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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date OFFICE USE ONLY <br />To: San Joaquin County <br />JOB #REF # <br />Department of Public Works APN CR # <br />EXP. DATE <br />VALID TO DRIVEWAYS: <br />(Applicant Name)STREET * <br />AREA QUAD * <br />TYPE * <br />(Mailing Address)FORMS <br />NOTES <br />(City, State, Zip Code) <br />(Area Code - Telephone Number) <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on &ounty Kighway ULght-of-Zay on <br />the ______________ side of ___________________________________ approximately ____________ feet/mile _________ <br />of _______________________________________, ____________________, by performing the following work (description of work): <br />Work will commence on or after _____________________________________ for approximately ________________________ days. <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 />Signature of Applicant - Title Date <br />5/2/22 <br />PaleoWest, LLC <br />1870 Olympic Blvd., Suite 100, <br />Walnut Creek, California, 94596 <br />(918) 232-4312 <br />rthomas@paleowest.com <br />Proposed activity map included as attachment. <br />north and south Peltier Road 0.25 west <br />North Bender Road in the city of Lodi San Joaquin County, CA <br />Proposed ground disturbance associated with the archaeological investigations for the Peltier Road Bridge (Caltrans Bridge No. 29C-0037) over the Mokelumne River Replacement Project include <br />a combination of mechanical trenching and shovel test pits (STPs). A maximum of six trenches will be placed systematically at selected locations within the Mokelumne River floodplain beneath the <br />bridge near the proposed pile locations (see attached map). Trenches will be approximately 6 meters (m) (20 ft) long and will be excavated in 30-centimeter (cm) (12 inch [in]) levels to depths of at <br />least 1.5 m (5 ft) bgs. A total of 15 STPs will also be excavated near the proposed wall features, and where grading is proposed to occur in the County’s right-of-way and temporary construction <br />easements (see attached map). STPs will be excavated in 20-cm (8-in) levels to a maximum depth of 1 m (3.5 ft). All Trenches and STPs will be backfilled with the excavated soils and returned to grade. <br />5/23/22 5 <br />Roberta Thomas Digitally signed by Roberta Thomas <br />Date: 2022.05.02 16:41:10 -07'00'5/2/22