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01103/2013 69:46 2094640195 CAL WATER PAGE 02/02 <br /> CO TY Of STOCKTON <br /> 094 Pustoc, <br /> AP LF, <br /> e n ,�,�y1.�� %4 d <br /> 3 �pP.i icartt's hlcne• � •^���v�`� ����.�.,D std � APPROVED'.i5,�°'TI`�i� �.0 <br /> (Owner/contractor (}� , Subject to the General Previsions 90dSq Gal Conditions,l�delress. f S� f. Phone�t r' � and MI work must conform to the project's approved S4arrn <br /> S4,ste i� :.r,�dip .''Jr Water Pollution Pmverr5w Plan air the most current version <br /> Cly of iho City at Stooldon 18=m Watsr,Poi@ an P'ravention <br /> Location of Proposed Work, etc. t�faiotert�noe tali C ido,vul�iche�►er is applicable, <br /> On-4 eA�, <br /> a ivner)Con'trae'tor'Address <br /> Estimated$tlsrting Fiat+ P pla�tfon Dae G "`��' Pewit E xpirkt on Data <br /> 1 (or We).h eby a for an l=rocraao-hroent Permit to carry out thift-frollo.ui g 111ra t. 4 <br /> 14) .7nn <br /> ,2(, 2 <br /> Y <br /> X E_N ON:A pp'l&cant/Cont>ractor—you are responsible to <br /> Wi <br /> replace ail broken,dama*gad,and/or raised side�walk,,curb and P'E=RARIT FEE.............................. $ .� <br /> gutter front score mark to score mark adjacent to the parcel; <br /> remove USA markings upon completion of the parmiti<ed work. AdOp al Footage Fee'..,,...... $ <br /> The abotm,named applicant hereby requests pe(tnl•F:tQn to <br /> Serer Trap Deposit................... � <br /> Building Permit No. <br /> ImpiroVement Plan No. <br /> su, plemctntsal CoPEPiffrNOn 'tions: <br /> T VAUD W' O <br /> L NUMBER.• <br /> CALL Poo) 937- Tt R%�tEST A TRW <br /> NUMBER l LESS TFWW 24 Fit T IN <br /> EXCMO <br /> F72H OURI S PPO r OMM <br /> Sfww sleeed:abavp tor refer to drn+►htg euhmhted <br /> ==VeG1fic*ti6ns <br /> plicarit hereby agrees to comply'with all provisions•qfr this permit,as well as all applicable cityf ordinances,resolutions, <br /> currently In effect„and to pay to the City its actt,tal cast for removal and proper replacement of any Item which <br /> does not meet the above requirements.Failure td comply-All be cause.for revocation of this permit Applicant agrees to Indemnify and 1iold <br /> the City harmiesa against any and all Imes,costs,.or•damages rasul4ng from injury to'persons,death of person or dimage to property <br /> occurring at the site of,or as a to—suit of,wrk o be erforrr�e under this permit.A certificate of insurance shall be submitted to the City Risk <br /> Manager prior to issuance of this permit. t <br /> 8F THE W0KK DdES koT CommENCIr w m7 E ISSUANCE OF-A MKTROL NUMBER,THE C*NTROL NUMBER WILL <br /> Bl-C -INVALID AND THE PF-R ilTTEE SHALL•CALL FOR A NEW CONM 7iL iViUMBEL�.(FORCAPITAL B�fiP'RD�FEMEB�tT PROJECTS OR <br /> SUBDIVISION ir4pRE1llEiilBEi'+ETS,PEAW11'T7E_E SHALL CONTACT THE ASSIGNED CITY PROJECT Ei+BOWEER AT( )937,8411 FOR SPaEOWIC <br /> NSTRUCTiONG PRIOR TO THE®EGiND IM8•EBF ANY WORK.)PRIOR TO ANY.REGY11RED INSPECTI NS,AS BDE=M'6"IFIM ON THE REVERSE <br /> SIEGE OF'l HIS PERMIT,PERW7EE SMALL CALL(209)8V-5391.': <br /> READ GENERAL P>; OIASiONS ON THE RMASE SIDE OF THIS PERMIT BEFORE SIGNING.. <br /> Signe d: Phone:' r <br />