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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 2/11/22 <br />To: San Joaquin County <br />Department of Public Works <br />ARB /Sean Tanner <br />(Applicant Name) <br />1875 Loveridge Road <br />(Mailing Address) <br />Pittsburg, CA 94565 <br />(City, State, Zip Code) <br />(925) 499-0984 <br />(Area Code - Telephone Number) <br />stanner@prim.com <br />(Email Address) <br />may <br />JOB # <br />APN <br />EXP.DATE <br />VALID <br />STREETest <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />110005 REF # <br />CR # <br />4M 1t2022 TO 511312022DRIVEWAYS: <br />-7poni2d. <br />Manteca QUAD SW <br />hemp Roa oTC suf re <br />88f9VW, R-29, iiii Cut Policy <br />Special Conditions <br />See attached drawings for PG&E project ID -614G-1,2,5 D-1396 84018702 <br />3 sites all located on W Ripon Rd. Please see the details of the locations below as well as the site <br />specific traffic control plan and drawings. <br />Per the City's request - Revised Site 2 Traffic Control Plan requires a full road closure. This will be <br />day work M -Fri between the hours of 7AM - 6PM and the detour will be removed at the end of every <br />work day. The work for this site is tentatively scheduled for 4/11-5/13 depending upon an approved <br />permit prior to start date. See Attached Traffic Control Plan. <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the South side of vv Ripon Rd. approximately 1.5 Q feet/ @ mile East <br />of Manteca Rd. , by performing the following work (description of work): <br />This project is a gas transmission pipeline project to excavate, assess and repair a PG&E gas transmission pipeline. There are 3locations along W Ripon Rd. <br />Site 1 approximately .14 miles east of Manteca Rd. Site 5 approximately .47 miles east from site 1. <br />Site 2 approximately 1.45 miles further east of site 5. <br />Scope of work - excavate existing PG&E gas transmission pipeline. Asses the line for damage. Repair the line as needed. Backfill and restore the sites. <br />Work will commence on or after � for approximately 30 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 />Sean Tanner ogirrzur signed by Sean Tanner 2/28/22 <br />Oiaia 2022 0228 13 21.59 -98'99' <br />Signature of Applicant - Title <br />Date <br />