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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date November 24, 2010 OFFICE USE ONLY <br /> To: San Joaquin County JOB# REF# <br /> Department of Public Works APN CR# <br /> ROSS ISLAND SAND & GRAVEL CO. EXP.DATE <br /> VALID �2 to TSO! Z 5 _ DRIVEWAYS: <br /> (APPk STREET Gc/jn Go✓c / <br /> AREA �_ QUAD AI <br /> P.O. Box 82249 <br /> �GHtHn¢ <br /> (MailTYPE <br /> ing Address) FORMS / AZ9 <br /> Portland, OR 97282-0249 NOTES <br /> (City,State,Zip Code) <br /> cell office <br /> ( 503 ) 314-3348 / (209 ) 933-0609 <br /> 0. (Ani Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> SEE ATTACHED DRAWINGS <br /> Trench cut Windmill Cove Road for the temporary installation of a <br /> 20" O.D. dredge discharge pipeline. rredging under authority of <br /> U.S. Army Corps of Engineers Contract No. W91238-09-D-0026 TO#2. <br /> Levee Encroachment permit already held from Reclamation District 684 <br /> (Lower Roberts Island) for the dredging placemnt of materials. <br /> Ross Island Sand & Gravel Co. - Randall H. Steed - (503 ) 314-3348 <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Wa on <br /> the across gf Windmill Cove Road <br /> approximately 930 linear feet Ea s t <br /> Of intersection w/ N. Holt Rd. Stockton,CA by performing the following work(descriptionofwork): <br /> Saw-cut road where previously patched from our previous dredging work. <br /> Excavate road base and common materials. Install HDPE pipe. Cover pipe <br /> per county specification for typical trench backfills. Gravel Patch <br /> for 1 day of dredging, then remove pipe, fill per spec and hot - patch <br /> Windmill Cove Road to prior condition. See also attached traffic <br /> Work will commence on or about Wedne sday Dec 1 , 2 010 p an. <br /> for approximately 2 hours eac p aap, <br /> I,the undersigned,certify that I am the owner of the respective property,or am qualified 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 /> November 24, 2010 <br /> Signature of Applicant-Title Randall H. Steed Date <br /> FWUMVWK"ASTER.PWNCROAOWEWPEfUTAPR"TMDM (o„m) Dredge Project Manager <br />