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gage 1or 2­ ENCROACHMENT PERMIT PERMIT NO. _ rT��.9 <br /> ,. <br /> CITY OF TRACY PERMIT GRANTED:_ <br /> PROJECT COST_ _ E <br /> PERMIT FEE: <br /> APPLICATION IS HEREBY MADE FOR A PERMIT TO ENCROACH ON THE Sc LIJI, SIDE OF //--44 <br /> FROM FEET OF sT C ITS <br /> FOR THE PURPOSE OF CIP"ll"AJ <br /> NAME OF APPLICANT fou.d �Te� ��� 1` ,1JADDRESS #d$0 17T�C. Lu �rcoed PHONE : / <br /> APPROVED BY [[ {� � -' FOREMAN: <br /> COMPLETION DATE : <br /> The Permittee shall. notify the City Engineer (836-4420) Twenty-Four Hours prior to start of work <br /> pertaining hereto. <br /> CITY INSPECTOR'S REPORT <br /> 1 . Temporary paving must be placed after backfill . YES NO BACKFILL PAVING <br /> 2 . Plan required YES x NO <br /> 3 . Profile required YES ' NO INITIALS _ <br /> 4 . Performance Bond required YES NO a HOURS <br /> 5 . Notify Police & Fire Departments YES NO DATE <br /> 6 . Open Trench Maximum LENGTH ►ni,,v WIDTHCONCRETE -_ <br /> 7 . Approximate Starting Date ,r_ -?.,R - 1.7 y Z ASPHALT <br /> 8 . Approximate Completion Date _ �.Iv L 5 Lei KI SIDEWALK <br /> 9 . This Permit void 90 days from .issue date unless otherwise SIZE OF CUT <br /> stated in Special Provisions SQ. FT. INCHES <br /> 10 . Pavement Replacement (Sawcut) PAVED BY: T T <br /> 11 . Paving to be done by f ( ONTR_ACTQR BILL NO . <br /> 12 . Minimum cover street 36" sidewalk 30"'-�~ CHARGES . BACKFILL_ <br /> 13 . Contractors must display name and phone number at work site - PAVING _ <br /> Preferably on barricades . PAVING INSP. <br /> 14 . The cost of emergency work required to restored unsatisfactory <br /> construction that becomes a hazard will be charged to the DESCRIBE STREET SECTION BELOW <br /> Permittee. <br /> 15 . Replace full concrete sidewalk squares, as required, by sawcutting <br /> along score marks. - � � <br /> 16. All work to be done per City of Tracy Standards. A , ' <br /> 17 . Special Provisions <br /> 18 . Compaction Tests Required on Backfilled Trenches (Contact City Engineering Depa tment ) <br /> ,.i � 1987 ,. <br /> 19 . Agreement Required. YES ' NO. <br /> ds <br /> ENViRUN'iE-04AL HEALTH <br /> PERMIT/SERVICES, <br />