STANDARD ENCROACHMENT PERMIT APPLICATION
DOT TR-0100 (REV 12t2024)
TRACKING
o625-6RT-1223
2. ROUTE
216
3. POST MILE
'13.65
5. C|TY
Woodlake
Complete ALL fields, write 'N/A" if not applicable. Type or print clearly.
This application is not complete until all requirements have been approved.
Permission is requested to encroach on the State Highway right-of-way as follows:
1. COUNTY
Tulare
4. ADDRESS OR STREET NAME
515 W. Naranjo Blvd
6, CROSS STREET (Distance and direction from project site) N. St
7. WORK TO BE PERFORMED BY 8. IS THIS APPLICATION FOR A RIDER? USE
G NO.
0625-6RT-1223
DIST/CO/RTE/PM
06fiu11216/13.65
SIMPLEX STAMP
DATE OF SIMPLEX STAMP
X ves. lf "YES", the Parent Permit Number 0625-6CS-1217 ! APPLICANT CONTRACTOR
9. ESTIMATE START DATE
10t01t2024
NO
10, ESTIMATED COMPLETION DATE
10t31t2025
11. ESTIMATED NUMBER OF WORKING DAYS WITHIN STATE HIGHWAY RIGHT-OF-WAY 180
12. ESTIMATED CONSTRUCTION COSTS WITHIN STATE HIGHWAY RIGHT-OF-WAY 515,000
13. HAS THE PROJECT BEEN REVIEWED BY ANOTHER CALTRANS BRANCH? nNO X YES. lf "YES", which branch?
14. FUNDTNG SOURCE(S)
FEDERALNSTNTE ELOCAL PRIVATE SB1 ROAD REPAIR AND ACCOUNTABILITY ACT OF 2017
15. CALTRANS PROJECT CODE (lD)
N/A
16, APPLICANT'S REFERENCE / UTILITY WORK ORDER NUMBER
1 8595
17. DESCRIBE WORK TO BE DONE WITHIN STATE HIGHWAY RIGHT-OF-WAY (in 20 lines or less) Attach 6 complete sets of plans (folded to 8.5" x 11") and any applicable specifications, calculations, maps, traffic control plans, etc.
Extension Permit Application for Parent 0624-6CS-1217
18 (a). PORTION OF STATE HIcHWAY RIGHT-OF-WAY WHERE WORK lS BEING PROPOSED (check all that apply) ! Traffic lane ! Shoulder ! Sidewalk ! Median ! At or near an intersection ! Mobile work I Outside of the shoulder, feet from edge of pavement ! Other 18 (b). PROPOSED TRAFFIC CONTROL PLANS AND METHOD
! No traffic control needed I State Standard Plans (T-Sheets) # T-10 f] Project specific Traffic Control Plans included E To be submitted by contractor This document is availabfe in al-ternative accessibLe formaLs. For more information, please contact the Forms Management Unit at (279) 234-2284, TTY 711, in writj-ng at 289
STANDARD ENCROACHMENT PERMIT APPLICATION
DOT TR-0100 (REV 1212024)
NO.
0625-6RT-1223
MAX. DEPTH (in) LENGTH (ft)
30 MlN. DEPTH (in)
2 AVG. WIDTH (in)
24 CARRIER PIPE
DIAMETER 10 (in.) MATERIAL C900
PRODUCT BEING TRANSPORTED
Water
19. EXCAVATION
20. PIPES
PROPOSED INSTALLATION METHOD
SURFACE TYPE (e.9. Asphalt, concrete, soil, etc.)
CASING PIPE
DIAMETER (in.) MATERIAL
s Bore & Jack, Open Cut, etc.) VOLTAGE / PSIG
Cut
DOES THE PROPOSED PROJECT INVOLVE THE REPLACEMENT AND/OR ABANDONMENT OF AN EXISTING FACILITY? X NO n YES. lf "YES", provide a description
21. IS A CIry, COUNTY OR OTHER PUBLIC AGENCY INVOLVED IN THE APPROVAL OF THIS PROJECT? X YES (if "YES", check the type of project AND attach the environmental documentation and conditions of approval)
X COMMERCIAL DEVELOPMENT N BUILDING N GRADING N OTHTN
f] CATEGORICALLY EXEMPT N NEGATIVE DECLARATION f] ENVIRONMENTAL IMPACT REPORT N OTHER ! NO (if "NO", check the category below which best describes the project AND answer questions A-K) f] DRIVEWAY OR ROAD APPROACH, RECONSTRUCTION,
MAINTENANCE OR RESURFACING
f] PUBLIC UTILITY MODIFICATION, EXTENSIONS, HOOKUPS
N TLACS, SIGNS, BANNERS, DECORATIONS, PARADES AND CELEBRATIONS fl FENCE fl EROSTON CONTROL
N MAILBOX f] LANDSCAPING
E orHrn
The following questions must be answered when a City, County or other public agency lS NOT involved in the approval of this project.
Your answers to these questions will assist Caltrans staff in identifying any physical, biological, social or economic resources that may be affected by your proposed projectwithin State Highway right-of-way and to determine which type of environmental studies may be required to approve your application for an encroachment permit. lt is the applicant's responsibility for the production of all required environmental documentation and supporting studies and in some cases this may be costly and time consuming. lf possible, attach photographs of the location of the proposed project. Answer these questions to the best of your ability. Provide a description of any "YES" answers (type, name, number, etc.).
A. Will any existing vegetation and/or landscaping within State Highway right-of-way be disturbed? N/A
B. Are there waterways (e.9. river, creek, pond, natural pool or dry streambed) adjacentto or within the limits of the proposed project? N/A
C. ls the proposed project located within five miles of the coast line? N/A
D. Will the proposed project generate construction noise levels greaterthan 86 decibels (dBA) (e.9. Jack-hammering, pile driving)? N/A
E. Will the proposed project incorporate land from a public park, recreation area or wildlife refuge open to the public? N/A
F. Are there any recreational trails or paths within the limits of the proposed project? N/A
G. Will the proposed project impact any structures, buildings, rail lines or bridges within State Highway right-of-way? N/A
H. Will the proposed project impact access to any businesses or residences? NiA
l. Will the proposed project impact any existing public utilities or public services? N/A
J. Will the proposed project impact any existing pedestrian facilities, such as sidewalks, crosswalks or overcrossings? N/A
K. Will new lighting be constructed within or adjacent to State Highway right-of-way? N/A
This document is avail-abl-e in al-t.ernative accessible formaLs. For more information, please contact the Forms Management Unit at Q79) 234-2284, TTY 711, in writj-ng at 290
STANDARD ENCROACHMENT PERMIT APPLICATION
DOT TR-0'100 (REV 1212024)
NO
0625-6RT-1223
22.Wil the proposed project cause a substantial change in the significance of a historical resource (45 years or older) or cultural resource? n YES X NO (if "YES", provide a description)
23. Will the proposed project be on an existing State Highway or streei where the activity involves removal of a scenic resource? (e.9. A significant tree or stand of trees, a rock outcropping or a historic building) ! YES X NO (if "YES", provide a description)
24. ls work being done on the applicant's property in addition to State Highway right-of-way? XYES n NO (lf "YES", attach 6 complete sets of site and grading plans)
25. Will the proposed project require the disturbance of soil? XYES NNO lf "YES", estimate the area of disturbed soil within State Highway right-of-way in acres: 0.01 acres and estimate the area of disturbed soil outside State Highway right-of-way in acres: 1.8 cy
26. Will the proposed project require dewatering?
lf "YES", estimate Total gallons AND gallons/monih
SOURCE*: E STORMWATER n NON-STORMWATER
(*See Caltrans S\ A/lP for definition of non-storm water discharge:
EYES XNO
(Total gallons) AND (gallons/month)
27. How will any storm water or ground water be disposed? n Storm Drain System ! Combined Sewer / Stormwater System ! Stormwater Retention Basin X N/A n Other (explain)
This document is avaj-lable j-n afternatj-ve accessibfe formats. For more information, please contact the Forms Management Unit at (279) 234-2284, TTY 711, in writing at 291
STATE OF CALIFORNIA . DEPARTMENT OF TRANSPORTATION
STANDARD ENCROACHMENT PERMIT APPLICATION
DOT TR-01 00 (REV 05/2023)
*o'062s-6RT-1223
READ THE FOLLOWING CLAUSES PRIOR TO SIGNING THIS ENCROACHMENT PERMIT APPLICATION.
The applicant's submission of this application to the California Department of Transportation constitutes the applicant's agreement and representation that the work or other activity contemplated by the encroachment permit application shall comply with all applicable standards, specifications, policies, requirements, conditions, and regulations of the California Department of Transportation, and the applicant understands the application may be denied if there is non-compliance with any of the above. An exception process exists and may result in approval of a noncompliant encroachment, in the discretion of the California Department of Transportation, but the exception pro€ss may require additional time to complete. The applicant understands and agrees all work or other activity contemplated by the encroachment permit application is subject to inspection and oversight by the California Department of Transportation. The applicant understands and agrees encroachment permit fees must still be paid if an application is withdrawn or denied. The applicant understands a denial may be appealed, in accordance with California Streets and Highways Code, Section 671.5, and the related regulations found in California Code of Regulations, fitle 21 , Division 2, Chapter 8, Article 2.
The applicant understands and agrees that immediately upon issuance of the encroachment permit the applicant is bound by, subject to, and must compiy with the "Encroachment PLrmit General Provisions" (TR-0045), "stormwater Special Provisions" (TR-0400) and any other applicable Special provislons and Conditions of the encroachment permit. The "Encroachment Permit General Provisions" (TR-0045), and the Stormwater Special provisions (TR-0400) are available s1] https://dot.ca.gov/-/media/dot-media/programs/traffic-operations/documents/encroachment-permitdaPPendixk-ada-a11y.pdf.lf a paper copy is needed of the "Encroachment Permit General Provisions" (TR-0045) and/or "Stormwater Special Provisions" (TR-0400), please contact the District Office of Encroachment Permits. Their contact information is available at:
https://dot.ca.gov/programs/traffic-operations/ep/district-contacts. The "Encroachment Permit General Provisions" (TR-O045) and any other appf icaUte SpJcial provisions and Conditions will be provided as part of the encroachment permit. lnformation about Stormwater requirements is available at the lnternet address' https://dot.ca.gov/programs/environmental-analysis/stormwater-management-program.
The applicant understands an encroachment permit may be denied, revoked, and/or a bond may be required, for non-payment of prior or present encroachment permit fees. An encroachment permit is not a property right and does not transfer with the property to a new owner' Each of the persons purporting to execute this application on behalf of the applicant and/or on behalf of the applicant's authorized agent or engineer represents and warrants such person has full and complete legal authority to do so and to thereby bind applicant to the terms and conditions herein and to the terms and/or conditions of the encroachment permit. Applicant understands and agrees this application may be executed in one or more counterparts, each of which shall be deemed an original, but all of which togethershall constitute one and the same instrument. Executed copies of this application and/or its counterparts may be reproduced and/or exchanged by copy machine, mailing, facsimile, or electronic means (such as email), and such copies shall be deemed to be effective as originals.
28. NAME OF APPLICANT (Project or Property Owner or Organization) Michael Dunaway
ADDRESS OF APPLICANT (lnclude City, State and Zip Code) 916 Glenburn Ave. Ca MO 21613
E-MAIL ADDRESS FAX N BER
mdun reenbeanpharm.com
29. NAME OF AUTHORIZED AGENT / ENGINEER
(A "Letter of Authorization" is required if different from #28)
AW ENGINEERING
ADDRESS OF AUTHORIZED AGENT / ENGINEER (ln
810 W. Acequia Ave. Visalia, CA 93291
IS A LETTER OF
YES f] NO
ON ATTACHED?
City, State and Zip Code)
I 1 8-693-0846
E NUMBER
E-MAIL ADDRESS
awi ll iams@awe-i nc. com
30. NAME OF BI
FAX NUMBER
(Same as #28 X Same as #29 n)
PHONE NUMBER
559-71 3-6 1 39
Michael Dunaway - Green Bean
BILLING ADDRESS WHERE INVOICE(S) lS / ARE TO BE MAILED (lnclude Ciiv, State and Zip Code) 916 Glenburn Ave. Cam , MO 21613
E-MAIL ADDRESS FAX NUMBER
reenbeanpharm.com
* I hereby certify under penalty of perjury under the laws of the State of California that the information in this application and any document submitied with or in support of this application are true and correct to the best of my knowledge and belief, and that copies of any documents submitted with or in support of this application are true and correct copies of unaltered original documents. I further understand that if I have provided information that is false, intentionally incomplete, or misleading I may be charged with a crime and subjected to fine or imprisonment, or both fine and imprisonment. (Penal Code Section 72)
31. SIGNATURE OF APPLICANT OR AUTHORIZED AGENT* 32. PRINT OR TYPE NAME Michael Dunaway
33. 34. DATE
coo 0912412024
Michael Dunaway Digitally signed by Michaei Dunaway
D ale: 2024.09.24 1 6:4 1 :07 -04'00'
PHONE NUMBER
I 1 8-693-0846
This document is available in alternative accessible formats. For more information, please contact the Forms Management Unit at (279) 234-2284 TTy 7 j1, in writing at Forms Management Unit, '1120 N Streei, MS-89, Sacramento, CA 95814, or by email at [email protected]'gov. ADA Notice 292
STATE OF CALIFORNIA. DEPARTMENT OF TRANSPORTATION
ENCROACHMENT PERMIT GENERAL PROVISIONS
ENCROACHMENT PERMIT GENERAL PROVISIONS
TR-0045 (REV. 12/2022)
1. AUTHORITY: The California Department of
Transportation ("Department") has authority to issue
encroachment permits under Division 1, Chapter 3,
Article ',l, Sections 660 through 734 of the Streets and Highways Code.
2. REVOGATION: Encroachment permits are revocable on
five (5) business days' notice unless otherwise stated on the permit or otherwise provided by law, and except as
provided by law for public corporations, franchise holders, and utilities. Notwithstanding the foregoing, in an
emergency situation as determined by the Department,
an encroachment permit may be revoked immediately.
These General Provisions and any applicable Special
Provisions are subject to modification or abrogation by the Department at any time. Permittees' joint use
agreements, franchise rights, reserved rights or any other agreements for operating purposes in State of California ("State") highway right-of-way may be exceptions to this revocation.
3. DENIAL FOR NONPAYMENT OF FEES: Failure to pay
encroachment permit fees when due may result in
rejection of future applications, denial of encroachment permits, and revocation of the encroachment permit if
already issued.
4. PERMITTEE AUTHORIZATION FOR OTHERS TO
PERFORM WORK: This encroachment permit allows
only the Permittee and/or Permiftee's authorized
contractor or agent to work within or encroach upon the State highway right-of-way, and the Permittee may not
assign or transfer this encroachment permit. Any attempt to assign or transfer this encroachment permit shall be null and void. Permittee shall provide to the Department a list of Permiftee's authorized contractors/agents, in the form and at the time specified by the Department but if no time is specified then no later than the pre-construction meeting. Permittee shall keep the list current and shall provide updates to the Department immediately upon any
change to the list of authorized contractorslagents,
including but not limited the addition, removal, or
substitution of an authorized contractor/agent, or a new address or contact information for an existing authorized contractor/agent. Permittee is responsible for the acts and/or omissions of any person or entity acting on behalf of the Permittee, even if such person or entity is not
included on Permittee's list of authorized contractors
and/or agents.
5. ACCEPTANCE OF PROVISIONS: Permittee, and the
Permittee's authorized contractors and/or agents,
understand and agree to accept and comply with these
General Provisions, the Special Provisions, any and all terms and/or conditions contained in or incorporated into the encroachment permit, and all attachments to the
encroachment permit (collectively "the Permit
Conditions"), for any encroachment, work, and/or activity to be performed under this encroachment permit and/or
under color of authority of this encroachment permit.
Permittee understands and agrees the Permit Conditions
are applicable to and enforceable against Permittee as
long as the encroachment remains in, under, or over any part of the State highway right-of-way. The Permittee's authorized contractors and/or agents, are also bound by the Permit Conditions. Non-compliance with the Permit
Conditions by the Permittee's authorized contractor
and/or agent will be deemed non-compliance by the
Permittee.
6. BEGINNING OF WORK: When traffic is not impacted
(see General Provision Number 35), the Permittee must
notify the Department's representative two (2) business days before starting permitted work. Permittee must notify the Department's representative if the work is to be
interrupted for a period of five (5) business days or more, unless otherwise agreed upon. AII work must be
performed on weekdays during regular work hours,
excluding holidays, unless otherwise specified in this
encroachment permit.
7. STANDARDS OF CONSTRUCTION: All work performed
within State highway righlof-way must conform to all
applicable Departmental construction standards including but not limited to: Standard Specifications, Standard
Plans, Project Development Procedures Manual,
Highway Design Manual and Special Provisions.
Other than as expressly provided by these General
Provisions, the Special Provisions, the Standard
Specifications, Standard Plans, and other applicable
Departmental standards, nothing in these General
Provisions is intended to give any third party any legal or equitable right, remedy, or claim with respect to the
encroachment permit and/or to these General Provisions
or any provision herein. These General Provisions are for the sole and exclusive benefit of the Permittee and the Department.
Where reference is made in such standards to
"Contractor" and "Engineer," these are amended to be
read as "Permittee" and "Department's representative,"
respectively, for purposes of this encroachment permit.
8. PLAN CHANGES: Deviations from plans, specifications, and/or the Permit Conditions as defined in General
Provision Number 5 are not allowed without prior approval from the Department's representative and the Federal
Highway Administration ('FHWA") representative if
applicable.
9. RIGHT OF ENTRY, INSPECTION AND APPROVAL: All
work is subject to monitoring and inspection. The United States, the State, the Department, and the Directors,
officers, employees, agents, and/or contractors of the
State and/or of the Department, and other state, and
federal agencies, and the FHWA, through their agents or representatives, must have full access to highway
Page I of6
@ 20 I 8 California Department of Transportation. All rights resen'ed. 293
STATE OF CALIFORNIA . DEPARTMENT OF TRANSPORTATION
ENCROACHMENT PERMIT GENERAL PROVISIONS
facilities/encroachment area, at any and all times for the purpose of inspection, maintenance, activities needed for construction/reconstruction, and operation of the State highway right-of-way.
Upon completion of work, Permittee must request a
final inspection for acceptance and approval by the
Department. The local public agency Permittee must not
give final construction approval to its contractor until final acceptance and approval by the Department is obtained.
10. PERMIT AT WORKSITE: Permittee and Permittee's
authorized contractors/agents must keep the permit
package and cunent list of authorized contractors/agents, or copies thereof, at the work site at all times and must show such documents upon request to any Department
representative or law enforcement officer. lf the permit package or current list of authorized contractors/agents, or copies thereof, are not kept and made available at the work site at all times, then all work must be suspended.
11. CONFLICTING ENCROACHMENTS: Permittee must
yield start of work to ongoing, prior authorized work
adjacent to or within the limits of the Permittee's project site. When existing encroachments conflict with
Permittee's work, the Permittee must bear all cost for
rearrangements (e.9., relocation, alteration, removal,
etc.).
12. PERMITS, APPROVALS, AND CONCURRENGES
FROM OTHER AGENCIES AND/OR ENTITIES: This
encroachment permit is invalidated if the Permittee has not obtained all permits, approvals, and concurrences
necessary and required by law, including but not limited to those from the California Public Utilities Commission ('CPUC), California Occupational Safety and Health
Administration ("Ca|-OSHA"), local and state and federal environmental agencies, the California Coastal
Commission, and any other public agency and/or entity
having jurisdiction. Permittee is responsible for providing notice of the encroachment to, and obtaining concurrence from, any person or entity (whether public or private)
affected by the scope of work described in the
encroachment permit, regardless of whether such notice
or concurrence is required by law; the Department is not responsible to provide such notice or obtain such
concurrence. Permittee warrants all such permits,
approvals, and concurrences have been obtained before
beginning work under this encroachment permit. The
Department may, at the Department's discretion, require the Permittee to demonstrate that Permiftee has obtained all such permits, approvals, and concurrences, and
Permittee shall demonstrate this at the time and in the manner specified by the Department.
13. PEDESTRIAN AND BICYCLIST SAFETY: A safe
continuous passageway must be maintained through the
work area at existing pedestrian or bicycle facilities. At no time must 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 must be installed at the limits of construction and in advance of the limits of construction at the nearest crosswalk or intersection to detour
@ 201 8 California Departrnent ofTransportation. All rights reserved. pedestrians to facilities across the street. Attention is directed to Section 7-1.04 "Public Safety," and to Section 12-4.04 "Temporary Pedestrian Access Routes," and to
Section 16-2.02 "Temporary Pedestrian Facility," of the Department's Standard Specifications, and to California Vehicle Code section 21760, subdivision (c).
14. PUBLIC TRAFFIC CONTROL: The Permittee must
provide traffic control protection, warning signs, lights, safety devices, etc., and take all other measures
necessary for the traveling public's safety as required by law and/or the Department. While providing traffic control, the needs of all road users, including but not limited to motorists, bicyclists and pedestrians, including persons with disabilities in accordance with the Americans with Disabilities Act, must be an essential part of the work activity.
Lane, Bike Lane, Sidewalk, Crosswalk, and/or
shoulder closures must comply with the Department's
Standard Specifications and Standard Plans for
Temporary Traffic Control Systems & Temporary
Pedestrian Access Routes, and with the applicable
Special Provisions. Where issues are not addressed in
the Standard Specifications, Standard Plans, and/or
Special Provisions, the California Manual on Uniform
Traffic Control Devices (Part 6, Temporary Traffic Control) must be followed.
15. MINIMUM INTERFERENCE WITH TRAFFIC: Permittee
must plan and conduct work so as to create the least
possible inconvenience to the traveling public (motorized vehicles, unmotorized vehicles such as bicycles,
pedestrians, person(s) with disabilities, etc.), such that traffic is not unreasonably delayed.
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 encroachment permit. lf
encroachment permit Special Provisions allow for the
storage of equipment or materials within the State
highway right-of-way, the equipment and material storage must also comply with Section 7-1.04, Public Safety, of the Department's Standard Specifications.
17. CARE OF DRAINAGE: Permittee must provide alternate
drainage for any work interfering with an existing drainage facility in compliance with the Department's Standard
Specifications, Standard Plans, and/or as directed by the Department's representative.
18. RESTORATION AND REPAIRS IN STATE HIGHWAY
RIGHT-OF-WAY: Permittee is responsible for restoration
and repair of State highway righlof-way resulting from
permitted work (Streets and Highways Code, section 670
et seq.).
19. STATE HIGHWAY RIGHT-OF-WAY CLEAN UP: Upon
completion of work, Permittee must remove and dispose
of all scraps, refuse, brush, timber, materials, etc. off the State highway right-of-way. The aesthetics of the highway must be as it was before work started or better.
20. COST OF WORK: Unless stated otherwise in the
encroachment permit or a separate written agreement
with the Department, the Permittee must bear all costs
294
STATE OF CALIFORNIA. DEPARTMENT OF TRANSPORTATION
ENCROACHMENT PERMIT GENERAL PROVISIONS
incurred for work within the State highway right-of-way and waives all claims for indemnification or contribution from the United States, the State, the Department, and
from the Directors, officers, and employees of the State and/or the Department. Removal of Permittee's personal
property and improvements shall be at no cost to the
United States, the State, and the Department.
21. ACTUAL COST BILLING: When specified in the permit,
the Department will bill the Permittee actual costs at the currently set Standard Hourly Rate for encroachment
permits.
22. AS-BUILT PLANS: When required, Permittee must
submit one (1) set of folded as-built plans within thirty (30) calendar days after completion and acceptance of work in compliance with requirements listed as follows:
a) Upon completion of the work provided herein, the
Permittee must submit a paper set of As-Built plans
to the Department's representative.
b) All changes in the work will be shown on the plans, as issued with the permit, including changes approved
by Encroachment Permit Rider.
c) The plans are to be prominently stamped or otherwise noted "AS-BUlLT" by the Permittee's representative
who was responsible for overseeing the work. Any
original plan that was approved with a Department
stamp, or by signature of the Department's
representative, must be used for producing the AsBuilt plans. d) lf construction plans include signing or striping, the dates of signing or striping removal, relocation, or
installation must be shown on the As-Built plans when
required as a condition of the encroachment permit.
When the construction plans show signing and
striping for staged construction on separate sheets,
the sheet for each stage must show the removal,
relocation, and installation dates of the appropriate
staged striping and signing.
e) As-Built plans must contain the Encroachment Permit
Number, County, Route, and Post Mile on each
sheet.
0 The As-Built Plans must not include a disclaimer
statement of any kind that differs from the obligations and protections provided by sections 6735 through
6735.6 of the California Business and Professions
Code. Such statements constitute non-compliance
with Encroachment Permit requirements and may
result in the Department retaining Performance
Bonds or deposits until proper plans are submitted.
Failure to comply may also result in denial of future
encroachment permits or a provision requiring a
public agency to supply additional bonding.
23. PERMITS FOR RECORD PURPOSES ONLY: When
work in the State highway right-of-way is within an area under a Joint Use Agreement (JUA) or a Consent to
Common Use Agreement (CCUA), a fee exempt
encroachment permit is issued to the Permittee for the
purpose of providing a notice and record of work. The
Permittee's prior rights must be preserved without the
intention of creating new or different rights or obligations.
O 201 8 California Department ofTransportation. All rights reserved. "Notice and Record Purposes Only" must be stamped
across the face of the encroachment permit.
24. BONDING: The Permittee must file bond(s), in advance, in the amount(s) set by the Department and using forms
acceptable to the Department. The bonds must name the
Department as obligee. Failure to maintain bond(s) in full force and effect will result in the Department stopping all work under this encroachment permit and possibly
revoking other encroachment permit(s). Bonds are not
required of public corporations or privately-owned utilities unless Permittee failed to comply with the provisions
and/or conditions of a prior encroachment permit. The
surety company is responsible for any latent defects as provided in California Code of Civil Procedure section
337.15. A local public agency Permittee also must comply with the following requirements:
a) ln recognition that 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 public agency
Permittee agrees to require the construction
contractor to furnish both a payment and performance
bond in the local public agency's name with both
bonds complying with the requirements set forth in
Section 3-1.05 Contract Bonds of the Department's
Standard Specifications before performing any
project construction work.
b) The local public agency Permittee must defend,
indemnify, and hold harmless the United States, the
State and the Department, and the Directors, officers,
and employees of the State and/or Department, from
all project construction related claims by contractors, subcontractors, and suppliers, and from all stop
notice andior mechanic's lien claimants. The local
public agency also agrees to remedy, in a timely
manner and to the Department's satisfaction, any
latent defects occurring as a result of the project
construction work.
25. 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 must
comply with said notice at the Permittee's sole expense.
26. ENVIRONMENTAL:
a) ARCHAEOLOGICAL/HISTORICAL: lf any
archaeological or historical resources are identified or encountered in the work vicinity, the Permittee must
immediately stop work, notify the Department's
representative, retain a qualified archaeologist who
must evaluate the site at Permittee's sole expense,
and make recommendations to the Department's
representative regarding the continuance of work.
b) HAZARDOUS MATERIALS: lf any hazardous waste
or materials (such as underground storage tanks,
asbestos pipes, contaminated soil, etc.) are identified or encountered in the work vicinity, the Permittee
must immediately stop work, notify the Department's
representative, retain a qualified hazardous
295
STATE OF CALIFORNIA. DEPARTMENT OF TRANSPORTATION
ENCROACHMENT PERMIT GENERAL PROVISIONS
waste/material specialist who must evaluate the site
at the Permittee's sole expense, and make
recommendations to the Department's representative
regarding the continuance of work.
Attention is directed to potential aerially deposited
lead (ADL) presence in unpaved areas along
highways. lt is the Permittee's responsibility to take all appropriate measures to protect workers in
conformance with California Code of Regulations
Title 8, Section 1532.1, "Lead," and with Ca|-OSHA
Construction Safety Orders, and to ensure roadway
soil management is in compliance with Department of
Toxic Substances Control (DTSC) requirements.
c) BIOLOGICAL: lf any regional, state, orfederally listed biological resource is identified or encountered in the work vicinity, the Permittee must immediately stop
work, notify the Depadment's representative, retain a
qualified biologist who must evaluate the site at
Permittee's sole expense, and make
recommendations to the Department's representative
regarding the continuance of work.
27. PREVAILING WAGES: Work performed by or under an
encroachment permit may require Permittee's contractors and subcontractors to pay appropriate prevailing wages
as set by the California Department of lndustrial
Relations. lnquiries or requests for interpretations relative to enforcement of prevailing wage requirements must be
directed to the California Department of lndustrial
Relations.
28. LIABILITY, DEFENSE, AND INDEMNITY: The Permittee
agrees to indemnify and save harmless the United States, the State, the Department, and the Directors, officers, employees, agents and/or contractors of the State and/or of the Department, including but not limited to the Director of Transportation and the Deputy Directors, from any and all claims, demands, damages, costs, liability, suits, or actions of every name, kind, and description, including but not limited to those brought for or on account of property damage, invasion of privacy, violation or deprivation of a right under a state or federal law, environmental damage or penalty, or injury to or death of any person including but not limited to members of the public, the Permittee, persons employed by the Permittee, and/or persons
acting on behalf of the Permittee, arising out of or in connection with: (a) the issuance and/or use of this
encroachment permit; and/or (b) the encroachment, work, and/or activity conducted pursuant to this encroachment permit, or under color of authority of this encroachment permit but not in full compliance with the Permit
Conditions as defined in General Provision Number 5
("Unauthorized Work or Activity"); and/or (c) the
installation, placement, design, existence, operation,
and/or maintenance of the encroachment, work, and/or
activity; and/or (d) the failure by the Permittee, or by anyone acting for or on behalf of the Permittee, to perform the Permittee's obligations under any part of the Permit Conditions as defined in General Provision Number 5, in respect to maintenance or any other obligation; and/or (e) any change to the Department's property or adjacent
O 2018 California Department ofTransportation. All rights reserved. property, including but not limited to the features or
conditions of either of them, made by the Permittee or
anyone acting on behalf of the Permittee; and/or (f) a
defect or obstruction related to or caused by the
encroachment, work, and/or activity whether conducted in compliance with the Permit Conditions as defined in
General Provision Number 5 or constituting Unauthorized Work or Activity, or from any cause whatsoever. The duty of the Permittee to indemnify and save harmless includes the duties to defend as set forth in Section 2778 of lhe Civil Code.
It is the intent of the Department and the Permittee
that except as prohibited by law, the Permittee will defend, indemnify, and hold harmless as set forth in this General Provision Number 28 regardless of the existence or
degree of fault or negligence, whether active or passive, primary or secondary, on the part of: the United States, the State; the Department; the Directors, officers,
employees, agents and/or contractors of the State and/or of the Department, including but not limited to the Director of Transportation and the Deputy Directors; the Permittee; persons employed by the Permittee; and/or persons
acting on behalf of the Permittee.
The Permittee waives any and all rights to any type of
expressed or implied indemnity from or against the United States, the State, the Department, and the Directors,
officers, employees, agents, and/or contractors of the
State and/or of the Department, including but not limited to the Director of Transportation and the Deputy Directors.
The Permittee understands and agrees to comply
with the obligations of Titles ll and lll of the Americans with Disabilities Act in the conduct of the encroachment, work, and/or activity whether conducted pursuant to this encroachment permit or constituting Unauthorized Work
or Activity, and further agrees to defend, indemnify, and save harmless the United States, the State, the
Department, and the Directors, officers, employees,
agents, and/or contractors of the State and/or of the
Department, including but not limited to the Director of Transportation and the Deputy Directors, from any and all claims, demands, damages, costs, penalties, liability,
suits, or actions of every name, kind, and description
arising out of or by virtue of the Americans with Disabilities Act.
The Permittee understands and agrees the Directors,
officers, employees, agents, and/or contractors of the
State and/or of the Department, including but not limited to the Director of Transportation and the Deputy Directors, are not personally responsible for any liability arising from or by virtue of this encroachment permit.
For the purpose of this General Provision Number 28
and all paragraphs herein, "contractors of the State and/or of the Department" includes contractors, and their
subcontractors, under contract to the State and/or the
Department.
This General Provision Number 28 and all
paragraphs herein take effect immediately upon issuance of this encroachment permit, and apply before, during,
and after the encroachment, work, and/or activity
296
STATE OF CALIFORNIA. DEPARTMENT OF TRANSPORTATION
ENCROACHMENT PERMIT GENERAL PROVISIONS
contemplated under this encroachment permit, whether
such work is in compliance with the Permit Conditions as defined in General Provision Number 5 or constitutes
Unauthorized Work or Activity, except as otherwise
provided by California law. The Permittee's obligations to defend, indemnify, and save harmless under this General Provision Number 28 take effect immediately upon
issuance of this encroachment permit and have no
expiration date, including but not limited to situations in which this encroachment permit expires or is revoked, the work or activity performed under this encroachment
permit is accepted or not accepted by the Department, the encroachment, work, and/or activity is conducted in
compliance with the Permit Conditions as defined in
General Provision Number 5 or constitutes Unauthorized
Work or Activity, and/or no work or activity is undertaken by the Permittee or by others on the Permittee's behalf. lf the United States or an agency, depadment, or
board of the United States is the Permittee, the first two paragraphs of this General Provision Number 28
(beginning "The Permittee agrees to indemnify..." and "lt is the intent of the parties... ") are replaced by the following paragraph:
Claims for personal injury, death, or property damage
allegedly caused by the negligent or wrongful act or
omission of any employee of the United States acting
within the scope of their official duties are subject to the Federal Tort Claims Act, as amended, 28 U.S.C. S 1346
and $ 267'l et seq. (Chapter 171).
29. NO PRECEDENT ESTABLISHED: This encroachment
permit is issued with the understanding that it does not establish a precedent.
30. FEDERAL CIVIL RIGHTS REQUIREMENTS FOR
PUBLIC ACCOMMODATION:
a) As part of the consideration for being issued this
encroachment permit, the Permittee, on behalf of
Permittee and on behalf of Permittee's personal
representatives, successors in interest, and assigns,
does hereby covenant and agree that:
i) No person on the grounds of race, color, or
national origin may be excluded from participation
in, be denied the benefits of, or be otherwise
subjected to discrimination in the use of said
facilities.
ii) That in connection with the construction of any
improvements on said lands and the furnishtngs
of services thereon, no discrimination must be
practiced in the selection and retention of first-tier
subcontractors in the selection of second-tier
subcontractors.
iii) That such discrimination must 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 State highway right-of-way.
iv) That the Permittee must use the premises in
compliance with all other requirements imposed
pursuant to Title 15, Code of Federal
O 201 8 Calilornia Department ofTransportation. All rights resen'ed.
Regulations, Commerce and Foreign Trade,
Subtitle A. Office of the Secretary of Commerce,
Part 8 (15 C.F.R. Part 8) and as said Regulations
may be amended.
b) That in the event of breach of any of the above
nondiscrimination covenants, the State and the
Department have the right to terminate this
encroachment permit and to re-enter and repossess
said land and the facilities thereon and hold the same
as if said permit had never been made or issued.
31. MAINTENANGE: The Permittee is responsible at
Permittee's sole expense for the encroachment, and the
inspection, maintenance, repair, and condition thereof, and is responsible to ensure the encroachment does not
negatively impact State highway safety, maintenance,
operations, construction, State facilities, activities related to construction/reconstruction, or other encroachments.
The Permittee's obligations in the preceding sentence
take effect immediately upon issuance of this
encroachment permit and continue until the
encroachment is entirely and permanently removed.
Additional encroachment permits or approval documents
may be required authorizing work related to inspection, repair, and/or maintenance activities. Contact the
Department for information.
32. SPECIAL EVENTS: ln accordance with subdivision (a) of Streets and Highways Code section 682.5 and 682.7, the
Department is not responsible for the conduct or
operation of the permitted activity, and the applicant
agrees to defend, indemnify, and hold harmless the
United States, the State, the Department, and the
Directors, officers, employees, agents, and contractors of the State and/or of the Department, including but not
limited to the Director of Transportation and the Deputy Directors, from any and all claims, demands, damages,
costs, liability, suits, or actions of every name, kind and description arising out of any activity for which this
encroachment permit is issued.
The Permittee is required, as a condition of this
encroachment permit, for any event that awards prize
compensation to competitors in gendered categories, for any participant level that receives prize compensation, to ensure the prize compensation for each gendered
category is identical at each participant level. (Streets and Highways Code, section 682.7.)
The Permittee understands and agrees to comply
with the obligations of Titles ll and lll of the Americans with Disabilities Act in the conduct of the event, and
further agrees to defend, indemnify, and save harmless
the United State, the State and the Department, and the Directors, officers, and employees of the State and/or
Department, including but not limited to the Director of the Department and the Deputy Directors, from any and all
claims, demands, damages, costs, liability, suits, or
actions of every name, kind and description arising out of or by virtue of the Americans with Disabilities Act.
33. PRIVATE USE OF STATE HIGHWAY RIGHT.OF.WAY:
State highway right-of-way must not be used for private purposes without compensation to the State. The gifting 297
STATE OF CALIFORNIA. DEPARTMENT OF TRANSPORTATION
ENCROACHMENT PERMIT GENERAL PROVISIONS
of public property uses and therefore public funds is
prohibited under the California Constitution, Article XVl, Section 6.
34. FIELD WORK REIMBURSEMENT: Permittee must
reimburse the Department for field work performed by or on behalf of the Department to correct or remedy issues created by the Permittee or by others acting on behalf of the Permittee, including but not limited to hazards or
damaged facilities, or to clear refuse, debris, etc. not attended to by the Permittee or by others acting on behalf of the Permittee.
35. LANE CLOSURE REQUEST SUBMITTALS AND
NOTIFICATION OF CLOSURES TO THE
DEPARTMENT: Lane closure request submittals and
notifications must be in accordance with Section 12-4.02, and Section 12.4-04, of the Department's Standard
Specifications or as directed by the Department's
representative. The Permittee must notify the
Department's representative and the Traffic Management
Center ('TMC") before initiating a lane closure or
conducting an activity that may cause a traffic impact. ln emergency situations when the corrective work or the
emergency itself may affect traffic, the Department's
representative and the TMC must be notified as soon as
possible.
36, SUSPENSION OF TRAFFIC CONTROL OPERATION:
The Permittee, upon notification by the Department's
representative, must immediately suspend all traffic lane, bike lane, sidewalk, crosswalk, and/or shoulder closure operations and any operation that impedes the flow of
traffic. All costs associated with this suspension must be borne by the Permittee.
37. UNDERGROUND SERVICE ALERT (USA)
NOTIFICATION: Any excavation requires compliance
with the provisions of Government Code section 4216 el
seq., including but not limited to notice to a regional notification center, such as Underground Service Alert
(USA). The Permittee must provide notification to the
Department representative at least five (5) business days before, and the regional notification center at least fortyeight (48) hours before, performing any excavation work within the State highway right-of-way.
38. COMPLIANCE WITH THE AMERICANS WITH
DISABILITIES ACT (ADA): All work within the State
highway right-of-way to construct and/or maintain any
public facility must be designed, maintained, and
constructed strictly in accordance with all applicable
Federal Access laws and regulations (including but not
limited to Section 504 of the Rehabilitation Act of 1973, codified at 29 U.S.C. S 794), California Access laws and regulations relating to ADA, along with its implementing regulations, Title 28 of the Code of Federal Regulations Parts 35 and 36 (28 C.F.R., Ch. l, Part 35, $ 35.101 et seq., and Part 36, S 36.101 et seq.), Title 36 of the Code of Federal Regulations Part 1191 (36 C.F.R., Ch. Xl, Part 1191, S 1119.1et seq.), Title 49 of the Code of Federal Regulations Part 37 (49 C.F.R., Ch. A, Part 37, $ 37.1 et seq.), the United States Department of Justice Title ll and Title lll for the ADA, and California Government Code
O 201 8 California Department ofTransportation. All rights reserved. section 4450 et seq., which require public facilities be made accessible to persons with disabilities.
Notwithstanding the requirements of the previous
paragraph, all construction, design, and maintenance of public facilities must also comply with the Department's Design lnformation Bulletin 82, "Pedestrian Accessibility Guidelines for Highway Projects" and Standard Plans &
Specifications on "Temporary Pedestrian Access
Routes."
39. STORMWATER: The Permittee is responsible for full
compliance with the following:
a) For all projects, the Department's Storm Water
Program and the Department's National Pollutant
Discharge Elimination System (NPDES) Permit
requirements under Order No. 2012-0011-DWQ,
NPDES No CAS000003; and
b) ln addition, for projects disturbing one acre or more of soil, with the California Construction General
Permit Order No. 2009-0009-DWQ, NPDES No
CAS000002; and
c) ln addition, for projects disturbing one acre or more of soil in the Lahontan Region with Order No. R6T-2016-
0010, NPDES No CAG616002.
d) For all projects, it is the Permittee's responsibility to install, inspect, repair, and maintain all facilities and devices used for water pollution control practices
(Best Management Practices/BMPs) before
performing daily work activities.
298
Unruh General Engineering, Inc.
39428 Millwood
Woodlake, CA 93286
Lic#1113830
GREEN BEAN SCHEDULE
Duration
of
Working
Days
Start Finish
Provide Traffic Control &
Install Electrical Conduit for Street
Lights
5 4/14/2025 4/18/2025
Re-grade for Curb & Gutter 3 4/21/2025 4/23/2025
Installation of Curb & Gutter
(Concrete)
7 8/12/2025 8/20/2025
Sidewalk 7 8/21/2025 9/1/2025
Grinding, grading & Paving 3 9/2/2025 9/5/2025
Haul off Grindings 1-2 9/5/2025 9/11/2025
Striping per plans 1-2 9/17/2025 9/17/2025
299
City of Woodlake
AGENDA ITEM V-D
August 11, 2025
Prepared by Emmanuel Llamas, City Staff
SUBJECT:
Action: Adoption of Resolution: Approve the 3-month Uncle Green Conditional Use Permit Extension Request with Conditions and Require Uncle Green Pays Off Any Outstanding Regulatory Fees and Taxes by November 2025– PUBLIC HEARING
BACKGROUND:
The Woodlake Municipal Code allows for 3 maximum extensions per Conditional Use Permit. The City requires an Extension Application for any Conditional Use Permit which has not met conditions of approval and would like to apply for an extension to meet the conditions. The City may choose to extend CUPs to allow a business time to fully meet all the conditions listed in the CUP. A CUP permit extension request can be denied by the Planning Commission. An applicant who had their CUP extension denied may appeal the decision to City Council per Woodlake Municipal Code procedures set in Chapter 17.70 Permits and Applications.
For Cannabis businesses, in order to maintain a CUP in good standing the business must also not fail to pay their regulatory fees and cannabis taxes in a timely manner, as stated in Woodlake Municipal Code Chapter 5.48 – Suspension and Revocation of Regulatory Permit or Employee Permit.
DISCUSSION:
Uncle Green had a renewed CUP application approved on February 21, 2024, subject to a 3-month expiration in order to complete the following conditions:
CUPs 18-001 Cultivation, 18-002 Manufacturing, 18-003 Distribution, and 21-006 Non-Storefront Retail - Uncle Green. Meet all City Development Standards and State Building Code Requirements.
Meet all State Requirements, laws, and regulations for cannabis businesses in the State of California.
Construct curb, gutters, sidewalks, streetlights on Naranjo (SR-216) and Road 196 need to be installed to meet design standards established by the City. All sidewalk areas and parking shall have ADA access and meet the design standards established by the City. Construction and install landscaping and irrigation in compliance with City’s design standards.
Uncle Green was granted a 6-month extension on May 15, 2024, to continue progress towards the outstanding conditions required of the Conditional Use Permit as detailed in the paragraph above. At the time of the 6-month extension, Uncle Green’s cannabis business license was in good standing regarding City taxes and regulatory fees owed to the City.
Uncle Green’s 6-month extension expired in November 2024. During November 2024 Uncle Green’s cannabis business license was no longer in good standing, as the City cannabis taxes and regulatory fees were outstanding, with cannabis taxes and regulatory fees being three quarters delinquent. Due to Uncle Green’s taxes and regulatory fees outstanding balance, their conditional use permit extension request at the November Planning Commission was denied by the Planning Commission. 300
Uncle Green appealed the denied extension from the Planning Commission, and the extension request was considered at the January 13, 2025 City Council Meeting. City Council at the January 13, 2025, meeting agreed to extend the CUP for 3 months, and once again agreed to a 3 month extension lastly at the April 14, 2025 Council Meeting. These extension were granted due to Uncle Green making some progress payments on their outstanding balances, and due to the incidents which caused hardship for Uncle Green during the Spring of 2025.
The City staff met with Uncle Green ownership on July 11th, 2025, to discuss the businesses plan to remedy the delinquent taxes and fees. Uncle Green made a payment in August 2025 towards their regulatory fees balance and cannabis taxes balance.
RECOMMENDATIONS:
City staff is recommending that City Council approve a 3-month Conditional Use Permit extension to allow Uncle Green to pay off their outstanding regulatory fees balance and taxes. Progress was made towards those balances as Uncle Green did submit payment in August 2025 towards their delinquent regulatory fees and taxes. Uncle Green has assured to City staff that they have a business plan in place to catch up on their outstanding balance by November 2025.
FISCAL IMPACT:
Currently Uncle Green should pay approximately $132,000 annually in cannabis taxes to the City of Woodlake General Fund.
ATTACHMENTS:
1. Resolution: Approve the 3-month Uncle Green Conditional Use Permit Extension Request with Conditions and Require Uncle Green Pays Off Any Outstanding Regulatory Fees and Taxes by November 2025
301
BEFORE THE PLANNING COMMISSION
OF THE CITY OF WOODLAKE
COUNTY OF TULARE
STATE OF CALIFORNIA
In the matter of:
APPROVE THE 3 MONTH UNCLE GREEN )
CONDITIONAL USE PERMIT ) Resolution No. 25-
EXTENSION REQUEST WITH CONDTIONS )
AND REQUIRE UNCLE GREEN PAYS OFF ANY )
OUTSTANDING REGULATORY FEES AND TAXES )
BY NOVEMBER 2025 )
Councilmember _______ offered the following resolution and moved its adoption. Approve the 3-month Uncle Green Conditional Use Permit Extension Request with Conditions and Require Uncle Green Pays Off Any Outstanding Regulatory Fees and Taxes by November 2025.
WHEREAS, The Woodlake Municipal Code allows for 3 maximum extensions per Conditional Use Permits; and
WHEREAS, the listed Conditional Use Permits was subject to a renewal and the renewed permit was approved on February 21, 2024, and
WHEREAS, the Conditional Use Permit Extension application was submitted for the issuance of an extension to the Conditional Use Permit on May 15, 2024, and subject to completing the conditions of approval, and
WHEREAS, the following conditions were to be met within six (6) months:
1. CUP 18-001 Cultivation, 18-002 Manufacturing, 18-003 Distribution 21-006 Non-Storefront Retail – Uncle Green. Curb, gutters, sidewalks, streetlights on Naranjo (SR-216) and Road 196 need to be installed. Landscaping and Irrigation around site.
WHEREAS, the lastly requested Conditional Use Permit Extension for the application was denied at the Planning Commission meeting in November 2024, however the decision was appealed by the applicant, and City Council granted an extension during the January 13, 2025 Council meeting with a 3 moth extension granted, and on April 14, 2025 Council meeting with a 3 month extension granted, so that Uncle Green can proceed making progress towards compliance; and WHEREAS, in order to maintain a Conditional Use Permit for a cannabis business, the cannabis business license must be in good standing as stated in Woodlake Municipal Code Chapter 5.48 – Suspension and Revocation of Regulatory Permit and Employee Permit; and WHEREAS, approving a 3-month extension will allow the City staff to monitor Uncle Green’s progress towards becoming compliant as stated regarding outstanding taxes and regulatory fees, and will require the Conditional Use Permit extension to be reconsidered during a November 2025 City Council meeting accordingly.
NOW, THEREFORE, THE CITY OF WOODLAKE DOES RESOLVE to Approve the 3-month Uncle Green Conditional Use Permit Extension Request with Conditions and Require Uncle Green Pays Off Any Outstanding Regulatory Fees and Taxes by November 2025. 302
The foregoing resolution was adopted upon a motion of Councilmember ________ and seconded by Councilmember ___________ and carried by the following vote at the City Council meeting held on August 11, 2025.
AYES:
NOES:
ABSTAIN:
ABSENT:
________________________
___________________
Rudy Mendoza, Mayor
ATTEST:
_____________________
Irene Zacarias, City Clerk
303