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' Department of Public Works <br /> S A N<J O A Q U I N Kds Sloan.Deectorof Public Worts <br /> APPLICATION FOR ENCROACHMENT PERMIT l —COUNTY— pro:eaehrSe,Cavity tzmnarNawtovmpm <br /> PLEASE PRINT: —� �reatnrn grows here. `t D' Alen choppy.1,ei.Deputy DrreclwEiIit l <br /> Wpddea ass Yniu Jim Stone.Deputy Dlm[yw/Oporolbns <br /> Date February 18.2020 OFFICE USE ONLY Keep Reoa.6lopege.dslOpi kRI.Oves <br /> To: San Joaquin County JOB# 110005 REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE itfitiT <br /> ATC Group Services LLC VALID 74manno To DRIVEWAYS: Acknowledgement of Monument Preservation <br /> (Applicant Name) STREET Beet Mein aL <br /> AREA stoubut QUAD ES <br /> 1117 Lone Palm Avenue,Suite 201 B TYPE Bodn -re lrt shoWderf— <br /> (Mailing Address) FORMS 5 ..nine Erik Ohlwn ,a duly Licensed Land Surveyor or a Professional Engineer <br /> NOTES (Please print) <br /> Modesto,CA 95351 <br /> (City,State,Zip Code) --rve vw.mmt cpn rvePe...n— authorized to perform Land Surveying in the State of California,Registration No. LS 8375 <br /> 209579.2221 hereby acknowledge and accept all responsibility,for the monument preservation w required <br /> (Area Code-Telephone Number) <br /> phn sellmenigiatcgs porn per Section ST71(a-f)of the Business and Professions Code within the bounds of the <br /> (Email Address) <br /> construction activity permitted by San Joaquin County Permit No. vs-z002051 <br /> Sketch(Detailed plans may be submitted) <br /> a I further acknowledge that I am hereby responsible for the Acknowledgement of Monument <br /> See dached map. <br /> Preservation prior to final acceptance of the Construction activity. <br /> `aq 3.0 4 <br /> P`p 1.ON( AF <br /> 4S,9n , Seal t No.aaxs <br /> er <br /> Date <br /> The undersigned hereby applies for permission to excavate,construct and/orotherwlse encroach on County Highway Right-oi-Way on <br /> ft south sideof F M I s approximately 150n facumle NE <br /> Of the Intersection of Eastmain St.and Scum "On <br /> Ave.115 r be ,by performing the following work(desedpdon of work): R 0NUMCNTPRESTRva110N <br /> Aa two d' t 'I w6 a th f Iv t he sholderof East mairst,The borincs men be aemnsyInsitely Notes:Per the attached map generated by the San Joaquin County GIS Benchmark Search tool,there are <br /> 3'incruss in cl meter and will be advanced!vertically. CiOe lootingill be advanced to conduct cone penetration tesfing and the second two benchmarks located approximately 500 feet west near the northeast writer and southwest comer of the <br /> acIscent b ri g il beadvanced with a hydropunch samplartoi n ll e t up id f am soil born the E.Main St/S.Oro Ave.intersection.The soil borings proposed by ATC Group Services will not impact the <br /> borings All be destroyed by completely backnrng with neat cement grout according to San Joaquin County well pope specifications. This two San Joaquin County benchmarks.A search was also done for any USGS benchmarks in the area and <br /> work is part of the Jamar Serviee Center site investigation overseen by the Central Valley Regional Water Quality Control Boom. none were found. <br /> Work Will commence on or after approval of all Permits forapprournately 1 days. <br /> I,the undersigned,certify that I am the owner of the respective property,or am qualifled to represent the owner and agree to do the <br /> work described above In accordance with the rules and regulations of San Joaquin County and subject to Inspection and approval, <br /> 04I0=020 <br /> Ignsture of Applicant-Title Date <br /> .apwa,�..rs,e,n...,.ni <br /> 1810 East Hazelton Avenue t Stockton,California 95205 1 T 209 468 3000 1 F2094682999 <br />