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fp COUNTY OF SAN JOA UIN <br /> 1 DEPARTMENT OF PUBLIC WORKS <br /> � P.O. BOX 1810-1810 E. HAZELTON AVENUE Permit No: PS-1001181 <br /> STOCKTON.CALIFORNIA 95201 <br /> Date Issued: 06/10/2010 <br /> (209)468-3000 Exp. Date: 08/01/2010 <br /> FAX#(209)468-9324 Project No: PWP1 10005 <br /> Quad: LV <br /> To: HALEY CONTRACTING ENCROACHMENT PERMIT <br /> 4228 NEWTON RD. <br /> STOCKTON,CA 95205 <br /> Encroachment Type: <br /> Bell Hole <br /> Location: <br /> S/S OF DOUGLAS RD. 800' W/0 PACIFIC AVE. <br /> In compliance with your request of 06/10/2010,permission is hereby granted to do work in County right-of-way as shown on attached <br /> application and subject to all the terms, conditions and restrictions written below or printed as general or special provisions on any part of <br /> 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 <br /> the Director. Surface of trench patches shall match in kind and be smooth and even with that of abutting surface. Special attention shall <br /> be given to depth of utilities through roadside area in anticipation of future drainage facilities,road profile and/or frontage development. <br /> All underground utility facilities are to be established and accurately dimensioned on sketches from surveyed centerline of road right of <br /> way,or from right of way(border)lines. <br /> Permittee shall call the Department of'Public Works, Field Engineering Division at(209)953-7421 (Permits Inspections)at least <br /> forty-eight hours prior to beginning any work within the County right of way. All work performed under this permit shall conform to the <br /> rules and regulations pertaining to safety established by the 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 <br /> maintained 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 <br /> in a neat workmanlike manner. Immediately following completion of construction permitted herein, Permittee shall fill out and mail notice <br /> of completion (see attached post card)provided by Grantor. <br /> Special Comments: <br /> Traffic Control Per MUTCD****Contractor shall notify Utility Maintenance(468-3091)at least 24-hours in advance with the date <br /> and time of taps**"Contractor shall provide tap plugs to Utility Maintenance personnel upon request**** <br /> i <br /> FORMS: SSS/WW, R-29 <br /> Est. Permit Fee: $262.70 <br /> THOMAS R. FLINN, Director <br /> WHfI'1' -PcrmStcc Department of Public Works <br /> GOLDENROD -PWD Central File ; <br /> YELLOW -Field Inspection <br /> PINK _ ---— <br /> -Permit Secuor, ------ <br /> Pe it Section <br />