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JUL-21-1998 1G:44 PUBLIC WORKS PERMIT CENTR 209 937 8901 P.04 <br /> • CITY OF STOCKTON • 64906 <br /> DEPARTMENT OF PUBLIC WORKS <br /> Aa APPLICATION FOR ENCROACHMENT ON PUBLIC RIGHT-OF-WAY <br /> ,eeNilk; Dry Cora .:y e-tar.��lt(seeiril <br /> Applicant's Narria i+(i.•r��l4YL^reDare—_... <br /> (Ownwlcomvacbr)��tlMorass <br /> APPROVED: <br /> aNT/ire_l –. (aQfY-i P1j . _ PhoneSb'(.Td`SrS[t� <br /> APPROVED: PUBLIC WORKS DIRECTOR <br /> Leearon of Pro Wdrx,ab. ,� snJ'a-.r,l,.�,_ <br /> 01—ade . Ric ',• (f/ -— J <br /> Dile yp <br /> O..nerl Cantrecbr Aeeras .G +e . {(K=WW gf.e])pl�.r( 9r B - �'1(/�,�_ <br /> YYY <br /> Estimated Starting Data ZA& Gompletion Dare OG.T 1 ; _ Pei mit Eamralwn Date r to <br /> I (or We) he y apply for an encroachrent permit to carry out the following work, l <br /> t a_�l/n�1tin rpA fLr� .Pl'7.M�''[•^'� _L+.N�IAH-Pl! Q -. <br /> �pT �t2 Ec t �-1r,r..C, ar DnX Per 1tGiC A�1�40e.sTldr.� � <br /> — m I `S"iaLL�r3pa� Os;- ..CW{tf6-Q mn.a tTTYLIw►L <br /> ---. <br /> Tne aeo.c Nl.wd epo�kem neiabr me.rnc pnrmbeN)n w- PERMIT FEE ..– <br /> Additional Footage Fee <br /> Sower Tap Depoell - <br /> ZZ <br /> TOTAL DEPOSIT <br /> �y� Q �•yL�^ Building Permit No. _ <br /> Improvement Plan No. _ <br /> Supplemental Conditions: <br /> KErcC' pJt, l Ot+ -TQaJFFC_ <br /> cps>,a te-J �caLM e.araeTorl Alm <br /> ZILA-- <br /> tr LL INSTsU.C�CID�I 511aLL ►3E <br /> Snc,.f4kx abw.n.r.s,to oa..a autr,.nard QEy'TD.vt�1r� '{b `moi.. �t��1G <br /> IMPORTANT Applicant hereby agrees to comply with all provisions of This permit as well as all applicable City ordinances,resolutions, <br /> standards and specifications currently in effect,and to pay to City its actual cost for removal and proper replacement of any item which <br /> does not meet above requirements. Failure to comply will be cause for revocation of permit- Applicant agrees to indemnity and hold <br /> the City harmless against any and all losses,costs,or damages resulting from injury to persons,death of person or damage to property <br /> occuring at the site of or as a result o1 work to be performed under this permit. A certificate of insurance shall be submitted to the <br /> City Risk Manager prior to beginning construction <br /> PERMITTEE SHALL CONTACT UNDERGROUND SERVICE ALERT(1.800.4 2444) TWO WORKING DAYS BEFORE BEGINNING <br /> WORK FOR LOCATION OF UNDERGROUND UTILITIES. <br /> PERMITTEE SHALL GALL(209)937-11411124 HOURS PRIOR TO START OF WORK FOR A CONTROL NUMBER AND TO SCHEDULE <br /> INSPECTION. <br /> Read General Provisions on reverse side of this permit before signing — Note requirement of n tifieatlons and inspections, <br /> = .upon `//1//?f <br /> rtl–IYrmxue )ne..rik Jrd unarm 111, Uwg1SI-1 <br />