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12/04/98 FRI 10:18 FAX 209 467 1118 Z002 <br /> City Of LQd i ENCRC'�ACHMENT <br /> -Public Works Department PERMIT <br /> PERMITADORESS 108 West Elm Street frontage DATE 11/25/98 <br /> APPLICANT'S NAME jOwn@rW"W&cmr) . ADDRESS <br /> Advanced Geo Environmental 4005 N. Wilson Way, Stockton, CA 95245 <br /> PHONE <br /> STARTINt3DATE 11/30/98 coMPLETIDNDATE UCENSENo. �(2o9) 467-1006 <br /> OMMUCONTRACMR ADDRESS PHONE <br /> Kevin McKibben, Geologist <br /> Pursuant loft PMWI orM of ft Lad MWni ipel code.the undersigned sppues for p anther other encroach an Cuy Strom RIpM-d•wsy or Enatmrri by p4rforrnirW <br /> tee maowav <br /> NOTIFY USA(900)2272600 49 HOURS PRIOR TO ANY EXCAVATION. <br /> The work consists of {'K t Al l a t i(1n-_^_'f tiao--tEr!""nd wa t A r <br /> monitoring wells in street pavement in parking <br /> stalls. (Wrrk purr. addendum submitted)) NOTIFY CITY INSPECTOR AT <br /> Monitoring weil to be flush moun ed; tratflc lids, START OF WORK: <br /> backfill with existing or 3" Min. Asphalt Concrete eurt Juran 333-6836 <br /> apron. No foreign material to enter storm drain <br /> system; Waste material to be stored in metal drubs, <br /> rlaarler iaha:arl nff rf nithti right-of-wPy- <br /> Traffic control per Cal Trans Traffic Control Manual, <br /> current issue. No vehicles on sidewalk; no open <br /> excavations, except at time of work. <br /> **No WORM. ON 'THURSDAY, DEC 3rd. <br /> MonitoripQ wells to /i ii /ham <br /> parking lanes. <br /> Permit void if work not started within 6 months of permit date. ( ce or Sk� <br /> Ucensed Contractor required for this work <br /> I <br /> xx Certificate of Insurance in the owner's name which names the'City of Lodi,Its elected and appointed Boards,CommISsiDns, <br /> Officers.Agents and Employees'as an Additional Named Insured is required for Comprehensive General Aggregate in the amount of <br /> $1,000.000 per occurrence and Automobile Usbility Insurance In the amount of$1,000,000 combined single limit <br /> The undersigned does hereby soros to Wet.fly and am the Lay d Lodi fret and harmine from any .in.ceord.na with the p VMou Of Sec.12.04.040 of fie Lod M nftfi code. <br /> Permtlae is spedffuly aware d sec 12.04200 Owed r8WQ to the rdoabm or renavai of and encroa hrr erd tr Were eon0ruclon taqutros Much ratocOMM. <br /> N the wok fpr which oda erwoachry re pwn*hat been WwW has not bam com awd by .ft c1y d Lod shW ho a eM right to c nV1@•ttr:work ane+o+1e.Gwe d Aeeon m <br /> recoup go City's experaes in cor ptmkq ere work and for al oerw cost and fees in accordance <br /> /wtlh�ft PI ASID M Of sec 12.04.120 of the Lau Murkipel code. <br /> Date "I Signed &14 �r'^t/�•�ir'fA '1 <br /> Required Improvement Security Tt*parna isa,>RA@w to a provision d chapter 12D4 d fro Lad UwJdPN code and to <br /> ore 9&WOprowsione rd eppsabw apedel p oNionas as shown on ft reveroe mea. <br /> Kealey, Renton df A s s oc i t!e s <br /> Certificate of Insufance Permit Approved: CITY OF i.ODf <br /> kP06646233 7/1/99 <br /> Comp.Gen.Polity No. Exp. <br /> Automotive Policy No. Exp. <br /> Referreidto Curt Juran 333-6836 --Date- <br /> Public <br /> Above Ground bate 1 <br /> Inspectedp Public Underground <br /> Cpmpleteri �- -- Date Prlvat•,soeterrwr,wW 1'. reaeyoa.Mr <br /> Reviewed Date Other PERMIT NO 1'. &y9~ <br /> Reviewed <br /> ` (Rw,"7) <br /> VA#*4 p.aor vellpw% Pkrk~440 <br />