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tU1 COUNTY OF SAN JOAQUIN <br /> �� oo DEPARTMENT OF PUBLIC WORKS <br /> GZj P.O.BOX 1810-1810 HAZELTON AVENUE EP No: P-06 186NW .jl <br /> STOCKTON CALIFORNIA 95201 <br /> ' • (209)468-3000 Date Issued: 5/08/2006 <br /> .P FAX#(209)468-9324 Expiration Date: 5/26/2006 <br /> '¢G/FORc� <br /> Job No: 11005 <br /> ENCROACHMENT PERMIT UE/CR/PM NO: MAl 3 <br /> To: ISA HENDERGART Encroachment Type: NCHING <br /> O BOX 409 ---- Location: SOUTH WEST CORNER OF MOKELUMNE ST@ LILAC <br /> ODI,CA,952411 IST. <br /> ii <br /> I <br /> I <br /> In compliance with your request of 05/02/2006 ,permission is hereby granted to do work in County right of way <br /> as shown on attached application and su sect to a erms,con i tons and restrictions written below or printed as general or special provisions <br /> on any part of this form. See reverse side and attached sheet,if any. <br /> Trench excavations for service connections will not be permitted within ten feet(10')of pavement centerline unless otherwise approved by the <br /> Director. Surface of trench patches shall match in kind and be smooth and even with that of abutting surface. Special attention shall be given to <br /> depth of utilities through roadside area in anticipation of future drainage facilities,road profile and/or frontage development. All underground <br /> utility facilities are to be established and accurately dimensioned on sketches from surveyed centerline of road right of way,not from right of way <br /> (border)lines. <br /> AP¢a e t blie UJorks,Field Inspection Section shall receive a notice at least forty-eight hours,prior to'beginnin any work within the <br /> tght ofva} All work performed under this permit shall conform to the rules and regulations pertaining to safety established by the <br /> C if <br /> a'Division of Industrial Safety and Cal-OSHA. <br /> The jobsite shall be kept in a safe condition at all times by the daily removal of any excess dirt or debris which might be a hazard to either <br /> pedestrian or automobile traffic. All necessary traffic convenience and warning devices and personnel shall be provided,placed and maintained <br /> by and at the sole expense of the Permittee in accordance with the latest edition of the CALTRANS Manual of Traffic Control. <br /> After completion of the work permitted herein.,all debris,lumber,barricades,or any excess material shall be removed and the jobsite left in a <br /> neat workmanlike manner ly following completion of construction.permitted herein,Permittee shall fill out and mail notice of <br /> npletipri;providedaby. ran o ,", <br /> Special Instructions: ******SEE ATTACHED FOR SPECIAL CONDITIONS FOR ENCROACHMENT PERMIT****** <br /> II <br /> THOMAS R. FLINN, Director <br /> Est. Permit Fee: 1$218.45 Department of Public Works <br /> FORMS: SS/WW,R-29 By <br /> WHITE -Permittee Permit Section <br /> GOLDENROD -PWD Central File <br /> YELLOW -Field Inspection PW 27 <br /> PINK -Permit Section <br /> Access\Permits\Forms\Encroachment Permit Revised 07/1000 <br />