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209 937 Owl 6,3327 <br /> wP.811 <br /> �T <br /> CITY OF STOCKTOIII V,3 3 c 7 <br /> I)EPMUMEITY OF PUSUG WORKS <br /> A9 APPLICATION FOR■NCROACNa EW ON PUOLIC RIGNT t1P-WAY <br /> K No"I David S. Marks s8� 3i 15!95 <br /> MunK______—$cpJ4S9rd. .C1A„ 94526 phon�510)603-7424 <br /> LOC9W a Frw"c Wont[Mo. City Sidewalk at 1 PPPROVaR: PUN=vio I coutcrm <br /> 14S Booth Sutter $treat J � _ <br /> Own.rrtiar4fLawrAdlrMw _ 222 8.._SFieber Ave, 8m 678.-,Slocktt�-ou. 20 Ot41 <br /> snlra d ateromp Oa1e 3/30/9$ Damdadoa Erle Owl./ <br /> I(or War! her"Y apply for an encr38d71T1enl permit to carry Out the Idilowing +,,Wk; Abandon two none or veils <br /> itzUaef4ure as <br /> zand NW-3.XV-2A <br /> nd install tvo--raplaCeReai <br /> mnitoelleahorrnon theattachedfiguree as XV-2Aa �3A <br /> rro 4"ru•b r♦ab,may n9wr+,p.wlarr,o PERMIT FFE.... ............... <br /> netltid'al ftatrpe tai.. ........ - <br /> aa..a 1sp pgaW ........., <br /> TZlML DEPOSIT 128 __. ..00 <br /> Refer to the Attached Figure. Buildirio %rmil No. _ <br /> Impfcvemant Plan No <br /> Post-Ir Fax Note 7671 lrve� �, �� Suppltrtrantel CbrtQitionH: <br /> To ✓ Ferar <br /> ColpapG Cpl_ <br /> PhmwY <br /> .3a 37— <br /> FuY <br /> 8n ckMh&h.m reWe a 0L 1,g ruumso <br /> IMPORTANT:Appliearn hereby agrees t0 ocinaly YAth all provisions of trim permk as well as all sppticable City ordinances,rsso;utiona, <br /> standards and WWlTiCMnv OWrently in afteM and to pay m City its actual cavi V removal and proper n1placerriSM e1 any Item which <br /> does not meet above requirOmerrls. Failure to comply writ be cause tar reveeatiorl P permit_ Applicant agrees to Incemnify and held <br /> tha City narmisas agairst any and all Imes.costs.or damages resultino from injuryto persons,death oT person or damsgeto properly <br /> occuring at the altw of or as a result of work to be performed untlaf Chia permit. A cer1iliowe of insurance stall be submitted to the <br /> Chy Risk Nanayar prior to beginning constuctimt. <br /> PERMITTEF SH/LLL CONTACT UNPERGtOUND BERYICE ALERT'(1-800842-2444) TWO WORKING DAYS 13EFORE BEGINNING <br /> WORK FOR LOCATION OF UROEROROUND UIRMIES. <br /> PERUFTTEF SHALL CALL(2f)9)937-0411 F4 HOun®PRIOR TO START OF WORK FOR A CONTROL NUMBER AND TO SCHEDULE <br /> INSPECnON- <br /> Read De.rerat Provisions On reveres &tae of this Pe - Man sl sing Ngte requlremerrl of nottfk;alierm and inaMotlons. <br /> .�—�1On11'Y Jrec._F[Y �—.'M[I[e 4Tr M.r9Ym' <br /> 4; .'c �:AF,TOfi9660ZT6fi6 �-V� QYO� NO,L53M 94t0i S6-L -L =,t9 .L43S <br />