Laserfiche WebLink
WORK LOCATION: 2.15C/S β€žSt. Dom 0 sta <br />y-r o CA <br />Start Dat <br /> Complbtion Date: <br />1 1 67 i 11 <br />ATTENTION: Applicant/C tracto.-rt are responsible to replace all broken am d, <br />and/or raised sidewalk, curb and gutter from score mark to score mark adjacent to the <br />parcel; remove USA markings upon completion of the permitted work. <br />Misc. $ 39 <br />Misc. $ 51 3-6 <br />Total $ <br />I (or we) hereby apply for an Encroachment Permit to carry oil/ the following work: <br />C3) <br />ilizi4.40 A OP 11412,ES.-- GAsN,:woweeritr ID4NAt "X) Wr)) v4--Irkz. 'Ac) <br />Pre') 1 gieb A(1 bil-initc,1s c C) so el ikrip.cyt kof bt. ilavit)-Acco For- <br />-Tht_ krpost_ c;/ c o vizr siN AO)* <br />Show sketch or refer to attached Drawing Official Use Only <br />51e 01-rTActiD Si it 191ANI <br />Base Permit Fee <br />Additional Footage Fee <br />$ 7.i2O <br />Misc. <br />Special Conditions: <br />I-0y- I 14 5 re,47β€˜b c.0 ±71-C4β€” <br />Titc[Oet P-1t di-W- 44- 201-1051- )2-ts2 <br />APPROVED: BY THE DEPARTMENT DIRECTOR <br />Subject to the General Provisions and Special Conditions, and all work must <br />conform to the project's approved Storm Water Pollution Prevention Plan or <br />the most current version of the City of Stockton Storm Water <br />Pollution Prevention Maintenance Staff Guide, whichever is applicable. <br />By: M'614( K CakaPtila <br />Associated Permit(s): Expiration: <br />OsvN OFFICIAL USE ONLY Date: <br />PUNT NOT VALID WITHOUT A <br />.C,ONTROL EIMER. <br />CALL (200) 937-3an TO REQUEST 'A =ROL <br />NUMBER NO LESS THAN 24 HOURS, RUT NOT <br />EXCESS OF 72 HOURS FiR1,0R TO START OF K(. <br />CONTROLii <br />CITY OF ACROACHMENT PERMIT <br />STOCKTON ON PUBLIC RIGHT-OF-WAY <br /> <br />Permit Number <br />q%'13- 16b1 <br />et4L <br /> TA <br />Applicant: MANc eC <br />Address: 8.57 S A A. LA, 1 Z0/4-0 <br />State: C4- ZIP: q6z-)5 <br />Phone: 2-oci. 9(07 -/Ov k-mail: 1Eve1i445344v9toz., <br />IMPORTANT: Applicant hereby agrees to comply with all provisions of this permit, as well as all applicable city ordinances, resolutions, Standards and <br />Specifications currently in effect, and to pay to the City its actual cost for removal and proper replacement of any item which does not meet the above <br />requirements. Failure to comply will be cause for revocation of this permit. Applicant agrees to indemnify and hold the City harmless against any and <br />all losses, costs, or damages resulting from injury to persons, death of person or damage to property occurring at the site of, or as a result of, work to be <br />performed under this permit. A certificate of insurance shall be on file with the City Risk Manager prior to issuance of this permit. <br />IF THE WORK DOES NOT COMMENCE WITHIN 72 HOURS OF THE ISSUANCE <br />OF A CONTROL NUMBER, THE CONTROL NUMBER WILL BECOME INVALID <br />AND THE PERMITTEE SHALL CALL FOR A NEW CONTROL NUMBER. PRIOR TO <br />ANY REQUIRED INSPECTIONS, AS IDENTIFIED ON THE REVERSE SIDE OF THIS <br />PERMIT, PERMITTEE SHALL CALL INSPECTIONS AT (209) 937.8381. <br />Sign <br />Print <br />READ GENERAL PROVISIONS ON THE REVERSE SIDE OF THIS PERMIT BEFORE <br />SIGNING. <br /> <br />β€”7;;) 0 'y 3. C4t114r <br /> <br />City: <br /> -"roc_r -r-ory <br />t 7