Grading Permit Application - City of Lathrop

City of Lathrop390 Towne Centre DriveLathrop, CA 95330(209) 941-7430(209) 941-7430 faxGENERAL PROVISIONS FOR GRADING PERMIT1. This permit is issued under and subject to all laws and ordinances of the City of Lathrop (City) and any other governingrules, regulations or guidelines cited in this permit of the City’s Code of Ordinances including the City’s Standard Plansand Specifications.2. The Applicant/Permittee shall provide the City Public Works Department a notice of at least forty-eight (48) hours prior tobeginning any work. All work performed under this permit shall conform to the rules and regulations pertaining to safetyguidelines established by the California Division of Industrial Safety and Cal-OSHA.3. All work shall be done subject to the supervision of and to the satisfaction of the City. The Applicant/Permittee shall at alltimes during the progress of the work keep City Street(s) in as neat and clean a condition as possible and upon completionof the work granted herein shall leave the streets in a thoroughly neat, clean and useable condition.4. If work is necessary in the public ROW for traffic control purposes, warning devices and personnel shall be provided,placed and maintained by and at the sole expense of the Applicant/Permittee in accordanace with the latest edition of theCaltrans Manual of Traffic Control.5. All work shall be planned and carried out so that there will be as little inconvenience as possible to the traveling publicwithin the public right-of-way (ROW). No material shall be stacked within eight (8) feet of the edge of pavement ortraveled way unless provided herein.6. The Applicant/Permittee, by the acceptance of this permit, shall assume full responsibility for all personal injury liabilityor property damage which may arise out of the work herein permitted or under this permit. In the event any clain of suchliability is made again the City of Lathrop or any department, official or employee thereof, the Applicant/Permittee shalldefend, indemnify and hold them and each of them harmless for such claim.7. Whenever mecessary to secure permission from abutting property owners, such authority must be secured by theApplicant/Permittee prior to starting work.8. A certificate of insurance shall be required for liability (general, worker and auto) in the amount of $1,000,000 naming theCity of Lathrop, elected officials, employees, agents and volunteers are included as additional insureds.9. A faithful performance bond in the amount of ten percent (10%) of the estimated cost of improvements shall be providedto the City prior to issuance of the permit.10. Applicant shall provide certification from the Geotech Engineer, Kleinfelder, that all requirements contained in theGeotech report for site preparation have been met. Any changes, modification or revisions to the report proposed byKleinfelder must be approved by the City in writing.11. Applicant shall provide certification from the Geotech Engineer to the Building Division at the time a building permit isrequested, that site preparation have been completed in full conformance with the UBC requirements Chapter 33.12. The applicant shall clearly specify where stripped soil will be taken and stockpiled.13. Prior to the issuance of a building permit, the applicant’s engineer shall provide certification to the Building Division andPublic Works Department that the site conforms to the approved site grading plans.14. The applicant shall grade the one million gallon tank site to a rough grade elevation of 14.3 to 17.5 feet. (See attachedexhibit)

GRADING PERMITAPPLICATIONAddress or Location of Work: ___________________________________________________Building Permit Application: Yes NoThe work to be performed is described as follows: _________________________________________________________________________________________________________________________________________________________________________________________Applicant Name: _________________________ Site/Owner Name: _______________________Mailing Address: _________________________ Mailing Address: ________________________City, State, Zip: __________________________ City, State, Zip: _________________________Telephone: (____) _______________________ Telephone: (___) ________________________Contractor/Representative: ________________ Contractor License: ______________________Contracting Firm Name: ___________________________________________________________Address: ______________________________ City, State, Zip: _________________________Telephone: (____) _______________________ To be self installed? Yes NoThe Applicant Hereby Certifies:1. That he/she has read all the provisions of this application, and that the descriptionsincluded above are correct to the best of his/her knowledge.2. That he/she is the owner of the respective property, or is qualified to represent theowner.3. That, if permission is granted as requested, he/she agrees to do work described inaccordance with all terms, conditions and restrictions. (see Conditions of Issuance)_________________________________________Applicant’s Signature____________________DateI:\PublicWorks\General\Templates\Forms\Encroachment Permit Application.doc