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Page 1 of 2 ENCROACHMENT PERMIT PERMIT NO. r <br /> CITY OF TRACY DATE OF ISSUANCE <br /> PERMIT VALID UP TO <br /> PROJECT COST <br /> DINSPECTION DEPOSIT �- A <br /> PERMIT FEE 3 S <br /> ENGINEERING•FEES <br /> TESTING FESS <br /> 'F+4.EV PERFORMANCE BOND <br /> THIS PERMIT IS HEREBY ISSUED TO ENCROACH ON THE �y T SIDE OF '�H 0 W V L-0T-5 &f J �I ACS, XK4 <br /> wo(9DfV1-F➢ Ir - 1 VaOL9 0'1'j � � r*.ST. <br /> FOR THE PURPOSE OF D <br /> NAME Or APPLICANT S "�a-'T'CLQ CU-V�5 u ( �• ADDRESS IU "y}ef Sf (2.4 F I f- PHONE: <br /> ' DA. �a. taw� 941v12 <br /> APPROVED BY FIELD SUPERINTENDENT: <br /> CONTACT PHONE NUMBER: <br /> CONDITIONS OF PERMIT <br /> 1. The Permittee shall notify the Public Works Department - Inspection Diviaion (Q32004M) forty-eight (49) hourn <br /> prior to start of work pertaining hereto. 3 1 Y Ll(a 0 <br /> 2. The Permittee agrees to perform work under this permit in accordance with the prevailing City Standards, <br /> Specifications and shall comply with all existing codes and policies. <br /> J. Permittee shall notify Police C, Fire Departments before starting construction of any work. <br /> 4. Tentative, starting date �+-45 1-0 y 2 A O-T j C_e- <br /> 5. <br /> 5. Tentative completion date CITY INSPECTOR'S COMPLETION REPORT <br /> 6. If construction is not started within 90 days from <br /> the issue date, thin permit will be void' unlese DATE OF COMPLETION <br /> , - Otherwise stated In the special conditions. CONCRi:TE <br /> 7. ,-•Co4ractprs must- dieplay riaiuh• and phone.number at woj;k ASPHALT <br /> site - preferably on barricades. SIDEIIALK <br /> B. The cont of emergency work required to restored BAWILL <br /> unsatisfactory construction that becomes a hazard will PAVING <br /> be charged to the Permittee. SIZE OF CUT <br /> 9. Replace full concrete sidewalk squares, an required, SQ. FT. INCHES <br /> by eawcutting along score marks. PAVED BY: <br /> 10. Compaction tests shall be required on backfilled trenches <br /> at the expense of the Permittee (contact City Engineering COMMENTS: <br /> Department) . <br /> 11. • Traffic control shall be In accordance with the "ST7►TE <br /> Traffic Manual. <br /> 12. Trenching and resurfacing is to comply with standard <br /> Plan No. S01 and 501A, _ <br />