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liRp Department of Public Works <br />SAN JOA 0 U I N Old vnb such..., mr.cror <br />iYeBEy A. YOU Al.a Ch.Uy, Deputy Dtredpt-Developmem <br />Raell Rhea, Deputy Dlredm- AOmimsuatron <br />NOW Me,.r, Deputy Dmpter-OpamO.ne <br />Nafaa Zeus, Deputy pmclu•-Fs9tneering <br />Acknowledgement of Monument Preservation <br />t1�Y.,Ay✓.S%iDJi <br />1, Al , a duly Licensed Land Surveyor or a Professional Engineer <br />(Please print) <br />authorized to perform Land Surveying in the Slate of California, Registration No. L % 73 <br />hereby acknowledge and accept all responsibility for the monument preservation as required <br />per Section 8771 (a-0 of the Business and Professions Code within the bounds of the <br />Eh [ r.1�c..i �e rwaF <br />construction activity permitted by San Joaquin County Permit No.(,(A�/�/�y�gJfP� <br />I further acknowledge that I am hereby responsible for the Acknowledgement of Mo u en Cont <br />Presentation prior to final acceptance of the construction activity. <br />q�yoJ✓+3 <br />-116-1 4A Signatureu�� Seal <br />9 U Ay Z3 <br />Dete <br />PSMONUMfNT PRESERVATMN <br />Survey Monuments Found —Post Acknowledgment/ <br />Corn r Record to follow. <br />No Survey Monument Found. <br />/vr/Z'7 /e/'Niale�'�iY/a/!i ✓AYea OA 9�za�zp?3, .(7i✓net0'7eOV✓ / <br />Any IOAVF. o" or'_ /JockL 2e.c �r 9'ao 'Go*J <br />/It"v- Wot[,eA el' lz V7 [-oz.gE /Zo. d" C.oc/[[-<tl�dr CA <br />1810 East Hazelton Avenue I Stockton, California 95205 1 T 209 468 3000 1 F 209 468 2999 <br />N Follow uson Facebook@ PublicWorksSJC Visit our websile: www.sjgov.org/pubworks <br />