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l�e�m► 17 IaUA <br /> MM«a on <br /> 6fwi•y <br /> �1 OblE' <br /> CITY OF MANfECA <br /> 1001 W.Center Street <br /> Manteca CA 95337 <br /> ENCROACHMENT PERMIT <br /> Contractor: Ahtna Environmental, Inc. Project Name: Sharpe Well Abandonment <br /> Well closures to be performed by <br /> License No: Cascade Drilling, LP, C57#938110 Project Location: Louise Ave(1 location) <br /> Address: 2255 Contra Costa Blvd, Suite 312 Airport Way(2 locations) <br /> Pleasant Hill, CA 94523 Date Issued: 113 ZIF New Date: 8/13/18 <br /> dLicense Verified [Z Insurance Verified <br /> Pursuant to Section 12 of the City of Manteca Municipal Code and all the terms, conditions and <br /> restrictions written below or printed as general or special provisions on any part of this for, and/or <br /> attached hereto, PERMISSION IS HEREBY GRANTED TO: <br /> b L7(� (A f4CW �011( <br /> C <br /> (Attach two sets of plans or sketches, if applicable) <br /> PLEASE READ THIS PERMIT CAREFULLY. KEEP IT AT THE WORK SITE. To arrange for an <br /> inspection,phone 639-5964 or 923-0528, at least 48 hours prior to construction. <br /> Your attention is directed to the general provisions printed on the back of this form. This permit is to be <br /> strictly 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 /> / , 20_. <br /> Accepting this permit or starting work hereunder shall constitute acceptance and agreement to all the <br /> conditions and requirements of this permit. <br /> Signature of Permittee/Contractor Engineering Division <br /> By: By: <br /> Permittee or Authorized Agent <br /> PERMIT NOT VALID UNLESS EXECUTED BY DIRECTOR OF PUBLIC WORKS OR HIS AGENT. <br /> WORK COMPLETED: <br /> Date: By: <br />