Laserfiche WebLink
CITY OF <br /> ENCROACHMENT PERMIT Permit Number <br /> STOCKTON ON PUBLIC RIGHT-OF-WAY <br /> Applicant. Ground Zero Analysis, Inc. Date: April 29, 2024 J APPROVED:BY THE DEPARTMENT DIRECTOR <br /> Z Subject to the General Provisions and Special Conditions,and all work must <br /> Address: 1172 Kansas Avenue 0 conform to the project's approved Storm Water Pollution Prevention Plan or <br /> v, the most current version of the City of Stockton Storm Water <br /> Modesto CA 95351 Pollution Prevention Maintenance Staff Guide,whichever is applicable. <br /> City: State: ZIP: Q <br /> 209-522-4119 jweese@groundzeroanalysis.com LL By: Date: <br /> Phone: E-mail: Q <br /> [Associated Permit(s): Expiration: <br /> WORK LOCATION:Sidewalk in front of 536 E Lafayette st. PERMIT NOT VALID WITHOUT A <br /> -r June 15 2024 same day, 1 day job CONTROL NUMBER <br /> , <br /> Start Date: Completion Date: <br /> CALL(209)937-8366 TO REQUEST A CONTROL NUMBER NO LESS <br /> ATTENTION:Applicant/Contractor-you are responsible to replace all broken,damaged, THAN 24 HOURS, BUT NOT IN EXCESS OF 72 HOURS PRIOR TO START <br /> and/or raised sidewalk,curb and gutter from score mark to score mark adjacent to the OF WORK. <br /> parcel;remove USA markings upon completion of the permitted work. <br /> CONTROL# <br /> I(or we)hereby apply for an Encroachment Permit to carry out the following work: <br /> Existing MW-10 will be destroyed under County Permit requirements. Site was a LUST Fund site and was <br /> granted closure by the RWQCB. Refer to the attached directive dated 11/15/2023. <br /> Show sketch or refer to attached Drawing Official Use Only <br /> Refer to the attached map. Base Permit Fee $ <br /> Additional Footage Fee $ <br /> Misc. $ <br /> Misc. $ <br /> Misc. $ <br /> Total $ <br /> Special Conditions. <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 Sign <br /> PERMIT,PERMITTEE SHALL CALL INSPECTIONS AT(209)937.8381. <br /> READ GENERAL PROVISIONS ON THE REVERSE SIDE OF THIS PERMIT BEFORE Gregory Stahl <br /> SIGNING. Print <br />