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! }� ca.invn. nviatvi ranwll PERMIT NO. `d or- <br /> CITY OF TRACY PERMIT GRANTED: <br /> PROJECT COST <br /> 1 DF 3 5 PERMIT FEE : AD t AIO B67"VJ) <br /> See C�+rrrtc-o ) -/c)/'JSslAwN <br /> APPLICATION IS HEREBY MADE FOR A PERMIT TO ENCROACH=OIC-THE= 6N Lbw _G.rng=D� r�1 S/ft'� j of 3 <br /> �,,FRaM-_ /ir o2 N EE2T �� oCti PAzK � 09+L41 <br /> FOR THE PURPOSE OF _ /N�Tlt«�T/u J dr- <br /> NAME <br /> ^AV G Fc)�n O wA i�7L /hONi TdP��� WEA[ 5 <br /> NAME OF APPLICANT t9cy yes t /l4aare(d/I d'7 /�,A�DRESS SoyJanSomesf� S.F. CA 94 u1 PHONE: �¢!S� 43j- 0700 <br /> APPROVED BY lc�a G /�C(� (A Vv�Jp�,p' (-- SJ/�p ��� 7 ) FOREMAN: <br /> CALL U.S.14. $E4=: ,IRE D/46v,) � j (6o O) 642 ^ 2-44 ¢ COMPLETION DATE : <br /> e Permittee shall notify the City Engineer (836-4420) Twenty-Four Hours prior to start of work <br /> rtaininLg hereto. <br /> jov),_ )uo Bo-/- we-0 cdjer 5tict be Set -Rv5� WA )AWn sure (YdJ we// cilli- CITY INSPECTOR'S REPORT <br /> 1 . 17ac-ftEA *, 13ojC Pdye � ha vo1ds) where wells , sFv Ilec4 rr Aide, Park. "� �" <br /> 1 . emporary paving must be placed after backfill . YES NO NLA BACKFILL PAVING <br /> 2 . Plan required YES NO _ <br /> 3 . Profile required Subm;� weld logs ) YES x NO INITIALS <br /> 4 . Performance Bond required YES NO HOURS _ <br /> 5 . Notify Police & Fire Departments .F b(nck�n9 sfreof-s YESNO DATE <br /> _ <br /> 6 . Open Trench Maximum LENGTH NIA WIDTH Nfq CONCRETE <br /> 7 . Approximate Starting Date AP2iC , �'q� ASPHALT _ <br /> 8 . Approximate Completion Date See No. 9 4P,1613 SIDEWALK <br /> 9 . This Permit void 90 days from issue date unless otherwise SIZE OF CUT <br /> stated in Special Provisions SQ.FT. INCHES <br /> 10. Pavement Replacement (Sawcut) PAVED BY: <br /> 11 . Paving to be done by ^FTY CONTRACTOR BILL NO. <br /> 12 . Minimum cover street 36" sidewalk 30" CHARGES BACKFILL <br /> Contractors must display name and phone number at work site - PAVING <br /> Preferably on barricades. PAVING INSP . <br /> 14 . The cost of emergency work required to restored unsatisfactory <br /> construction that becomes a hazard will be charged to the DESCRIBE STREET SECTION BELOW <br /> Permittee . _ <br /> 15 . Replace full concrete sidewalk squares, as required, by sawcutting <br /> along score marks. <br /> 16. All work to be done per City of Tracy Standards . <br /> /17 . special Provisions Sea below r oT - " " - IF us re vreJ F� c c�ppl,wnf will be <br /> 18 . Compaction Tests Required on Backfilled Trenches (Contact City Engineering De artment) ; lied . <br /> 19 . Agreement Required. YES NO. ea <br /> Y 1# _ <br /> /ns i/fa Soni m4�nfenonce and vllimufe gbgndonme., 04 rnona nn9 We1f� s/u// he do e ^ uE a�PJi�4nfs eX�e,,se� <br /> qnd ih acc6l^JQ,7ce with <br /> Creof -Fra <br /> (.Y an1! <br /> d Sot, Jou; <br /> apphcabfe ) n Heal ! or C /. ZU.Q.cB. as <br /> caP <br /> S G l)G fJf ac,C.d 0.t' GPO rO XIm a�Pil4 SiX !, ,I inr �.i. hi 1� .i 1 i.l o..r n.l� <br />