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SEP-12-94 NON 9:40 KLEINFECIER FAA NO, 2090480621 P, 01/01 <br /> • CITY OF STOCKTON <br /> DEPARTMENT OF PUBLIC WORKS <br /> APPLICATION FOR ENCROACHMENT ONDPUBk ACIM <br /> IIILSS�� N2, 63055 <br /> I <br /> SEP 121994 <br /> A�dt ese_T,.—... ._•,.. _Phare <br /> APPROVEM DIRECTOR OF PUBLIC WORKS <br /> lededipl oT Propwead Wbrk,eie_ _____ <br /> NVIRONM NTryA(LHEESjL7T�H <br /> a.mar rGonrrbc4ar Addrep„ �-�TL� <br /> EuYmeed Sorting `f ✓/J, Dare-/(Y BY P�em�t <br /> Ezpfration Dale <br /> 3 !or Mel hereby apply for an encroachment permit to carry out the following work: <br /> 1N_ '_ T-�- _.tx1+L rZlr�c� L�LttL --- <br /> The obp nbmed oppliabnt hereby regnasra permlaian to PERMIT FEE..... coo <br /> ...- <br /> AddtlP l Foetey Fes. . .. <br /> Swan Tap Depese ...................... ..... .. <br /> TOTAL DEPOSIT •..................... S �� <br /> Building Permit No. <br /> Improvement Plan No— <br /> Supplemental Conditions_ <br /> ,• •1 r..+�,. Shaw skah:h b3xwe br refae To d�pryw[ng whm�tled <br /> IMPORTANT: Applicant heraby ogrees to comply with all provisions of this permit as well as all applicable City ordinances, <br /> resolutions, standords and specifications currently in effect, and to pay to City its actual cost for removal and proper replace, <br /> ,m6m.of any item which does not meet above requirements. failure to comply will be cause for revocation of permit. Apple- <br /> cant agrees to indemnify and hold the City harmless against any and all losses, costs, or damages resulting from injury to <br /> persons, death of person or damage to property occurring at the site of or as a result of work to be performed under this <br /> peTmit. Cenificate of insurance will be presented by applicant upon regaest. <br /> Rand General Provisions an ravono side of this pe*mil before al nln *Note rogalrement o1 notifications and Inspections. <br /> Permit Engineer)Inspector <br /> 944-8251 ?- <br /> 944.43366 s grad: _rho <br /> SMALL CALL 93T-841I. <br /> 24 HOURS PRIOR TO START Of <br /> Ia4•.,-{rurneln ze 2nd—F.4 WORK FOR A COfITRIX NUMBER <br /> AND <br /> TO SCHEDULE INSPEMION <br />