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04/27/2004 09: 51 5306766005 STRATUS NO CALIF PAGE 03/03 <br /> PUBLIC WORKS D0XRTMENT <br /> 16775 South Howland, Suite 1 Na 261 <br /> Lathrop, California 95330 <br /> (209) 858-s592 <br /> Fax 858-5259 <br /> ENCROACHMENT PERMIT <br /> Steve Carter <br /> - <br /> TO: Name Stratus Environmental Inc. Date Issued_ <br /> 3330 Cameron Park Drive, Ste 550 ` —� <br /> Address Cameron Park, CA 95682 Contractor CDd 7 <br /> c�w <br /> Phone _(530) 676-6004 Phone V17 <br /> (Permit! e) 3!3_Q36z— <br /> Date work to begin /o ot� License No. C 65?/O7 <br /> PERMISSION IS HEREBY GRANTED TO: � <br /> To perform soil borning as per attached plans. - <br /> (Attach 1 set of plans or sketches) <br /> to do work in City right of way as shown on attached application and subject to all the <br /> terms, conditions and restrictions written below or printed as general or special provisions <br /> on any part of this form, and/or attached hereto. <br /> Your attention is directed to the general provisions printed on the back of this form. This <br /> Permit is to be strictly construed and no work, other than that specifically mentioned above, <br /> is hereby authorized. <br /> This permit shall be void unless the work herein contemplated shall have been completed <br /> by 19 <br /> Accepting this permit or starting work hereunder shall constitute acceptance and agreement <br /> to all the conditions and requirements of this permit. <br /> Signature of Permittee Directo of P 1' <br /> By: By. <br /> P rmit ee r Authorized Agent <br /> PERMIT IS NOT VALID UNLESS EXECUTED BY DIRECTOR OF PUBLIC WORKS OR <br /> HIS AGENT. <br /> WHITF--Permittee YELLOW-Accounting PINK-File <br />