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f <br /> paw of 2 <br /> This permit is issued pursuant to all provisions of City of Tracy Municipal Cotte. Trils hermit is grarftc!upon the <br /> oxpreaa Condition thSt the perrrllttei;shall be relponslbfe for alf Claims ana iiablitties aftng out df-work performed <br /> under.the permit or arising out of parmittae's failure to perform this Dbkga,ions with respect to street maintenance. <br /> The pormittae shsii,and by acceptance cf ire perrnf#agrees to,defend, indemnify;'save and hold harnmless the <br /> city,its of cem and employeas,from and agsirst any and all scats,chime or acticns brought by any person far or <br /> on account of any bodily injuries,disease or Ilrnass or damage to persons and/or property sustained or arlslrNj in <br /> the cor tr'udon of the work performed under the permit or in o4neeRuence or permittee's feiiure to perfarm the <br /> oblollons with reaped to Streit maintenance. <br /> Pemtlttee ag a9 to away t►y the provielonn of title permit, <br /> V . <br /> PE i=t=s SIGNATURE 7E <br /> Priorto ext:ttvtltron, Cantraatar must Cantact the following to have below-ground facilldet l6med(48 hours prior to <br /> work): <br /> UNDERGROUND SERVICE ALERT " <br /> Tall free:'(800)221.2800 <br /> Soya Gefft&Canter <br /> (209)831-4424 <br /> Nato: You are/notMe:d that Section 6500 of the Labor Code faqulres th6 issuance of a psrmr t by the Division of <br /> Induzir'Ial 98f*of the State of California prior to the condruction of any trench or exuavafinn which is five feet:or <br /> deeper-and into which a person is required to descent. Excavation in city street areas without ars axuavation <br /> permit may be punlshablo b'y a lino. <br /> Permfte agrees that they herfiby accept complete reap¢nsibility for coordinmpon with, repot lne to;and complying <br /> with the direction of,any and alt ooarcia or aistricta,Including out riot flrnim to,San Joaquln County Loot Medio <br /> District and Celifomia Regional Water Quality Control Hoard,or any other regulatory agency having jurisdiction or <br /> authority over Soil or ground water uontwminatian such os that currently found at the aura of this work, including the <br /> preservation of the health arra aafoty Of persons working near or in any trench or excavation or on tile tvrfal:v of <br /> the construciOm project,or arty pbi"ebna Pawlig by or observing,or any persons riving in the vidrilty of the <br /> corletruction project,for any roman whatsoever that may adversely,OF OlherMse affect the health or Safety,notch <br /> and in the future,of thus persons or group of parsons. <br /> Furthermore,penrrrittrxe hereby accepts complete re'5pbnsibiTty for dloposal of any petroleum affacted sol%,or <br /> ground water,htdudha ranarting to and complyft with the requirements of any,or all,of thb state iC or any other, <br /> reguleltory Denotes is di icussod above. <br /> OfTy IN�PECTQB'S COMPLgLION"PORT PrmpoiT NUMBER <br /> BATE bF GOMPLI_[ION: Concrete: <br /> Sidewalk; <br /> Backfill! <br /> Paving, <br /> �1za of C ut _ <br /> Sq.Ft._. Inches Ptved By" <br /> IMf r9CTQR SIGN OFF <br /> Od WdTT:EO 2_00Z 9Z 'unr 2886 8E8 60E 'ON dNOHd s?sFjeud oaaZ punoao WoNj <br />