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o. <br /> Page i of 2 9NCROACHME14T PERMIT PERMIT NO. <br /> CITY OF TRACY DATE: OF ISSUANCE" 2 ,x{ <br /> PERMIT VALID UP TO q <br /> PROJECT COST <br /> INSPECTION DEPOSIT <br /> PERMIT FEE 3S <br /> ENGINEERING <br /> -' TESTING FEES r <br /> PERFORtiANCE. BOND <br /> THIS PERMIT I5 HEREBY ISSUED TO ENCROACH ON THE' SIDE OF <br /> OF FOR THE PURPOSE..,OF <br /> FEET . <br /> NAME OF APPLICANT �� " ADDRESS <br /> lIo <br /> / P FIELD SUPERINTENDENT. <br /> ,.APPROVED BY _ <br /> x. , CONTACT PHONE NUMBER: �/�_ �'¢-Ot <br /> " �. <br /> 66NDiTIONS4 OF PERMIT <br /> 1. The Permittee shall notify the Public Works Department - Inspection Division (836=4420} 'forty-e.ight�{48) hours <br /> z 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. PeYmittee ehall. notify Police .& Fire Departments before starting. constzuctian of any work. <br /> 4:- Tentative starting date". -/ -9Q <br /> CITY INSPECTOR'S COMPLETION REPORT <br /> »5. .,; Tentative completion date <br /> 6. If construction is not started within 90 days from DATE OF COMPLETION <br /> the issue date, this permit will be void unless <br /> 04erw1je stated in the special conditions. CONCRETE <br /> 7. Ccntractore must display name and phone number at work ASPHALT <br /> l site —preferably. on barricades: SIDEWALK <br /> B. The cost of emergency work required to restored BACKFILL <br /> unsatisfactory conatruction ,that becomes a hazard will. . PAVING <br /> be charged to the Permittee. ._ SIZE of CUT <br /> 9. Replace full concrete, sidewalk squares, as. required, *, � f It <br /> , <br /> PAVED 'BY: <br /> by sawcuttinq along score marks. <br /> 10. ".Compaction tests shall be required on backfilled trenches <br /> at the expense of the Permittee (contact Cl'ty. Engiheering 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 CITY I11sPECTOR <br /> Plan No. 501 and 501A. <br />