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City of Public Works Department <br /> 390 Towne Centre Drive,Lathrop CA,95330 <br /> ""R� Main(209)941-7430 Fax (209)941-7449 <br /> Permit No. 2019-17 <br /> ENCROACHMENT PERMIT <br /> Applicant Information: <br /> Applicant Name: Athna Environmental Date: 7/3/2019 <br /> Mailing Address: 2244 Contra Costa Blvd., Ste 312 Applicant Phone No.: 916-224-9248 <br /> City, State, Zip: Pleasant Hill, CA 94523 <br /> Encroachment Location: Cedarbrook Way and Brookfield Ave. <br /> Contractor Information: <br /> Contractor: Athna Environmental Construction/Project Manager: Rachel Kerr <br /> Address: 2244 Contra Costa Blvd., Ste 312 Contractor Phone No.: 916-396-5309 <br /> City, State, Zip: Pleasant Hill, CA 94523 License No.: _ <br /> Bond Required: Yes: 0 No: Amount: Check/Bond: p <br /> Release of Bond Approved By: Date: <br /> Final Inspection and Accepted By: Date: <br /> 24-Hour Contacts - Name & Phone No: <br /> Primary Contact: Rachel Kerr Mobile No.: 916-396-5309 <br /> Secondary Contact: Megan Gehrke Mobile No.: 831-582-7199 <br /> Permission Is Hereby Granted To: <br /> Install one groundwater extraction well,associated well vault and conveyance line, and bull box. <br /> Drilling to be performed under permit issued by SJCEHD. <br /> Approximate Duration: July-Aug 2019 <br /> Contractor must contact the Public Works Inspector at least 48 hours prior to start of construction. <br /> Final inspection is required prior to acceptance. Contact Robert McGinnis at (209) 992-0701. <br /> Submit accepted and signed permit to encroachmentpermits@ci.lathrop.ca.us to close out after final inspection. <br /> To perform work in the City's right-of-way,as shown on attached documentation to this permit, applicant is subject to all provisions on <br /> any part of this permit,and or attached hereto.The applicant's attention is directed to the general provisions attached to this permit. <br /> This permit is to be strictly adhered to and no work other than specifically mentioned above is hereby authorized. <br /> This permit shall be void unless the work hereunder contemplated shall have been completed by: 1/3/2019 <br /> Accepting this permit or starting work hereunder shall constitute acceptance and agreement to all conditions and requirements of this <br /> permit. <br /> PUBLIC WORKS DEPARTMENT: SIGNATURE OF APPLICANT: <br /> Dpaaiiy signed by <br /> Rachel Kerr RC)a1ai°'K°" <br /> e 2019 07 03 <br /> ' 08 41 06-07'00' <br /> StepIen J.Salvatore Date Name Date <br /> City Manager <br />