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`P City of Lodi ENCROACHMENT Public Works Department PERMIT Permit Address NORTH SCHOOL STREET AT WEST FLM STREET Date: 07/11/2007 Applicant's Name, Address Phone 209 467-1006 Advanced GeoEnvironrrtental, Inc. 837 Shaw Road Stockton,CA 95215 Cellular 209467-1006 Starting DateCompletion Date n/a License No 680227 ----.- Phone 209 467-1096 Contractor Advanced GeoEnvironmental,Inc. Address 837 Shaw Road Stockton,CA 95215 Cellular 209 467-1006 Pursuant to the provislons of the Lodi Municipal Code..the undersigned applies for Permission to excavate,construct,and/or othervrise encroach on City Street Right-of-way er Easement by performing the following: NOTIFY USA(800)227-2600 48 FLOURS PRIOR TO ANY EXCAVATION. Work Description The work consists of monitoring well destruction per attached plan at Elm Street between Sacramento& Church Street and School St between Pine and Lockeford Streets including alleys off School Street North and South of Elm Street Contractor shall replace asphalt concrete and'paving stones within public right of way and with Matching material. Contractor•shall replace concrete curb and gutter on the south side of Elm Street W/School Street. . Provide sidewalk closure traffic control plan with"Sidewalk Closed Ahead" signs posted at nearest crosswalk Contractor shall provide traffic control per CA MUTCD. No closures or work allowed on Thursdays (Farmer's Market). Proper removal of all USA utility markings to be completed. Charges for city_ forces necessity to remove markings or comolete finish work will be billed. r r` FIRE ACCESS: 16-FOOT LANE CLEAR OF ANY OBSTRUCTION IS TO BE 1,06c; ' MAINTAINED ON ALL STREETS WITHIN CLOSURE. f (Sketch) Permit void if work not started within 6 months of permit date. ' / — !Yn Conditions�FKttached Plans Attached V Licensed Contractor required for this work ' Certificate of insurance in the owner's name which names the"City of Lodi,its elec d and appointed Boards,Commissions,Officers, Agents and Employees"as an Additional Named Insured is required for Comprehensiv -eneral Aggregate In the amount of$1,000,000 per occurrence and Automobile Liability Insurance in the amount of$1,000,000 c,ombirftd single limit. 'the undersigned does hereby agree to Indemnify and save the City os Lodi free and harmless tram gO 6i'ily,in accordance with the provisions of Sec.12.04.040 of the Lodi Municipal Code.Permittee is specifically aware of Sec.12.04.290 thereof relating to the relocation o.remavorof said encroachment if future construction requires such relocation. if the work for which this encroachment permit has been issued has not been completed by tine City of Lodi shall have the right to complete the work,and to file a cause of Action to recoup the Cily's expenses in completing the work and for all other costs and fees int@ccgrcj Win the provisions of Sec.12.04.120 of the Lodi Municipal Code. rr. :t Date Signed t -dl A J ~� Required Improvement Security Th permit is granted subject to ail provisions of Chapter 12.04 of the Lodi Municipal Code and to all general provisions and applicable special provisions as show on the attached Certification of Insurance Perml pproved: CITY OF Lo Frankel & Co.,Insurance Comp.Gen. Policy No FEC6109532 Exp _ 10/19/2007 By Automotive Policy No FEC6109532 Exp 10/19/2007 _1 Public Above Ground Date Other Policy: _ Exp i Public Underground Referred to .Jerry Dewalt/George Bradley Date I Private,to be maintained or relocated by owner as required. Inspected Date - Permit No. 2007-105 Completed Dater */I Other Reviewed Date Fee: $185.00 aid � Inspector Copy ❑File Copy Permittee Copy PWD-002(Rev.6/97)