Laserfiche WebLink
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 ighway ght-of-ay 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 />3/16/23 <br />Chevron Pipeline Company <br />2360 Buchanan Rd <br />Pittsburg, CA 94565 <br />(925) 309-0240 <br />tonylopez@chevron.com <br />See Attached <br />North Grantline Rd 100 <br />Chevron Pipe Line Company, construction contractor ARB Inc (ARB), will conduct Pipeline Integrity Management (PIM), maintenance and repairs to CPL’s <br />8-inch petroleum products pipeline located approximately 5 feet North of the west bound lanes of Grantline Road. ARB’s construction crew will use a backhoe <br />to excavate, locate, inspect, and make repairs to the pipeline. The excavation dimensions at the site will be approximately 12 feet in length with <br />an average width of 8 feet and an average depth of 3 to 6 feet. When necessary, the open excavation will be covered with steel plating. When the inspections <br />and repairs to the pipeline are complete, the excavation area will be back filled and compacted to the County standards. <br />August 14, 2023 15 <br />ugus, Thomas August Jr Digitally signed by ugus, Thomas August Jr <br />Date: 2023.03.16 14:45:37 -05'00'3/16/23