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WW Aww AM qW MW � as W "W 'jW aw "L im M Im <br /> Page 1 of 2 ENCROACHMENT PERMIT PERMIT NO. <br /> CITY OF TRACY DATE OF ISSUANCE IN. <br /> PERMIT VALID UP TO 1 <br /> PROJECT COST ...0 <br /> INSPECTION REPO IT <br /> PERMIT FEE 11t!�� �• <br /> j ENGINEERING FE f <br /> TESTING FEES <br /> PERFORMANCE BOND , <br /> THIS PERMIT IS HEREBY ISSUED TO ENCROACH ON THE C ' i` 4-1 SIDE OF L4�r,V" �� � FROM <br /> FEET e 5 OF ✓ M o t h r t 11 A r P e 1 y e FOR THE PURPOSE OF✓ Sell C r S to 41 old d _ M'a LA 0 4 W g f P r <br /> ott�lo C')W faV4 wcl�' 5o;fe 100 " ` <br /> v k""31 �kV1ro1 «1t'4 �q � ADDRESSv qPHONECy�� � y Z. 0 <br /> NAME OF APPLICANT <br /> APPROVED BYFIELD SUPERINTENDENT: <br /> V TV CONTACT PHONE NUMBER: _ 31 f <br /> CONDITIONS OF PERMIT <br /> 1. The Permittee shall notify the Public Works Department - Inspection Division (831-4420) forty-eight (48) hours <br /> prior to start of work pertaining hereto. <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 /> 3. Permittee shall notify Police & Fire Departments before starting construction of any work. <br /> 4. Tentative starting date Y tj CJ #� I4 I s <br /> 5. Tentative completion date✓ N X41 L-1 bfr Z CITY INSPECTOR'S COMPLETION REPORT <br /> 6. If construction is not started within 90 days from <br /> the issue date, this permit will be void unless DATE OF COMPLETION <br /> otherwise stated in the special conditions. CONCRETE <br /> 7. Contractors must display name and phone number at work ASPHALT <br /> site - preferably on barricades. SIDEWALK <br /> B. The cost of emergency work required to restored BACKFILL <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, as required, SQ. FT. INCHES <br /> by sawcutting 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 City <br /> Traffic Manual. <br /> 12. Trenching and resurfacing is to comply with Standard <br /> Plan No. 501 and 501A. CITY INSPECTOR <br />