must remove and replace Concrete Score line to Score line or as directed by the City staff.

    •    Install a minimum of 6-inch thick 3,250-PSI Concrete on drivable surfaces and a minimum of 4 inch thick in other places.

    •    Follow American Public Works Association (APWA) standards for Curb Core (Standards available at the City of Rancho Palos Verdes/Department of Public Works).

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