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1810 East Hazelton Avenue | Stockton, California 95205 | T 209 468 3000 | F 209 468 2999 <br />Follow us on Facebook @ PublicWorksSJC Visit our website: www.sjgov.org/pubworks <br />Department of Public Works <br />Kris Balaji, Director of Public Works <br />Fritz Buchman, Deputy Director/Development <br />Jim Stone, Deputy Director/Operations <br />Najee Zarif, Interim Deputy Director/Engineering <br />Kristi Rhea, Manager of Strategic Initiatives <br /> <br />Acknowledgement of Monument Preservation <br />I, _________________________, a duly Licensed Land Surveyor or a Professional Engineer (Please print) <br />authorized to perform Land Surveying in the State of California, Registration No.____________, <br />hereby acknowledge and accept all responsibility for the monument preservation as required <br />per Section 8771(a-f) of the Business and Professions Code within the bounds of the <br />construction activity permitted by San Joaquin County Permit No._____________. <br />I further acknowledge that I am hereby responsible for the Acknowledgement of Monument <br />Preservation prior to final acceptance of the construction activity. <br />_____________________________ <br />Signature Seal <br />_____________________________ <br />Date <br />PS-MONUMENT PRESERVATION <br /> <br />Kaiser I. Shahbaz <br />8599 <br />6/02/2022 <br />SEE ATTACHED 13-PM-28 MARKED IN RED AS REFERENCE TO THIS FORM <br />Pre-Construction <br />2974 N. WILCOX RD - ENCROACHMENT PERMIT