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Page 1 of 2 ENCROACHMENT PERMIT PERMIT NO. �- <br /> v <br /> CITY OF TRACY DATE OF ISSUANCE <br /> _ <br /> PERMIT VALID UP TO <br /> PROJECT COST e" <br /> INSPECTION DEPOSIT opo <br /> PERMIT FEE =� <br /> ENGINEERING FEES <br /> TESTING FEES <br /> o <br /> PERFORMANCE BOND °O <br /> —� p J. <br /> THIS PERMIT IS HERESY ISSUED TO ENCROACH ON THE _ SIDE OF I�'�G e '76U�• <br /> GmMqIpAhl, FOR THE PURPOSE OF <br /> 7 <br /> NAME OF APPLICANT �Gof��t� ADDRESS 3a�5a F -e G'ire_(e_,Se,20 PHONE: o <br /> APPROVED BY FIELD SUPERINTENDENT: <br /> CONTACT PRONE NUMBER: <br /> CONDITIONS OF PERMIT <br /> I. The Permittee shall notify the Public Works Department - Inspection Division (831-4420) forty-eight (46) 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 PolIC44 & Fire D partmenta before starting construction of any work. <br /> 4. Tent.atiye starting date - <br /> 5. Tentative completion date 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 0, <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 o <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 /> I. <br />