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COUNTY OF SAN JOAQUIN <br /> 4�1N DEPARTMENT OF PUBLIC WORKS <br /> 2 y P.O.BOX 1810-1810 HAZELTON AVENUE EP No: EP-07 270 SW <br /> t <br /> STOCKTON CALIFORNIA 95201 <br /> y < Date Issued: 09/04/2007 <br /> .: .. <br /> (209)468-3000 Expiration Date: 09/29/2007 <br /> c P FAX#(209)468-9324 - _ <br /> Job No: 11005 <br /> gC]FpRa <br /> ENCROACHMENT PERMIT UE/CR/PM NO: *NO FEE <br /> To: BUTTER TRACY HOSPITAL Encroachment Type: TEMPORARY ROAD CLOSURE <br /> - - - <br /> 1420 N.TRACY BLVD. Location: NAGLEE ROAD,CORRAL HOLLOW ROAD,LAMMERS <br /> — _ RD.,REEVES RD.,MIDDLE RD. AND BETHANY ROAD <br /> TRACY,CA. 95376 ON 09/29/2007 FROM 6:00 a.m. TO 12:00 p.m. (SEE <br /> - ATTACHED MAP) <br /> In compliance with your request of 06/12/2007 permission is hereby granted to do work in County right of way <br /> as shown on attached application and subject to all the terms.conditions 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 <br /> way(border)lines. <br /> The Department of Public Works,Field Inspection Section shall receive a notice at least forty-eight hours prior to beginning any work within the <br /> County right of way. All work performed under this permit shall conform to the rules and regulations pertaining to safety established by the <br /> California 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 /> pletion of construction permitted herein.. Permittee shall fill out and mail notice of <br /> neat workmanlike manner. Immediately following com <br /> completion provided by Grantor. <br /> Special Instructions: * NO FLEE ENCROACHMENT PERMIT FOR A NON-PROFIT ORGANIZATION. <br /> THOMAS R. FUNK, Director <br /> Department of Public Works <br /> Est. Permit Fee: $0.00 <br /> FORMS: SS/WW - - By <br /> WHITE Permittee Permit Section <br /> GOLDENROD PWD Central File <br /> YELLOW Field Inspeclion PW 27 <br /> PINK Permit Section <br /> Revised 07/2000 <br /> Access\Permits\Forms\Encroachment Permit <br />