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EPMS: Permit Rider Page 1 of 1 <br /> STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION Collected By Permit No.(Onginal) <br /> ENCROACHMENT PERMIT RIDER <br /> TR-0122(REV.6/1999) G. Chen 10-19-N-SV-0085 <br /> Rider Fee Paid Dist/Co/Rte/PM <br /> $ EXEMPT 10-SJ-VAR-VAR <br /> Date Rider Number <br /> 08/19/2020 10-20-N-RT-0546 <br /> TO: San Joaquin County of Governmens (SJCOG) <br /> 555 E. Weber Avenue <br /> Stockton, CA 95202 <br /> Attn: David Ripperda <br /> 209-235-0450 PERMITTEE <br /> In compliance with(your,eac)request of August 12, 2020 we are hereby amending the above numbered <br /> encroachment permit as follows: DATE <br /> Date of completion extended to: NO CHANGE ® February 28, 2021 <br /> DATE <br /> Time Extension <br /> Except as amended,all other terms and provisions of the original permit shall remain in effect. <br /> COPIES TO: APPROVED: <br /> 1-Permittee / <br /> 1-Foe Valdez Dennis T.Agar,District Director 6n! i ln, <br /> 1-Maintenance BY: <br /> '``� <br /> �� <br /> 1-Garry Horton i V 4/ <br /> Francisco Rodriguez P.E. ,Distr ct Permit Engineer <br /> ADA Notice For Individuals with sensory disabilities,this document is available in alternate formats.For alternate format information,contact the Fortes <br /> Management Unit at(916)445-1233,TTY 711,orwnte to Records and Forms Management,1120 N Street,MS-89,Sacramento,CA 95814. <br /> FM 91 1437(D10 Permit App) <br /> http://epms.dot.ca.gov/bin/print_rider.php 8/19/2020 <br />