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' UA PUBLIC WORKS DEPARTMENT <br /> Manieea � 1001 W Center Street <br /> Manteca, CA 95337 N2 4657 <br /> ENCROACHMENT PERMIT <br /> Contractor: GKEGG IN- SITu INC , Project Name: FORMER RLN4 STATION <br /> License No: C-S1 5 6 01 Pro jectLocation: .CITY STREET_FAST O!' <br /> Address: 950 HOWE ROAD 101 RA` LOW AVENV'E <br /> MARTINE-LCA 94S53_ Date Issued: Or-- S- O� <br /> Phone; (915 ) 311 - ,S200 <br /> J2 License Verified R1 Insurance Verified <br /> Pursuant to Section 12 of the City of Manteca Municipal <br /> Code and all the terms, conditions and restrictions <br /> written below or printed as general or special provisions on any part of this for, and/or attached hereto, <br /> PERMISSION IS HEREBY GRANTED TO DRILL '4 SIDE ~W�f- SIDE SOIL k3 O R i N 6 S WITH <br /> A C04I - PEtIETRA'tloN TEST RIG% SOIL 13ORING-S WILL 6E 3-INCHES iN DIAMETER <br /> AND WILL I3E SthLPD WITIA Btti-t NITE G-ROVT' THE SAME DAY Tli •%f ARF- DRILLED, <br /> TIDE SVREACE WILL t3E PATCHEO WITH ASPHALT , NO PERM414ENT WELL WILL BE 1 <br /> i INSIALLED. WORK SHOVLD REQVIRE DNF- FULL DAY TO COMPLETFE, <br /> ■ (Attach Two Sets of Pians or Sketches, If Applicable) <br /> PLEASE READ THIS PERMIT CAREFULLY KEEP IT AT THE WORK SITE To arrange for an <br /> inspection, phone 825-2309 or 239-8460, at least 48 hours prior to construction <br /> Your attention is directed to the general provisions rented on the back of this form This permit is to be strict/ <br /> g P P P Y <br /> construed and no work, other than that specifically mentioned above, is hereby authorized <br /> This permit shall be void unless the work herein contemplated shall have been completed by <br /> sEtIT111AWIEK 1i 1 20 VL <br /> Accepting this permit or starting work hereunder shall constitute acceptance and agreement to all the conditions <br /> and requirements of this permit <br /> Signature of Permittee/Contractor Director of Public Works <br /> ' By BY <br /> Peffnittee or Au razed Agent <br /> PERMIT NOT VALID UNLESS EXECUTED BY DIRECTOR OF PUBLIC WORKS OR HIS AGENT <br /> 0 WORK COMPLETED <br /> Forms\Encroach doc (Rev 08/95) Date By <br /> ' J d J PRINTING(2")23F241 <br />