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To: HOLT REPAIR &MFG. <br />P.O. BOX 187 <br />HOLT, CA 95234 <br />COUNT' OF SAN JOAQUIN <br />DEPARTMENT OF PUBLIC WORKS <br />P.O. BOX 1810-1810 K 14AZELTON AVENUE <br />STOCKTON, CALIFORNIA 95201 <br />(209) 468-3000 <br />FAX 4 (209) 468-9324 <br />Encroachment T e: <br />Trench & Road Closure <br />Location: <br />BOTH SIDES OF MCDONALD ISLAND RD. @ BOULTON RD. <br />Permit No: PS -2001172 <br />Date Issued: 05/01/2020 <br />Start Date: 05/13/2020 <br />Exp. Date: 05/21/2020 <br />Project No: PWPlIO005 <br />Quad: SW <br />In compliance with your request <br />of 05/01/2020 ,permission is hereby granted to <br />do work in County right -of --way as shown <br />on attached <br />application and subject to all the <br />terms, conditions and restrictions written below <br />or printed as general or special provisions <br />on any part of this <br />form. See reverse side and attached <br />sheet, if any. <br />Trench excavations for service connections will not be permitted within ten feet (10') of pavement centerline unless otherwise approved by the <br />Director. Surface of trench patches shall match in kind and be smooth and even with that of abutting surface. Special attention shall be given <br />to depth of utilities through roadside area in anticipation of future drainage facilities, road profile and/or frontage development. All <br />underground utility facilities are to be established and accurately dimensioned on sketches from surveyed centerline of road right of way, or <br />from right of way (border) lines. <br />Permittee shall call the Department of Public Works, Field Engineering Division (Permit Inspectimrs) at (209)953-7421 at least <br />forty-eight hours prior to beginning any wmdc within the County right of way. All work performed under this permit shall conform to <br />the rules and regulations pertaining to safety established by the California Division of hrdustrial Safety and Cal -OSHA. <br />The jobsite shall be kept in a safe condition at all times by the daily removal of any excess dirt <br />or debris which might be a hazard to either <br />pedest, an or automobile traffic. All necessary traffic convenience and warning devices and personnel shall be provided, placed and <br />maintained by and at the sole expense of the Permittee in accordance with the latest edition of the CALTRANS Manual of Traffic Control. <br />After completion of the work permitt <br />ed herein, all debris, lumber, barricades, or any excess material shall be removed and thejobsite left in a <br />neat workmanlike manner. Immediately following completion of consttuction permitted herein, Permittee shall fill out and mail notice of <br />completion (see attached post card) provided by Grantor. <br />it <br />Comments: <br />cant to: 1) Trench and install new urigation pipe across McDonald Island Rd. per County R-29 Std. 2) Provide <br />It AB on both sides of Holt Rd. <br />Maintenance (County) to: 1) Provide, set-up, maintain and remove the Traffic Control Devices per MUTCD 2) Repave <br />>nald Island Rd. after installation of the new pipe. <br />FORMS: <br />SS/W W, R-29 <br />Est. Permit Fee: $350.00 <br />WHITE <br />-Permittee <br />GOLDENROD <br />-PWD Cenn'nl File <br />YELLOW <br />-Field Inspection <br />PINK <br />-Permit Section <br />r iJYL <br />KRIS BALAJI, Director <br />Department of Public Works <br />Permit Section <br />