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L�Of � ENGR�ANCH <br /> MENT II <br /> Public Works: DepartlMehtF ,. PERMIT` <br /> Permft.Adtlress � .20pp WEST I_OD'I"AVf=NUEI �- <br /> Applrcant"s Name 31;1 ,N:L4.SAC.-.USA Date: <br /> Atldress 05/04/2006 <br /> STRATUS 1=nvlrontrlental Inc 3330°Cameroh Park Drive, Suite 55D Carrierort Park, Phone` <br /> Starttng:Date ' ;p�10 12040 Co*letion Date <br /> :Cellular <br /> 05/0812400' License Ho'' <br /> Contractor � 35882-8861 - <br /> Address Phone (530)676-6001., <br /> Pursuant 10 the provls�ons of the Lodi Mun,c,pal:Code Ihe'undersigried applies fer permission to excavate,construct,andlor otherwise encroach on City Street gh"af,Way ar Easein S 64046 <br /> performing'the following --' _- <br /> NO7lFY l]SA(800}22Z=2fiO4 ata HOURS PRIORTO qNY EXCAVA rEON: <br /> n y <br /> Work D <br /> escriptibh <br /> The work consist of dernolltion of,rrionitorin well<aoca#ed.in-dirt area-a#-bask of <br /> t <br /> .curb 311 N Lower Sacramento Road USA Service tat-ion,No 65. Work <br /> shall be irrt femented er submiitted.Work A.Ia'm,A ri1.28 2000=.P"o,ect:No. <br /> 2007-:065 41 :q'' endfx B. Coal"actio #ifl.`12"=,match exis"tire ra' e <br /> Peimlt void if work riot started wrthm 6-months of permit"date. <br /> Licensetl Contractor required for this work - <br /> �/ :land m.pl of insurance:rn the owners name which names the City of Lodi;its elected and appointed'Boards, Gommissions,.Offtcers; <br /> Agents and Employees as aniAddifional Named Insures!Is required.for.Gomprehensive General Aggregate In the amount of.$�400;000 per <br /> occurrence and Autornoblle Liability Insurance..in"the amount.of;$1,4t3D,0174 coitibiried single limit. <br /> �r.. <br /> The.unders�gried does hereby agreeIto-indemni and save the City of Lad,Tree andHarmlessfrom any tiaHflity,in_accordance with the rovlsien r <br /> Permillee is speclflcaify aware of5ec,i2 04;290Ahereof relating to the relocatiornorLremovsl'of sald�encio2chme P sof Sec_12,04:040 bf the Lodi.Munrcrpal'Code. <br /> If the work forwFiich this encroachment,permft'has;been issued has not been com feted`b' .-0 0812U0t) nt if future construction requires suchTeiocai:;& <br /> Acliomto recoup Iho City s,ezpenses inlcpmplefingahe work and foralfoth'ercosts and fees in accordan h he pr v's o�sl of all have Qa 20 q�the Lotletplun c p3 Code to file a Cause of <br /> Date. <br /> .: �' Signed <br /> Required Improvement security This permit is granted subiecl to all prowsldns of Chapter 12 04 o(.the Lodi Nlumap2l.Code <br /> x'^ F - and{dill general provision's and applicable,speaal:provisians as'show o i the attacRe@ sheet. <br /> Certification pf Insurance <br /> Wraith, Scarlett &:'Randolph.1ns.Ser Permit Ap'roved: CITY hQDI i <br /> Comp.Gen: Folroy,No NUr'07235-0- ExP tJ8/31/2000 By <br /> Automotive Pohc No`° <br /> Y NU 107235-.O'. " Exp' '.08 31'12000 <br /> Other Polrc ------ ❑ hu c Above Ground Date <br /> Exp <br /> Referred to �orri H6thaWti ylF.Forkas tJate ❑ Public Unclgrground <br /> Inspected Date ----- Private,lobe maint2ined orreldcaledbyowner as re?{u'rred. <br /> Completed Date ,`❑.Other Permit No. 20.681 <br /> Reviewed Date Fee: <br /> ❑ tnspectof Copy E]File Copy ❑Permittee Copy, Pwa402(ke'v.619i) <br />