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<br /> SAN
<br /> Cityof LodiENCROACHMENT
<br /> Public Works Department
<br /> PERMIT
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<br /> Permit Address 225 S. CHEROKEE LANE Date: 09/14/2009
<br /> Applicant's Name, Address Phone 925-275-3807
<br /> BP/ARCO P. O. Box 1257, San Ramon, CA 94583 Cellular
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<br /> Starting Date 09/21/2009 Completion Date 10/31/2009 License No 820959 Phone 530-676- 064
<br /> Contractor Stratus Environmental Address 3330 Cameron Park Dr#550,Cameron Park,Ca
<br /> Cellular 916-837-1688
<br /> Pursuant to the provisions of the Lodi Municipal Code,the undersigned applies for permission to excavate,construct,andlor otherwise encroach on City Street Right-of-Way or Easement y`„
<br /> by performing the following:
<br /> NOTIFY USA(800)227-2600 48 HOURS PRIOR TO ANY EXCAVATION. MARKINGS MUST BE REMOVED UPON COMPLETION OF WORK.
<br /> Work Description:
<br /> The work consists of destroying three (3) monitoriing wells in the public right-of-way. 2 on Lodi Ave @ Cherokee
<br /> (west side), 1 on Cherokee north of Lodi Avenue. Excavation to be approx. 5' deep and 12"wide. Wells to be filled
<br /> with portland cement. The top 5 ft of each well will be removed and the pavement will be restored to City of Lodi
<br /> specifications. See Standard Plan No. 506 attached, asphalt concrete replacement shall be existing plus 1 inch;
<br /> minimum of 3 inches A.C.; match finish grades.
<br /> No open excavations except at time of work; barricades required; traffic control per Caltrans Traffic Control Manual,
<br /> current issue; one way traffic shall require flaggers.
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<br /> Wienerschnitzel mgr, Abed (209-366-2477) to be contacted prior to construction on Cherokee. Work on Cherokee
<br /> to be performed in AM hours as per discussion. * .
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<br /> All USA markings to be removed at completion of job.
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<br /> PERMIT CONDITIONS ATTACHED ARE A PART OF THIS ENCROACHMENT PERMIT. "
<br /> NOTIFY CITY INSPECTOR, JERRY DEWALT(209) 333-6836, AT START OF WORK.
<br /> AS PER DISCUSSION WITH ALAN DUDDING, STRATUS ENVIRONMENTAL, WORK TO BE COMPLETED BY
<br /> .s 10/31/09 DUE TO CITY RECONSTRUCTION PROJECT ON LODI AVENUE.
<br /> Permit void if work not started within 6 months of permit date.
<br /> Q Licensed Contractor required for this work Q Conditions Attached El Plans Attached
<br /> ❑ Certificate of insurance in the owner's name which names the"City of Lodi,its elected and appointed Boards,Commissions,Officers,
<br /> Agents,Volunteers and Employees"as an Additional Named Insured is required for Comprehensive General Aggregate In the amount of
<br /> $1,000,000 per occurrence and Automobile Liability Insurance in the amount of$1,000,000 combined single limit.
<br /> The undersigned does hereby agree to insure,indemnify and save the City of Lodi free and harmless from any liability as set forth in attached City of Lodi Insurance Requirements and in
<br /> accordance with the provisions of Sec.12.04.040 of the Lodi Municipal Code.Permittee is specifically aware of Sec.12.04.290 thereof relating to the relocation or removal of said
<br /> encroachment if future construction requires such relocation.If the work for which this encroachment permit has been issued has not been completed by 10/3112009 the City of Lodi
<br /> shall have the right to complete the work,and to file a Cause of Action to recoup the City's expenses in completing the work and for all other costs and fees in accordance with the provisions
<br /> of Sec.12.04.120 of the Lodi Municipal Code.
<br /> Signed:
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<br /> Required Improvement Security This pe it is granted subject to all dovi
<br /> Lions of Chapter 12.04 of the Lodi Municipal Code
<br /> and to I general provisions and applicable special provisions as show on the attached
<br /> certification of Insurance Perm'Z Approved: CITY OF LODI
<br /> Mother Lode Insurance Services /
<br /> Comp.Gen. Policy No ENV023546090 Exp 08/31/2010 By !. / �t
<br /> Automotive Policy No Exp ❑ Public Above Ground Date
<br /> Other Policy: Exp
<br /> ❑ Public Underground
<br /> Referred to Jerry Dewalt Date
<br /> Q Private,to be maintained or relocated by owner as required.
<br /> Inspected Date Permit No. Iti4
<br /> Other 2009-141
<br /> Completed Date ❑ f ?
<br /> Reviewed Date
<br /> Fee: _ 150.00 Q Paid `
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