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N2010-0335
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BOX 1768, NEWPORT BEACH, CA 92659-1768 (949)644-3311 CONDITIONS OF APPROVAL TO: Mireya Gonzalez, 1-800-436-3627 MireyaG@dekra-lite.com DEKRA-LITE INDUSTRIES FROM: Socheata Chhouk, (949) 644-3346 schhouk cDnewportbeachca.gov DATE: December 23, 2010 SUBJECT: Encroachment Permit N2010-0335 Newport Beach Restaurant Week Banners at Various Locations (Citywide) The following is the Encroachment Permit N2010-0335 conditions of approval for the Newport Beach Restaurant Week installation: • All work shall be per City Council Policy L-16 Temporary Banners Extending Over the Public Right -of -Way. • Banners are to be installed only on the 100 street light poles as indicated on the attached exhibits. • The mounting hardware shall be per the Council Policy: "All banner brackets on streetlight poles must be installed using stainless steel band clamps and the brackets must be sufficiently strong enough to withstand wind -load generated by ninety (90) mile per hours wind." • Poles or standards must be wrapped with forty five (45) ml thick black rubber sheet or other pre -approved material under all steel brackets and clamps and no portion of any bracket shall be in direct contact with the surface of any street light pole or standard. • Applicant shall contact the City Electrician of the Utilities Division, Herb Wollerman, at (949) 718-3406 at least forty eight (48) hours prior to the installation of any banner on street light poles. • All banners shall be removed within thirty (30) days after the date of installation. o The proposed installation date for work within the City's right-of-wav is Monday, January 3, 2011 and the removal date is on Friday, January 28, 2011. o The proposed installation date for work within Caltrans' right-of-way is Friday, January 7, 2011 and the removal date is on Friday, January 28, 2011. • A Caltrans "DP" permit shall be obtained by the applicant prior to installation of banners within Caltrans right-of-way. Newport Beach Restaurant Week Banner Encroachment Permit N2010-0335 Page 2 • The applicant shall coordinate with the CdM BID for the removal of their "Happy Holidays" banners within the CdM BID area. • No banners shall be installed on traffic signal poles or metal/steel streetlight poles. • Traffic control shall be per the latest edition of WATCH manual and the attached traffic control plan. The work hours are limited to 9 AM to 3 PM. • The applicant must provide on-going maintenance of the banners and brackets. • Banners shall not impact any traffic signage. • The applicant must sign a "Hold Harmless Statement" requiring maintenance of the banners/brackets and indemnification and hold harmless for any liability associated with the banners/brackets. • The applicant must maintain a minimum of $1,000,000 in liability insurance from a company with a Best's Key Rating Guide parameter of "A" or better, and a financial size category of "VIII" or higher. • If needed, the City may require removal of some of the banners to allow other organizations to install banners at the same location and during the same time period. • A minimum of two 5 -inch wide half -circle wind slits per banner are required to minimize the wind load. \\cnb\data\users\pbw\schhouk\encroachment permits\n2010-0335 nb restaurant week 2011\n2010-0335 nb restaurant week bannerscoa 12-22- 10.doc Public Works Department 94"44,3311 3300 Newport Boulevard, Newport Beach, CA 9663 1ZI U 0 N N Q 4- c (I3 L (0 N Q) I U (6 Q) CD L- 0 O Q I ly] Y Ln z 0 Q V O z C N Z O Q � J z O 0 N Q cc In O z U 1 M U 0 N Q 4� (0 L D (0 N S U N m 0 Q z a \ �cb C L Ucr m mO C C O N U) N N C m m � C N N 04 _ O a) c c O IE CU m N CU i cp Z O Q V O N Z O Z < dJ V V 0 N Z Z J V ti00 r. I Three newbanner locations!& a0 \ \ \ } \ \ CO �2} }\ Co j ;o= :t} (f§ .K (/k .R 77§ [mom �» (5! (0 M CO ;7 (_0 Three newbanner locations!& a0 WONIN a t <41 -3 \ \ \ } \ \ } \ \ . WONIN a t <41 -3 « A In LA M ` e v y, iy gym0 N ® �X I [ } Jli p d e w *r r try y i P A • g \ y 2 f � j 5 C ��'. ••� VA's•I'V I M [ 4 s ',. � � � � � � LL Yc dS` it w � 9` W y� m. n` � � _ v1 $x � � � aw ... v � t 3�y d L 4 y e. >> !�! 4` M �w � .j v x'�,Y ? � �• �Y .�. qy �'� p' - «,., ri v ' "� K4 M � X'r A.p +� x � �" °a ��. w, N � n (� w � '9 A� � �^ y �A+% �i �� � ry + 1 yy z -4 "' - � �_ *� � �+ � w m6 �. � 4 � $. � �"/ � I 4" i C � f � � ., gyp ' au ..., i N O 4I� � v � � h +a Le ,:, f+ J +per, w Pr *a ar ',. �� W � 3 .. � � � � � � � �,� ., � �`. � i a: '�. as ... �'' w ' C} �, �p L am W ., � a'Y �: Yi ffi tix M ', s. w av '. !y rve ` U � ��, a G .. ; tS rZ at° Y �e bn ti � Y 9 �. ` AY � K e0 " � � .. ...., ,� � II. � � �.,.. 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Equ O;wJ mth -i ;d PfApee -d Ataxt; law am lw 50,h tb e wmd Of Of €tre h�2rrgr, sloaxwo W-11 Itx'4tt is � c4g," iengft' zwb��a*- di JmqevRg '.C, your t"nrw onagwl. t 5hree, a, bw FC r Up to 8° pf adi --' VZI izy �igfV at Turcvog 40ts UU-.It wits Le' % ^.XwjdKi munhalm mdc 'YW, inwit ed q*rjvs gem: Fwvhqvq Itwe, ark ff-, --,,dd z �iN mamna s on yoer pdg5. smvst 11 mt.31i 4 -YJ the ertrg rffmove a"Of. *^"en youff nar�1,4 prc4ran is mit re user. a lax veer ommee AML��q& Bariner I- fte,"Tec With a W WN�, aware mu` r i" i)"verT'c. City of Newport Beach Public Works Department Phone. 845-644-3319 Fax:: 549-644.3316 :?ROJECT ADDRESS Closure to Segm " r�rr�tr`r,.-=* I I. M f:smS,?�0fl Date Closure to Enda Tltne cf C" osure; DIAGRAM LOCATION OF ENCROACHMi=NT BELOW: q K- 3PM kAFr-DAqS St ;e aElff.ehe 543c"eLic. site plairs. Our truzk -Nv.'! move waif; 7 PO4? loo litort [0 pi,) e o, -:i6011 on"I". sto'-pin to .Ufitzd� n banner on ea(Ah light jl:lk-tib rlidicaQcl ou the site pkin arttachcd eby certify the foregoing statements are true and correct and the permAtee guarantees to indemnity hold the City of Newport Beach harmless against any claims, liability. ortudgments for damages ng out of the permifee's activities. Signature, ._..�..,._..,. ..,...�, ..._.._ Date: by: nate: M. - M e a s [p 0 C .2 C6 �_ m c to = H v— O -0 5 u7 C 0 Ew J OJ v —� C£ Q t U N C c c O Q N 0 m 30 U O M. - M e a s a � � o x 31 m ME < LE c u GJ � m (D — cc Lf) ro 00 —j< 0) Ln Ln U cc C-- L V) 0 t5 --- > iz 31 m ME m w 12 0i+ 0 no bZ LE c u �\ \ \� m w 12 0i+ 0 no 8 POP-, 0 Q Zffi u 0 Ln CL) Z3 0 _cz 0 V) U C E0 0 (D Z3 > -E 0 8 m piw.wrw—�. POP-, 0 Zffi m piw.wrw—�. a 0 a STATE DF CALIFORNIA -DEPARTMENT OFTRANSPDRTATION STANDARD ENCROACHMENT PERMIT APPLICATION TR -0100 (REV. 0212004) Permission is requested to encroach on the State highway right of -way as follows: (Complete all BOXES ]write N/A if not applicable]) This application is not complete until all requirements have been approved. 1 -COUNTY IZROUTE 13.POSTMILE I OWN FORCES M©M PIPES 0 Page I NO. 12—to 2—to — 6 JJ P` V O 4 k IRTEIPM 12 - D R/4 - 55- d ' i a ' ! 1l 0 A 8 DATE OF SIMPLEX STAMP )2-12-1110 12. EST. COSTIN STATE RAV 1s. K Double Permit Parent Pemdt Number _ /`1 c'/y, +� Applicant's Reference Number I Utility. Work Order Number �tL I (1O 16. Have your plans been reviewed by another Cattrans branch? NO YES❑ (If "YES") Who? 17. Completely describe wo/k to be done within STATE highway right-of-way : Attach 6 complete sets of FOLDED plans (folded 8.6" x 11" [216 mm x 286 mm]), and any applicable specifications, calculations, maps, etc. All dimensions shall be in dual.u1nits (English Mmetric), OR exclusively in metric units. f MOAVt4AI l l and remove 5?tU#11 "e vu + b"11 XS O rl tbct 91r"4 11g1%4 -s lwots odonj }auF%&C04fhgc" and IIuvpe+TiMvrA trtl�t��y o� IJewpor�-�t.�► cturl�q�fh� "N�,per�" Bea.eh R�g}avran�F wuk'�et�r� (nap s..rrk �rrcath. A-11, n etc dMk— ui ftv Cv t&� CaRnwi rola .. ape HAkvne and G+dr R.+ -d," , W F"w,1,4- p1Ans even+AAmltt Ntw?"+' 6t! Rt&lu�We-� (!j FiRANS Ri ilC��� Wer+ da! -e : Janu" 2(, 20(( Ary Jan" i «Fc 21 4010gr' 19. Is a city, county, or other agency involved in the approval of this project? ❑ YES (rf'YES :check type of project arrd aftaefr erMrvnmenta/ documenfatlon and caotlttions c/approve/. j yI ❑ COMMERCIALDEVELOPMENT❑BUILDING E3 GRADING 0OTHER,91 ❑ CATEGORICALLYEXEMPT ❑ NEGATIVE DECLARATION ❑ ENVIRONMENTALIMPACTREPORT ❑ OTHER XNO (It "NO', Please check Me category heroes which best descrtbes the pmJ.4 and complete pogo 4 of this appfferaRon.) ❑ DRIVEWAY OR ROAD APPROACH, RECONSTRUCTION, MAINTENANCE, OR RESURFACING ❑ FENCE ❑ PUBLIC UTILITY MODIFICATIONS, EXTENSIONS, HOOKUPS ❑ WJLSOX 9FIAGS, SIGNS, BANNERS, DECORATIONS, PARADES AND CELEBRATIONS ❑ EROSION CONTROL ❑ OTHER ❑ LANDSCAPING 19. Will this project muse a substantial change in the significance of a historical resource (45 years or older), or cultural resource? ❑ YES NO (If 'YES, pmdde a description) M. Is this project on an eAsling highway or streetsw,�here the activM1y involves removal of a manic resource, including a significant free-orsland of tees, a rock outcropping or a historic building? ❑ MU YES NO (If'YES', provide a description) 21. Is work being done on applicants property? ❑ YES A NO (if'YES% attach ails and grading plans.) A d. NOTICE: Foc iodividuais wnh scawry dieabilitics, thio docuacot u availoblc io d¢mwc fommw For infamwiea at (916) 654 410 or TDD (916) 654-3880 or wdw to Rcoadv and Forret Maeaymcnr, 1120 N Seca, MS 9, Sacramcoto, CA 95814 i STATE OFCALIFORNM-DEPARTMENT OFTRANSPORTATION Page 2 STANDARD ENCROACHMENT PERMIT APPLICATION TR-01DO (REV. 0712064) 22- Will chis Proposed proled require the disturbance of soil within highway right-of-XayR ❑YES � NO: - V' L:OF 7I %1 ' P U \ IATIO(V if -YES', estimate the area in square teat AND acres: (fp) (acnes) 23. Will this proposed project require daxatering7 [3 YES XNO - It "YES', estins par mate daily volume in galloday. (gpd) D 2010 24. Haw will any storm water or ground water be disposed of foam within or near the linin of this proposed project? t]Stoan Drain SYRear, ❑Combined Sewer/ Stwm System - ❑Stn -water Retention Basin 4 g 9Other(mi,isin): d Pj1 J PLEASEREADTHEFOLLOWINGCLAUSESPRIORTO SIGNINGTHIS ENCROACUMENTPERMITAPPLICATION The applicant, understands and herein agrees to that an encroachment parmit can be denied, and/ora bond requiredfornon-paymentofpriororpresentencroachmentpennitfees. EncroachmentPermitfaesmaystil/be due when an application is withdrawn or denied, and that a denial may be appealed, in accordance with the California Streets and Highways Code, Section 679.5. All work shall be done in accordance with Caltrans rules and regulations subject to inspection and approval. - - - - -- - - - - - - - Theap Lica{rt,understands and herernagreestothegeneralprovisions, speciatprovlstonsandconddionsofthe encroachmentpermit, and to indemnify and hold harmless the State, its officers, duectors, agents; employees and each ofthem (Indemnitees) from and againstanyand all claims, demands, causesofaction, damages, costs, expenses, actual attorneys'fees,judgments, losses and liabilities ofeverykindandnaturewhatsoever(Claims) - arising out oforin connection with the issuanceandlor use ofthis encroachmentpermit for, i) bodilyinjuryandl or death to persons including but not limited to the Applicant the State and its officers, directors, agents and ._employees, thehtdemnities, and the public; and 2) damage to property ofanyone. Except as provided bylaw, the indemnification provisions stated above shall apply regardless of the existence or degree of fault of indemnities. The Applicant however, shalt not be obligated to indemnify Indemnities for Claims arising from conductdelineated in Civil Code Section 27i 2; DISCHARGES OFSTORMWATERAND NON -STORM WATER: Workwithin State highwayrrght-of-wayshall be conducted in compliance with all applicable requirements of the National Pollutant Discharge Elimination System (NPDES) pennitissued to the Department ofTransportation (DepartmenQ, to govern the discharge ofstorm waterandnon-storm waterfrom itsproper res. Workshalf also be in compliance with all otherapplicableFederal, StateandLocallawsandregulations,andwith theDepartmenYsEntxoachmentPermitsManualand encroachmenf permit Compliance with the Departments NPDES permit requires amongst other things, the preparation and submission ofa Storm WaterPollutfon Protectfon Plan (SWPPP), ora Water Pollution Control Program (WPCP), and the approval of same by the appropriate reviewing authority prior to the start of any work. information on fherequiremenfs mayalso bereviewedon theDepariment's Construction Website at. h> p.11www dotca govlhglconstruclstormwaterl.htm M STATE OFCALIFORNIA•DEPARTMENT OF TRANSPORTATION Page 3 STANDARD ENCROACHMENT PERMIT APPLICATION TR -0100 (REV. 02/2004) PERMITNUMBER )210 - 6DF FEE CALCULATION' -FOR CALTRANS USE ❑ CASH ❑ CREDrrCARD NAME ON CARD PHONENUMBER CI-ECK NUMBER 1 /0Z7NAMEONCHECK �J GYM PHONENUMBER7)q- 43 o ❑ EXBvFT ❑ PROJECTEA______ ❑ DEFERRED WILLING (Utility) CALCULATED BY (1) (2) FZEVEW 1. HOURS @ $ 2. HOURS @ $ 1. FEE / DEPOSIT $ DATE 2. FEE/ DEPOSIT S DATE TOTAL FEEL DEPOSIT $ $ WSPECTION 1_ HOURS @ 2 HOURS @ $ 1. FEE 1 DEPOSIT DATE 2. FEE 1 DEPOSfi $ DATE -� TOTAL FEE iDEPOSIT $ FIELDWORK HOURS @ $ $ $ $ .... :..: ..::. EQUIPMENT & MATERIALS ._-DEPOSIT LATE, .,.-_gFPOSIT :_ DATE..- DEPOSIT CASH DEPOSRIN LIEU OF BOND $ $ $ TOTAI.ICOLLECTED CASHIER'S INITIALS C $ " The curumt hourly rate is set annually by Headquarters Accounting. Disirict Office staff do not have authority to modify this rate. PERFORMANCEBOND ❑ DATE AMOUNT PAYMENTBOND ❑ DATE AMOUNT $ LIABILITY INSURANCE REQU [RED? ❑ YES [:]NO AMOUNT D&AR11m, 0 DEC 2! 2o46— ME) Print Permit STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION ENCROACHMENT PERMIT TR -0120 (REV. 6/2000) In compliance with: ® Your application of ❑ Utility Notice No. ❑ Agreement No. ❑ RM Contract No. December 16, 2010 of of of TO: CITY OF NEWPORT BEACH 3300 NEWPORT BOULEVARD NEWPORT BEACH, CA 92663 Attn: SOCHEATA CHHOUK 949-644-3346 and subject to the following, PERMISSION IS HEREBY GRANTED to: Page 1 oft raid No. 12 -10 -N -ER -0823 >Co/Rte/PM 2 -ORA -55 PM 0 -PM 1 e 12/16/2010 Paid Deposit EXEMPT $ EXEMPT formance Bond Amount (1) Payment Bond Amount (2) 0.00 " 0.00 , PERMITTEE Install, maintain, and remove special event banners to eight (S) existing City -owned street light standards within the State R/W along Newport Boulevard in the City of Newport Beach during the "Newport Beach Restaurant Week" event, all in accordance with current Caltrans Standard Specifications and Standard Plans, the Encroachment Permits Manual, the attached Provisions, and Permit Plans stamp -dated December 16, 2010. Permittee shall contact SHAHRYAR DERAVI, State Permit Inspector, at 949-756-7677 a minimum of five working days prior to the start of work. Failure to comply with this requirement will result in the suspension of this permit. Permittee's Contractor shall furnish the State with a signed application requesting a separate Caltrans "DP" permit to perform the work within State right of way on the City's behalf. The Contractor shall pay a deposit of $492.00 at the time of the application for inspection costs and shall reimburse the State the actual inspection costs incurred within THIS PERMIT IS NOT A PROPERTY RIGHT AND DOES NOT TRANSFER WITH THE PROPERTY TO A NEW OWNER The following attachments are also included as part of this permit (Check applicable) ® Yes ❑ No General Provisions In addition to fee, the permittee will ❑ Yes ® No Utility Maintenance Provisions be billed actual costs for: ❑ Yes ®No Storm Water Special Provisions ❑Yes ®No Review ®Yes 11 No Special Provisions EI Yes ®No Inspection ❑ Yes 19 No A Cal -OSHA permit, if required: Permit No. ® Yes ❑ No Field Work ❑ Yes ®No As -Built Plans Submittal Route Slip for Locally Advertised Projects ❑ Yes ®No Storm Water Pollution Prevention Plan / Water Pollution Control Plan (if any Caltrans effort expended) ❑ Yes ® No The information in the environmental documentation has been reviewed and considered prior to approval of this permit. This permit is void unless the work is completed before February 2, 2011 _ 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 the other necessary permits and the environmental clearances have been obtained. Permittee File: 10-0823 S. Deravi Maintenance MORY MOHTASHAMI District Permit Engineer htip://capl/epermit/bin/print_lermit.php?id=128835 12/16/2010 CITY OF NEWPORT BEACH 1210-N BR -0823 DEC. 16, 2010 State right of way and for cost of all work performed by Caltrans Maintenance Forces relating to this permit. In addition to the attached Permit General Provisions, Form TR -0045, the following Permit Special Provisions are applicable: • Permittee shall contact the State Permit Inspector at least two working days prior to the start of sign installation/removal work. Local Police may provide traffic control (at no cost to the State) during banner installation/removal work. • Orange vests and hard hats shall be worn at all times while working within State right-of-way. • No work which interferes with public traffic shall be performed during peak rush hours, from 6 AM to 9 AM and from 3PMto7PM. • Banners shall not be installed within signalized intersections, and shall not contain private advertising, nor be of a political nature. • All temporary signs shall be installed at locations where the existing sight distances are maintained. Temporary signs shall not block any existing warning or regulatory signs, or motorists' visibility of electrical traffic signals. • Banners shall be made of substantial material, such as: cloth, canvas, or plastic. • The temporary banners may be installed two weeks prior to the start of the event, and shall be immediately removed upon its completion. • The lower edge of the banners shall be installed with a minimum vertical clearance of 18 feet above the pavement. • Installation of banners on State-owned traffic signal poles or other State-owned facilities is not authorized. • Immediately following completion of the work permitted herein, Permittee shall fax to 949-724-2265 the attached Questionnaire and Permit Number, completion date with the signature of Permittee's representative to initiate the final processing of this permit. Pase 2 of 2 STATE OF CALIFORN IA- DEPARTMENT OFTRANSPORTATION STANDARD ENCROACHMENT PERMIT APPLICATION TR -0100 (REV. 01/2004) Permission is requested to encroach on the State highway right-of-way as follows: (Complete all BOXES [write N/A if not applicable]) This application is not complete until all requirements have been approved. Page 1 PERMI I NO. /I/^ _ ® T Ii R—oq s .e STAMP 1.000NTY 2. ROUTE 3. POSTMILE �• OI'tAN ic. Li'SJJ JCPii-1 -".."�"""' 4. ADDRESS OR STREET NAME 5. CITY NlJNiVuj r' 30i' fARD Iq:Et PO -1f R:-.AOt-i 6. CROSS STREET (Distance and direction from site) 'IONS 7. PORTION OF RIGHT-OF-WAY DATE OF SIMPLEX STAMP VARtbUS L OCA ATTACHED) PARKWAY 8. WORK TO BE PERFORMED BY 9. EST. START DATE 10. EST. COMPLETION DATE ❑ OWN FORCES m CONTRACTOR 0 11111!/'20 11 02/01.^,Jrj1 II 11, MAX.DEPTH AVG.DEPTH AVG. WIDTH LENGTH SURFACE TYPE 12. EST.COSTIN STATE R/W EXCAVATION I'V%i4 i "A N/A N;;'r N14, MN 13. PRODUCT TYPE DIAMETER VOLTAGE]PSIG 14.CALTRANS PROJECTE.A, NUMBER PIPES INll> N/A NiA ti; t: 15. ❑ Double Permit Parent Permit Number Applicant's Reference Number / Utility Work Order Number 16. Have your plans been reviewed by another Caltrans branch? NO JZ YES[] (If "YES") Who? 17. Completely describe work to be done within STATE highway right-of-way : Attach 6 complete sets of FOLDED plans (folded 8.5" X 11" [216 mm X 280 mm]), and any applicable specifications, calculations, maps, etc. All dimensions shall be in dual units (English and metric), OR exclusively in metric units. iN(SI r,_L. MAINII AIN AND Nr IMiDV'E SIX F001 HIGH i) BY -I "WO =JO WIDE tti , � ECIr... rLcNT ', NNi: �iS TO IGHT 4r' -._XI""TING CITY iib INFO STR -F UGI -11 3TAN6ARU5 ,tL.ONti' N: 1r.YC)(; I" !it)U V/iPiiJ t JI ulh HE GITy Or Nr v/t 0 BFAC;l i, BANNF P, 1 OCP.T 10f!q,. i.A[ .,]A.1' r, DIMH!SiONS ANL, hA-)Ury i NG JVFJ,?R NIA 01d A-i--iACHED PLAN SET, -"dtEN (NAME: N EV 1r'JRT S E A H- �E=STAUk/V%lI WP EK EVEN? 1 F6:: JANUbrRY2'I.2011 TOJANUAZY27.2011 BANNt.R INS -,Ai... AfION JANUARY 7, 7x r f0 CFPB UAtiY 1, 2011 PL, 1 (;OdTPiSiCHiP10Uf g6«,46OR SG--OL<N u+iA GO_r';. A ✓ GR Ulf r] K -fi.i..Y A (949j F t'- d-� or 16rr cl},rl nr,r'r>e n.;ar,nca r,o� Gs riEN i' Ff.l -F IS Fti "ADY FOR. ' ;G -UP 18. Is a city, county, or other agency involved in the approval of this project? ❑ YES (if "YES", check type of project and attach environmental documentation and conditions of approval. ) ❑ COMMERCIALDEVELOPMENT ❑ BUILDING ❑ GRADING ❑ OTHER ❑ CATEGORICALLY EXEMPT ❑ NEGATIVE DECLARATION ❑ ENVIRONMENTAL IMPACT REPORT ❑ OTHEI NO (If "NO', please check the category below which best describes the project, and complete page 4 of this application.) ❑ DRIVEWAY OR ROAD APPROACH, RECONSTRUCTION, MAINTENANCE, OR RESURFACING ❑ FENCE ❑ PUBLIC UTILITY MODIFICATIONS, EXTENSIONS, HOOKUPS ❑ MAILBOX FLAGS, SIGNS, BANNERS, DECORATIONS, PARADES AND CELEBRATIONS ❑ EROSION CONTROL ❑ OTHER ❑ LANDSCAPING 19. Will this project cause a substantial change in the significance of a historical resource (45 years or older), or cultural resource? []YES 2 NO (If "YES", provide a description) 20. Is this project on an existing highway or street where the activity involves removal of a scenic resource including a significant tree or stand of trees, a rock outcropping or a historic building? ❑ YES Z NO (If "YES", provide a description) 21. Is work being done on applicant's property? ❑ YES [Z NO (If "YES", attach site and grading plans.) STATE OF CALI FORNIA• DEPARTMENTOFTRANSPORTATION Page 2 STANDARD ENCROACHMENT PERMIT APPLICATION ®�/l'v1� IQeO e 7 yry TR -0100 (REV. 01/2004) Oy 22. Will this proposed project require the disturbance of soil within highway right-of-way? ❑ YES 70 NO If "YES', estimate the area in square feet AND acres: (ft') (acres) 23. Will this proposed project require dewatering? ❑ YES m NO If "YES", estimate daily volume in gallons per day: (gpd) 24. How will any storm water or ground water be disposed of from within or near the limits of this proposed project? ❑Storm Drain System El Combined Sewer/ Storm System El Storm Water Retention Basin h(JOther(explain): N", PLEASE READ THEFOLLOWING CLAUSESPRTORTO SIGNINGTHIS ENCROACHMENTPERMITAPPLICATION. The applicant, understands and herein agrees to that an encroachment permit can be denied, and/or a bond requiredfornon-payment ofpriororpresent encroachmentpermit fees. Encroachment Permit fees maystillbe due when an application is withdrawn or denied, and that a denial may be appealed, in accordance with the California Streets and Highways Code, Section 671.5. All work shall be done in accordance with Caltrans rules and regulations subject to inspection and approval. The applicant, understands and herein agrees to the general provisions, special provisions and conditions of the encroachment permit, and to indemnify and hold harmless the State, its officers, directors, agents, employees and each of them (Indemnitees) from andagainstanyandall claims, demands, causes ofaction, damages, costs, expenses, actual attorneys'fees, judgments, losses and liabilities of every kind and nature whatsoever (Claims) arising out of orin connection with the issuance and/or use of this encroachment permit for: 1) bodilyinjuryand/ ordeath to persons including but not limited to the Applicant, the State and its officers, directors, agents and employees, the Indemnities, and the public; and 2) damage to property of anyone. Except as provided bylaw, the indemnification provisions stated above shall apply regardless of the existence or degree of fault of Indemnities. The Applicant, however, shall not be obligated to indemnify Indemnities for Claims arising from conduct delineated in Civil Code Section 2782. DISCHARGES OFSTORM WATER AND NON -STORM WATER: Work within State highway right-of-way shall be conducted in compliance with all applicable requirements of the National Pollutant Discharge Elimination System (NPDES) permitissued to the Departmentof Transportation (Department), togovern the discharge ofstorm waterandnon-stormwaterfromits properties. Workshallalsobeincompliance with all otherapplicableFederal, State andLocallaws and regulations, and with theDepartment's EncroachmentPermits Manual and encroachment permit. Compliance with the Departments NPDES permit requires amongst other things, the preparation and submission of a Storm Wa terPollution Protection Plan (SWPPP), ora Water Pollution Control Program (WPCP), and the approval of same by the appropriate reviewing authority prior to the start of any work. Information on the requirements may also be reviewed on the Department's Construction Website at: h tfpS11www:dof_cz_gov/hq/cons true/storm wa terl.htm or ORGANIZATION (Printor Type) CITY OF NE.WPORI BEACH SChhDLIICti�7lleVdjJ6rlb(•~aChC2i,y0V ADDRESS of APPLICANT or ORGANIZATION WHERE PERMIT IS TO BE MAILED (Include City and Zip code) 3300 NE'.41PORT BOULEVARD, W WPORI BEACH, CA 92663 PHONE NUMBER FAXNUMBER (949) 6.94-;346 (9491644-331£3 26. NAME of AUTHORIZED AGENT I ENGINEER (Print or Type) IS LETTEROF AUTHORIZATION ATTACHED? E-MAIL ADDRESS SOCHEA[A CHHOUK ❑ YES ® NO schhouk(41 eav(."rt6eaCFra,yry SAME AS ABOVE PHONE NUMBER FAXNUMBER 27. SIGNATURE RE ofApj LICANT or ORGANIZATION �////1�/ 28. PRINT OR TYPE NAME SOCHEATA CII 29.TITLE ASSOCIATE ENG, 30.DATE 12/14/2010 STATE OF CALIFORNIA• DEPARTMENTOFTRANSPORTATION Page 3 STANDARD ENCROACHMENT PERMIT APPLICATION ^ to TR -0100 (REV. 01/2004) /tv-�Ql�/Z d(3r FEE CALCULATION -- FOR CALTRANS USE ❑ CASH ❑ CREDITCARD NAMEONCARD PHONENUMBER ❑ CHECK NUMBER NAMEONCHECK PHONENUMBER EXEMPT ❑ PROJECT EA ❑ DEFERRED BILLING (Utility) CALCULATED BY (1) (2) REVIEW 1. HOURS @ $ 2. HOURS @ $ 1. FEE/ DEPOSIT $ DATE 2. FEE/ DEPOSIT $ DATE TOTAL FEE / DEPOSIT $ $ INSPECTION 1. HOURS @ $ 2. HOURS @ $ 1. FEE/ DEPOSIT $ DATE 2. FEE/ DEPOSIT $ DATE TOTAL FEE / DEPOSIT $ $ FIELDWORK HOURS @ $ $ $ $ EQUIPMENT & MATERIALS DEPOSIT DATE DEPOSIT DATE DEPOSIT CASH DEPOSIT IN LIEU OF BOND $ $ $ TOTAL COLLECTED $ $ CASHIER'S INITIALS $ ' The current hourly rate is set annually by Headquarters Accounting. District Office staff do not have authority to modify this rate. PERFORMANCEBOND E]DAiE MOUNT PAYMENTBOND F-1 DATE $MOUNT LIABILITYINSURANCE REQUIRED? E]YES [-]NO MOUNT Ns 0 m 101 DISTRICT 12 CALTRANS PERMIT PLANS n I= r 1 R 2010 ATTACHED TO PERMIT NO. ®®' 0P2 N z O Q O0 z in O O N c tq C f6 N m C c (n Z 00 w < Z p �r U� I- O o Z.2 J" <U) O-0 U >, Z c N N M m E O 65 E fn O 1-0 .Lo > o> 000 000 0 0 o Q c co 3 z N N = Z (n s o 0 m 101 DISTRICT 12 CALTRANS PERMIT PLANS n I= r 1 R 2010 ATTACHED TO PERMIT NO. ®®' 0P2 N z O Q O0 z z � J Q z O O 0 � Z z v C' ® h ti m CL Q Ocpeaatian tilYtUVttIi❑:5 Thti ttIWareaker B&-adr L &ys'rn nat be fe erga�erred -c aura -;a IncYh8Mv5na Ir•. > >r rtweaLner. The Wnrer Z,%,- n f45 wwr rn ahumrakrs houv5g wHh an adjust—,be fe wgless arm'.&iBeaxrnf Me khanner dgnt RIP nhndble arm pvus rhe w IW r.*¢5svre r'rr n tke'ri, and honer to "Iwg ttr ve of ycw pa3� .r program. speciitcatians • Adaptatte to any type of pole regardless ofs'wpe, size, or mattnai Equipper with a :antrlmred ticmtie nb^_rgWA arm that spills the vied off of rte banner, thereby adding h❑n;,-vttr to your banner program. Yzoaard arm le gtr is 3(r. Custom lengtta avWlabI2 upon revues. Smoker shores allow for av to 8" of adiustatilky in kheigI t without remevrng shoes, • ekelft with 100% extruded aluminum stock; vncm Inslal!ed wilt+ stainless vft[ handlnq there are m oAdMng maderias on yet piles. • Siwde 5 io-gail arw the sfru remoae easily when your banner proyeaa is not n use. • Includes a sx rear umltem wairom • Harmer s W-urec with a metal safety wire nvov-Jh a grc nrm' . , jjDekra=mLl't6 De,roratson tnmQvat1on A durable 1loz yr no sleeve between the pale and the WindBreaker hardware provdces pTateclion from scratche$, 72" Height 24" Width State of California WORK,COMPLETION NOTICE 12 -MP -0032 (REV. 05/07) Permit no. Dist./Co/Rte/PM Lisliectoi J. Permittee l: All work authorized by the above permit Nvas completed on Date: Sighed _ CUSTONIER SER'. Y'I(!E -f,,) -UES rTk' YLQNfN;AIRE PERFORMANCE EXCELLENT VERY GOOD GOOD POOR INSIDE, THE OFFICE Staff cnurte,nus and helpful SWFF quid< and efficient Explanations & instructions clear TELERRUNIE ANSWERING Timely responses Gide right information/answer INSPECTION inspector courteous and hel )fol Pre -construction meetin- set and held in a timely manner. Ins xector at the job site fret uently OVERALL PERFORMANCE What would you say is our overall performance Fill out the form immediately after completion of work and fax it to 949-724-2265 5TATE OF CALIF ORNIA -OEFAR T MENT OF TRANS POP,TATION CUSTOMER SERVICE QUESTIONNAIRE TR -0164 (REV. 02J01) - PERMIT NUMBER - Dear Cus Omer, Our goal is to provide the best service possible to our customers. Please take a few minutes to complete this questionnaire. Your comments will enable us to see how we are doing overall and any areas which may need improvement. PLEASE TELL US HOW WE'RE DOING t_ INSIDE THE OFFICE - EXCELLENT VERY GOOD G000 POOR Staff courteous and helpful - - INSPECTION Staff quick and efficient Explanations and instructions clear TELEPHONE ANSWERING Timely response Receiving information or answers - - INSPECTION Inspector courteous and helpfull Pre -construction meeting set and held in a timely manner - - — Inspector at job site frequently — Inspector able to answer questions and deal with problems OVERALL PERFORMANCE - What would you say is.our overall performance? Is there a staff person you would like STAFF'S NAME:. to commend? .COMMENTS: STATE OF CALIFORNIA, DEPARTMENT OF TRANSPORTATION ENCROACHMENT PERMIT GENERAL PROVISIONS TR -0045 (REV. 05/2007) 1. 2. 3. AUTHORITY: The Department's authority to issue encroachment permits is provided under, Div. 1, Chpt. 3, Art. 1, Sect. 660 to 734 of the Streets and Highways Code. REVOCATION: Encroachment permits me revocable on five days notice unless otherwise stated on the permit and except as provided by law for public corporations, franchise holders, and utilities. These General Provisions and the Encroachment Permit Utility Provisions are subject to modification or abrogation at any time. Permittees' joint use agreements, franchise rights, reserved rights or any other agreements for operating purposes in State highway right of way are exceptions to this revocation. DENIAL FOR NONPAYMENT OF FEES: Failure to pay permit fees when due canresult in rejection of future applications and denial of permits. ASSIGNMENT: No party other than the permittee or pernittee's authorized agent is allowed to work under this permit. ACCEPTANCE OF PROVISIONS: Permittee understands and agrees to accept these General Provisions and all attachments to this permit, for any work to be performed under this permit. 6. BEGINNING 'OF WORK: When traffic is not impacted (see Number 35), the permittee shall notify the Department's representative, two (2) days before the intent to start permitted work. Permittee shall notify the Department's Representative if the work is to be interrupted for a period of five (5) days or more, unless otherwise agreed upon. All work: srralrbe,-yLrflno eu on weekdays during regular work hours, excluding holidays, unless otherwise specified in this permit. 7. STANDARDS OF CONSTRUCTION: All work performed within highway right of way shall conform to recognized construction standards and current Department Standard Specifications, Department Standard Plans High and Low Risk Facility Specifications, and Utility Special Provisions. Where reference is made to "Contractor and Engineer," these are amended to be read as "Permittee and Department representative." 8.. PLAN CHANGES: Changes to plans, specifications, and permit provisions are not allowed without prior approval from the State representative. 9. INSPECTION AND APPROVAL: All work is subject to monitoring and inspection. Upon completion of work, permittee shall request a final inspection for acceptance and approval by the Department. The local agency permittee shall not give final construction approval to its contractor will final acceptance and approval by the Department is obtained. 10. PERMIT AT WORKSITE: Permittee shall keep the permit package or a copy thereof at the work site and show it upon request to any Department representative or law enforcement officer. If the permit package is not kept and made available at the work site, the work shall be suspended. _ 11. CONFLICTING ENCROACHMENTS: Permittee shall yield start of work to ongoing, prior authorized, work adjacent to or within the limits:of tf e project site. When existing encroachments conflict with new work, the permittee shall bear all cost for rearrangements, (e.g., relocation, alteration, removal, etc.). 12. PERMITS FROM OTHER AGENCIES: This permit is invalidated if the permittee has not obtained all permits necessary and required by law, from the Public Utilities Commission of the State of California (PUC), California Occupational Safety and Health Administration (Cal -OSHA), or any other public agency having jurisdiction. 13. PEDESTRIAN AND BICYCLIST SAFETY: A safe minimum passageway of 4' shall be maintained through the work area at existing pedestrian or bicycle facilities. At no time shall pedestrians be diverted onto a portion of the street used for vehicular traffic. At locations where safe alternate passageways cannot be provided, appropriate signs and barricades shall be installed at the limits of construction and in advance of the limits of construction at the nearest crosswalk or intersection to detour pedestrians to facilities across the street. Attention is directed to Section 7-1.09 Public Safety of the Department Standard Specifications. 14. PUBLIC TRAFFIC CONTROL: As required by law, the permittee shall provide traffic control protection warning signs, lights, safety devices, etc., and take all other measures necessary for traveling public's safety. While providing traffic control, the needs and control of. all road users [motorists, bicyclists and pedestrians, including persons with disabilities in accordance with the Americans with Disabilities Act of 1990 (ADA)] shall be an essential part of the work activity. Day and night time hoe closures shall comply with the California Manual on Uniform Traffic Control Devices (Part 6, Temporary Traffic Control), Standard Plans, and Standard Specifications for traffic control systems. These General Provisions are not intended to impose upon the permittee, by third parties, any duty or standard of -- car ---sate 4.... or d, fcrc- om, v. r =ed by'aw. 15. MINIMUM INTERFERENCE WITH TRAFFIC: Permittee shall plan and conduct work so as to create the least possible inconvenience to the traveling public; traffic shall not be unreasonably delayed. On conventional highways, pennittee shall place properly attired flagger(s) to stop or warn the traveling public in compliance with the California Manual on Uniform Traffic Control Devices (Chapter 6E, Flagger Control). 16. - STORAGE OF EQUIPMENT AND MATERIALS: The storage of equipment or materials is not allowed within State highway right-of- way, unless specified within the Special Provisions of this specific encroachment permit. If Encroachment Permit Special Provisions allow for the storage of equipment or materials within the State right of way, the equipment and material storage shall comply with Standard Specifications, Standard Plans, Special Provisions, and the Highway Design Manual. The clear recovery zone widths must be followed and are the minimum desirable for the type of facility indicated below: freeways and expressways - 30', conventional highways (no curbs) - 20', conventional highways (with curbs) — 1.5'. If a fixed object cannot be eliminated, moved outside the clear recovery zone, or modified to be made yielding, it should be shielded by a guardrail or a crash cushion. 17. CARE OF DRAINAGE: Permittee shall provide alternate drainage for any work interfering with an existing drainage facility in compliance with the Standard Specifications, Standard Plans and/or as directed by the Department's representative. 18. RESTORATION AND REPAIRS IN RIGHT OF WAY: Permittee is responsible for restoration and repair of State highway right of way resulting from permitted work (State Streets and Highways Code, Sections 670 et seq.). 19. RIGHT OF WAY CLEAN UP: Upon completion of work, permittee shall remove and dispose of all scraps, brush, timber, materials, etc. off the right of way. The aesthetics of the highway shall be as it was before work started. 20. COST OF WORK: Unless stated in the permit, or aseparate written agreement, the permittee shall bear all costs incurred for work within the State. right of way and waives all claims for indemnification or contribution from the State. 21. ACTUAL COST BILLING: When specified in the permit, the Department will bill the permittee actual costs at the currently set hourly rate for encroachment permits. 22 AS -BUILT PLANS: When required, permittee shall submit one (1) set of folded as -built plans within thirty (30) days after completion 25. and approval of work in compliance with requirements listed as follows: PAI 24. 1. Upon completion of the. work provided herein, the permittee shall send one vellum or paper set of As -Built plans, to the State representative.. Mylar or paper sepia plans are not acceptable. _ - 2. All changes in the work will be shown on the plans, as issued with the permit, including changes approved by Encroachment Permit Rider. 3. The plans are to be stamped or otherwise noted AS -BUILT by the ..permittee's. representative who was responsible for overseeing the work. Any original plan that was approved with a State stamp, or Caltrans representative signature, shall be used for producing the As -Built plans. 4. If As -Built plans include signing or striping, the dates of signing or strip removal_ Oo aminal, or installation „shall be shown on the plans when required as a condition of the permit. When the construction plans show signing and striping for staged construction on separate sheets, the sheet for each stage shall show the removal, relocation or installation dates of the appropriate staged striping and signing. 5. As -Built plans shall contain the Permit Number, County, Route, and Post Mile on each sheet. 6. Disclaimer statement of any kind that differ from the obligations and protections provided by Sections 6735 through 6735.6 of the California Business and Professions Code, shall not be included on the As -Built plans. Such statements constitute non-compliance with Encroachment Permit requirements, and may result in the Department of Transportation retaining Performance Bonds or deposits until proper plans are submitted. Failure to comply may also result in denial of future permits, or a provision requiring a public agency to supply additional bonding. PERMITS FOR RECORD PURPOSES ONLY: When work in the right of way is within an area under a Joint Use Agreement (JUA) or a Consent to Common Use Agreement (CCUA), a fee exempt permit is issued to the permittee for the purpose of providing a notice and record of work. The Permince's prior rights shall be preserved without the intention of creating new or different rights or obligations. "Notice and Record Purposes Only" shall be stamped across the face of the permit. BONDING: The permittee shall file bond(s), in advance, in the amount set by the Department. Failure to maintain bond(s) in full force and effect will result in the Department stopping of all work and revoking,permit(s). Bonds are not required of public corporations or privately owned ut0ities, unless permittee failed to comply with the provision and conditions under a prior permit. The surety company is responsibJ.e .for any latent defects as provided in California Code of Civil Pm°eedures, Section 337.15. Local agency permittee shall comply with requirements established as follows: In recognition that �a 27. 28. project construction work done on State property will not be directly funded and paid by State, for the purpose of protecting stop notice claimants and the interests of State relative to successful project completion, the local agency permittee agrees to require the construction contractor famish both a payment and performance bond in the local agency's time with both bonds complying with the requirements set forth in Section 3-1.02 of State's current Standard Specifications before performing any project construction work. The. local agency permittee shall defend, indemnify, and hold hornless the State, its officers and employees from all project construction related claims by contractors and all stop notice or mechanic's lien claimants. The local agency also agrees to remedy, in a timely manner and to State's satisfaction, any latent defects occurring as a result of the project construction work. FUTURE MOVING OF. INSTALLATIONS: Permittee understands and agrees to relocate a permitted installation upon notice by the Department. Unless under prior property right or agreement, the permittee shall comply with said notice at his sole expense. ARCHAEOLOGICALIHISTORICAL: If any archaeological or historical resources are revealed in the work vicinity, the permittee shall immediately stop work, notify the Department's representative, retain a qualified archaeologist who shall evaluate the site, and make recommendations to the Department representative regarding the continuance of work. PREVAILING WAGES: Workperformed by or under a permit may require permittee's contractors aid subcontractors to pay appropriate prevailing wages as set by the Department of Industrial Relations. Inquiries or requests for interpretations relative to enforcement of prevailing wage requirements- are directed to State of California Department of Industrial Relations, 525 Golden Gate Avenue, San Francisco, California 941-U2. -"`" RESPONSIBILITY FOR DAMAGE: The State. of California and all officers and employees thereof, including but not limited to the Director of Transportation and the Deputy Director, shall not be answerable or accountable in any manner for injury to or death of any person, including but not limited to the permittee, persons employed by the permittee, persons acting in behalf of the permittee, or for damage to property from any cause. The permittee shall. be responsible for any liability imposed by law and for injuries to or death of any person, including but not limited to the permittee, persons employed by the permittee, persons acting in behalf of the permittee, or for damage to property arising out of work or other activity permitted and done by the permittee under a permit, or arising out of the failure on the pennince's part to perform his obligations under any permit in respect tomaintenanceor any other obligations, or resulting from defects or obstructions, or from any cause whatsoever during the progress of the work, or other activity or at any subsequent time, work or other activity is being performed under the obligations provided by and contemplated by the permit. The permittee shall indemnify and save harmless the State of California, all officers, employees, and State's contractors, thereof, including but not limited to the Director of Transportation and the Deputy Director, from all claims, suits or actions of every time, kind and description brought for or on account of injuries to or death of any person, including but not limited to the permittee, persons employed by the permittee, persons acting in behalf of the permitteesnd the public, or damage to property resulting from the performance of work or other activity under the permit, or arising out of the failure on the permittee's part to perform his obligations under any permit in respect. to maintenance or any other obligations, or resulting from defects or obstructions, or from any cause whatsoever during the progress of the work, or other activity or at any subsequent time, work or other activity is being performed under the obligations provided by and contemplated by the permit, except as otherwise provided by statute. The duty of the permittee to indemnify and save harmless includes the duties to defend m set forth in Section 2778 of the Civil Code. The permittee waives any and all rights to any type of expressed or implied indemnity. against the State, its officers, employees, and Stale contractors. It is the intent of the parties that the permittee will indemnify and hold harmless the State, its officers, employees, and State's contractors, from any and all claims, suits or actions as set forth above regardless of the existence or degree of fault or negligence, whether active or passive, primary or secondary, on the part of the State, the permittee, persons employed by the permittee, or acting on behalf of the permittee. For the purpose of this section, "State's contractors" shall include contractors and their subcontractors under contract to the State of California performing work within the limits of this permit. 29. NO PRECEDENT ESTABLISHED: This permit is issued with the understanding that it does not establish a precedent. 30. FEDERAL CIVIL RIGHTS REQUIREMENTS FOR PUBLIC ACCOMMODATION: A'. - The permittee, for himself, hispersonal representative,_ successors in interest, and assigns as part of the consideration hereof, does hereby covenant and agree that: 1. No person on the grounds of race, color, or national origin shall be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination in the use of said facilities. 2. That in connection with the construction of any improvements on said lands and the furnishings of services thereon, no discrimination shall be practiced in the selection and retention of fust -tier subcontractors in the selection of second-tier subcontractors. ._ _. .. "+..Thatsurh discrimination shall not be practiced against the public in their access to and use of the facilities and services provided for public accommodations (such as eating, sleeping, rest, recreation), and operation on, over, or under the space of the right of way. 4. That the permittee shall use the premises in compliance with all other requirements imposed pursuant to Title 15, Code of Federal Regulations, Commerce and Foreign Trade, Subtitle A. Office of the Secretary of Commerce, Part 8 (15 C.P.R. Part 8) and as said Regulations may be amended. 5. That in the event of breach of any of the above nondiscrimination covenants, the State shall have the right to terminate the permit and to re-enter and repossess said land and the land and the facilities thereon, and hold the same as if said permit had never been made or issued. 31. MAINTENANCE OF HIGHWAYS: The permittee agrees, by acceptance of a permit, to properly maintain any encroachment. This assurance requires the permittee to provide inspection and repair any damage, at permittee's expense, to State facilities resulting from the encroachment. 32. SPECIAL EVENTS: In accordance with subdivision (a) of Streets and Highways Code Section 682.5, the Department of Transportation shall not be responsible for the conduct or operation of the permitted activity, and the applicant agrees to defend, indemnify, and hold harmless the State and the city or county against any and all claims arising out of any activity for which the permit is issued. Permittee understands and agrees that it will comply with the Obligations of Titles It and III of the Americans with Disabilities Act of 1990 in the conduct of the event, and further agrees to indemnify and save harmless the State of California, all officers and employees thereof; including but not limited to the Director of Transportation, from any claims or liability arising out of or by virtue of said Act 33. PRIVATE USE OF RIGHT OF WAY: Highway right of way shall not be ua�d' for private purposes without compensation to the State. The gifting of public property use and therefore public funds is prohibited under the California Constitution, Article 16. 34. FIELD WORK REIMBURSEMENT: Permittee shall reimburse State for field work performed on permittee's behalf to correct or remedy hazards or damaged facilities, or clear debris not attended to by the permittee. 35. NOTIFICATION OF DEPARTMENT AND TMC: The permittee shall notify the Department's representative and the Transportation Management Center (TMC) at least 7 days before initiating a lane closure or conducting an activity that may cause a traffic impact. A confirmation notification should occur 3 days before closure or other potential traffic impacts. In emergency situations when the corrective work or the emergency itself may affect traffic, TMC and the Department's representative shall be notified as soon as possible. 36. SUSPENSION OF TRAFFIC CONTROL OPERATION: The permittee, upon notification by the Department's representative, shall immediately suspend all lane closure operations and any operation that impedes the flow of traffic. All costs associated with this suspension shall be home by the permittee. 37. UNDERGROUND SERVICE ALERT (USA) NOTIFICATION: Any excavation requires compliance with the provisions of Government Code Section 4216 et. seq., including, but not limited to notice to a regional notification center, such as Underground Service Alert (USA). The permittee shall provide notification at least 48 hours before performing any excavation work within the right of way. CERTIFICATE OF LIABILITY INSURANCE CPO -Krs THIS GERI ffi-ICATE 13 ISSUED AS A MATTER OF INFORMATION Alliant insurance 1 ONLY AND CONF15TIS NO RIGHTS UPON THE CERTH'ICATE IT, 7 HOLDER, THIS CERTIFICATE OOSS NOT AMEND, FXrSNr} OR Ca�q�a Drive, Bra 200 AL SER THE COVERAGE AFFORDED RY THE FOUGtFS BELOW. �- Earnardino, CA, 92408 shone: Fax: 901�—iSG-2013 INSURERS AFFORDING COVERAGE WAIL Ookra Lite Industries ine, 1 3102 West. Alton Avenue Santa An& CA 92704 - COVERAGES 111-1111W--9 FOR !�1E"Ji IC, FTRX'UVMII A �eX) NO NMISTANDNG ANY OR CONDMUN WeCON7RA-T OF 9 - ER joctAAENTWFH -1115 MR,, RE fsUal OR At'OPME a PE '+ZOUCZU lqNO 'iAl"'O R61X7x7Tv11TrE uI iMTS S.T., M�N Yr SURANCE -,FUVRAL LIAMLITY 5 41 - a �W ONIPJRV AP1':R8;'VR �C— fARAI)t Ud NIJY f .. . ...... ................ E,.XOSS � UMRR5 LLA LMAN-A I IOFAMME, 5INGLE AX I 1vOKKVRs COMPt45ATION, I X AND EmPLGYaFWI IAIMIJ TfN UK-,;TjvTr--.. 03/21/10 1 03/21/11 F,. 11,000,000 El Or,xSV F A 4-r'EE i 1 0 0 0 0 0") rVA,ce 1 00 0 Job: Newport Beach Restaurant Association Various Locations Newport Beach CA 92659. *30 day N 0 C exQevt 10 day £or non-payment of uramitna, CERTIFICATE HOLDER CANCELLATION 5HOULO ANY OF 7HE ABOVE VESCRiNED FOIJOES aE CANCELLER ECTORr TNr P.XAAATC' CAISVMff�'N Newport Beach Restaurant WYES9 NO OBUGATcN OR LIAMLOY OF ANY KIND UFCN THE WVJPEr. fTS XOIraS OR Aasocia tion Pr, Box 2295. . . .......... --- - ------------- Newport Beach CA 92658-1295 AUTHORL WF4 A-E ACORD 25 (2009101) ID 1 8 -009 ACORD CORPORATION. All rights MSVrWd. The ACORD name and logo are ragisisrad maFks of ACORD ITU ONLY EA, ACZIUW HF -R K.A hLC 5 m aYz'i lus 3 .0 1vOKKVRs COMPt45ATION, I X AND EmPLGYaFWI IAIMIJ TfN UK-,;TjvTr--.. 03/21/10 1 03/21/11 F,. 11,000,000 El Or,xSV F A 4-r'EE i 1 0 0 0 0 0") rVA,ce 1 00 0 Job: Newport Beach Restaurant Association Various Locations Newport Beach CA 92659. *30 day N 0 C exQevt 10 day £or non-payment of uramitna, CERTIFICATE HOLDER CANCELLATION 5HOULO ANY OF 7HE ABOVE VESCRiNED FOIJOES aE CANCELLER ECTORr TNr P.XAAATC' CAISVMff�'N Newport Beach Restaurant WYES9 NO OBUGATcN OR LIAMLOY OF ANY KIND UFCN THE WVJPEr. fTS XOIraS OR Aasocia tion Pr, Box 2295. . . .......... --- - ------------- Newport Beach CA 92658-1295 AUTHORL WF4 A-E ACORD 25 (2009101) ID 1 8 -009 ACORD CORPORATION. All rights MSVrWd. The ACORD name and logo are ragisisrad maFks of ACORD IMPORTANT If the cert'fica+p NDIder is an ADDI, FIDNAL INSURED, tqF- palicy(ies) must be evidorsed. A azatemem Gv. 'his mrtificatle does nQt, urinfer r,c1, fi 1pt,s to .he tcottiicate molder in lieu of such endaisemellil(sl. I' SUIBROGATION 15 tNAIVED, 5unjewoo the lorryis and conciffions of the pplzy, ceriairt poklesai3y reifuirel ai� erdmrtmeot. A ntatemeM un c+,aificaile does mofrier rights lo the rierfificale hoWer o flea of sich pndw6emenl(s) DISCLAIMER This Cs-1-tificate ofInswance, dors tint crams. Itutea contract between ths, tssuing insurer(s), .41.31,Onzad fetiresentative or pioducer. and the certiftate ho'der, nus does it affirmadvely or negatiJelv amend, extend or .,ter trfe cvcra,e afforded `ay the pok,-Iail iisted tbreon, ACORN, CERTIFICATE OF LIABILITY CE INSURAN61r F 949-7561-1730 FAX -34q.756.5740 T ERIPICATET�� SUI MF INF,01 ATTFR �RX �1164 V spccTrum Tti"Ih mgmt. <u lnburpncf� 5rervice-, ONLY AND CONFERS NO RfGlqnUPON T€i.E CERTiFICATE IAL HO_DER, Tt I IS C E, RTJFJ CATE DOE S NO I AMEND, EXTE NU OR Ek 'HAF COVERAGE AVIPORDED BY THE POO CIES 5171,0iN, 1,5 4: 0ve �ry ---------- - ------ - ------ CA 9?635 iNSURFIR5 AFIlDRIANG COVER413E NAIC r a -I, T, t'fdwstHcs, Tir, CrIdLn Cagle ins Ccrp 1093c, 02 A, J1W, fin A"'e_ 3ina, CSA 92704 - ------ .. .... . .... ... . ............ .. r.DVERM'E_'; - --------- - r pj. "�UC ------ C 9429Z 04/08f2fito 04/08/2011 01) 0000, 00, 000, GUr l 0011 aA30q4244$ G41/08/2010 04/08/2011 X A N D i Lill 117 1 j - — -------- 04 'OS/Z010 04/081 2011 c JI 8 7 6 37-2 6�i 2, 0 0(o ..... ........ ... ....... . . L ',[,It T I Phi i AC -Mf li, dcwpof't 13ea'h Restaurant ASsLciition their ffic" oGIrs, cmpliiyces and agents arQ included as midi I'di 'ional insured. koditional Tnsured endorsemefrit ('62037 0704 attachild ATE HOLDE'i,, Ne -port ReStAurant ASS0601w, pef 80a; 2295 NPVTOrt Beads,: CA 922,59-22915 'AtIr ELLA1tCN G I ooLD All f , 7H= A50tF. pn t§FF i.%A11l .1.. Th rA'i'QYrU_ £!,IDIIMOA oa `8 N4:il,F it) Tif URIA-3LAlf,1litED -,a _EtT, i,n Fettle ,jo, ""oopfieL'Z311zJl 01 171 of A:eY f�Cl -JI,s4 JH=R,9 Aj_, RT "Tr. �10117A 111%11, tf Al fonro F u 'i ', rv=' j . The ACORD nain- and 1cgu are registueci narks of ACOM) In Sr,ectrum Risk M.gnLt. so,,ic,s ONLY AND COWERS NO MGHTS UPON THE CERINFICA! r, #W7085 1 101 OEM. THIS CERTWMATE DOES NOT AW -_?40, FXTEND(Y� QITER Irvine, CA 92618 H43UW; AFFORDIND COVERAGE No& p -1-Mbehra-Lite TdHS-j_f�s, TqC: —- Goldin Eagle ins Cori 10836 3 101 11, A] Lun Ave A n t T, A Ha Ek 9 71') ----- - m5WET 0 _ - -------------- -- . . ...... onc 1 or Asunymns - - — --------- �w.vE a'a�" v5uiE 577i,Q0,UNAJAWABnvF rcmITHETfI CR CONWOMOFANYWH PACI (MOTHER WEPANT VAIN RETPECT PIRGAN MAYBE WIP07, Trli,NSARAN(:ArFOR07'0 13y T"E v Tp0q 0 SUO-CT % ALL 1"E 7, , 'fi.REA- , f , �_!Hs A All mf, -------- c rl p 42921 13410S/201a 04/08/2011 ----- ----------- L' ', X hAm HOW 5 1,000,000 H'00"' :1 .... ....... ... 7d X 0015 So Tm A w A, WE A 1- .�' - X rc on I qmw um muc ... . ...... : -9-76-1 ---- — ---- TU -3 MAY ------- - 61 04fOS/2010 04/ . ...... . A "n �: md A E �f FHu LIHH' IT IE'1F�;E �f)evj ow;x;rt Beach Restaurant A�ssoc-Varinus J,OCatiQns, is nR'Q111_ i Is Additional insur�,d �EliLiflll,tl Insm-ed end(lr'Sement CCZ03? 0704 attached jWflLe._fOr no mr wuMATE HOLDER, CANCEU A 7KIN NewpGrl Beach Restaurant Association P'G' BOX 1295 Nef;6301't Beach. CA 926SI)-2?,4S ThOACURD Caw and GHH)ULD AN I etY tv�. LATE PC, FAE AU WE 70 THE CR IOCATE 4111Ae "I Fl, TO r1g, t,FFT, A j I ISFUM 90 0WAA WX 0 R LMOW 1 .1 1�1 11, IIPp. I HE N tWER, gy p,,, ,p AL(Pcoveo Al fonso lk