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A01 Z6VD <br />Department of Public Works <br />SAN J O A Q U I N Kris Balajl, Director of Public Works <br />C O i� N l Y y�. Fritz Buchman, Deputy DirectoNDevelopment <br />Michael Selling, Deputy DirectorlEngineering <br />Wari foj tw YOU Jim Stone. Deputy Director/Operations <br />Kristi Rhea, Manager of Strategic Initiatives <br />Acknowledgement of Monument Preservation <br />1, SCOI(' LAtNVtnt-3 ?"he , a duly Licensed Land Surveyor or a Professional Engineer <br />(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. PS -2101719 <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 />�� �-�4 <br />ignature Seal <br />2a)21 -(2)A5-1:1 <br />Date <br />PS -MONUMENT PRESERVATION'S \ <br />cn �j <br />ATC'.Tog -4F01-AGV0 <br />q joo HoF4,ieiz, t�JE►.r.��-S-Rx.K 01-1 <br />1810 East Hazelton Avenue I Stockton, California 95205 1 T 209 468 3000 1 F 209 468 2999 <br />