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SANJOAQUIN <br />' COUNTY-- <br />,,:• Greatness grows here. <br />a <br />working far YOU <br />Department of Public Works <br />Fritz Buchman, Director <br />Alex Chetley, Deputy Director— Development <br />Kristl Rhea, Deputy Director -Administration <br />David Tolliver, Deputy Director - Operations <br />Najee Zarif, Deputy Director - Engineering <br />Acknowledgement of Monument Preservation <br />70228-5340614 <br />13577 UNION RD <br />MANTECA, CA,95336 <br />Joseph F Dominick III <br />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. 5110 <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 />construction activity permitted by San Joaquin County Permit No. PS -2303434 <br />further acknowledge that I am hereby responsible for the Acknowledgement of Monument <br />Preservation prior to final acceptance of the construction activity. <br />J1NU S <br />Si ure Seal' Q`r F D� <br />Date LS5110 <br />PS -MONUMENT PRESERVATION <br />Survey Monuments Found — Post Acknowledgment/ <br />Corner Record to follow. <br />K No Survey Monument Found. <br />1810 East Hazelton Avenue I Stockton, California 95205 j T 209 468 3000 1 F 209 468 2999 <br />F1 Follow us on Facebook @ PublicWorksSJC Visit our website: www.sjgov.org/pubworks <br />