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COUNTY OF SAN JOAQUIN <br /> DEPARTMENT OF PUBLIC WORKS <br /> P.O. BOX 1810-1810 E.HAZELTON AVENUE Permit No: PS-1100784 <br /> V re STOCKTON,CALIFORNIA 95201 Date Issued:04/26/2011 <br /> Sl 'sj (209)468-3000 Exp. Date: 05/26/2011 <br /> FAX#(209)468-9324 Project No: PWPI 10005 <br /> Quad: NW <br /> ENCROACHMENT PERMIT <br /> To: HSA DEPT.OF AGING <br /> P.O. BOX 201056 <br /> STOCKTON,CA 95201 <br /> Encroachment Type: _ <br /> NO PARKING" <br /> WAIVER <br /> �R <br /> Location: <br /> W/S OF MICKE GROVE RD.@MICKE GROVE PARK-TEMP. WAIVER OF"NO PARKING" RESTRICTIONS THURS,MAY 26, <br /> 2011,TOOA.M.to 2:OOP.M <br /> In compliance with your request of 04/26/2011 ,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(Permit Inspections)at(209)953-7421 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 <br /> to the 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-Temporary "No Parking"Waiver on May 26,2011 from 7:00 A.M.to 2:00 P.M. <br /> FORMS: <br /> Est. Permit Fee: $0.00 <br /> THOMAS M. GAU, Interim Director <br /> De rtment of Public Works <br /> WHITE -Permitee /J <br /> GOLDENROD -PWD Central File <br /> YELLOW -Field Inspection By: <br /> PINK -Permit Section Z <br /> Pe t Section <br />