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����UU���~�" ���� ��^��� K��^���UK��� E.P. m»' ^ <br /> ~-. ~°" ^"a ~v���n�w��oxn <br /> DEPARTMENT OF PUBLIC WORKS <br /> po BOX `v`v 1810 E.HAZELTON AVENUE (Date Issued) <br /> (209)468-30M <br /> HENRY M. '/nArA ENCROACHMENT PERMIT <br /> (Expiration Date) <br /> To: <br /> Encroachment type: <br /> Location: w/p <br /> In compliance with Your request of <br /> granted to do work in County right of ^ l9 y� , permission is hereby <br /> all the terms, conditions and restrictions <br /> �" �u»wo on attached apPlic°+ion and subject to <br /> i»on writteo below or printed as general or special <br /> Provisions on any part of this form <br /> ' S=e reverse side and attached sheet, if any. <br /> of pane u <br /> Trench excavations for service connections will not be Permitted within ten feet (l0' } <br /> shall match in kind �`d '--na~o~^^"^°^^e approved by the Dizeotoz' Surface of trench patch es <br /> shall be given to de-'b ~� u" °�" uooeneo *1tb �ba� »f abutting our�ace' S�eoial atteoti <br /> age facilities, road profile <br /> ~� `i^icithrough hr»u9b roadoide area in anticipation � f � u» <br /> ties are �o be'established <br /> e aud/oz frontage development. All underground m�il« «re drain- <br /> of road right of wa �soe� aod accurately dimensioned oo oke�ches fzom « ity faoili- <br /> y' o«t from zigb� of way (border) lines. sorve�ed centerline <br /> The Department of Public Works, Field Inspection Section shall i <br /> forty-eight (48) hours prior to beginning any work within the reoe »e a notice a� <br /> least <br /> zu per�ormed under �biu permit shall conform e �ouoty right »� �ay. <br /> iog to safety established by the California. Divrules and regulations pertain' <br /> All woorm �o the <br /> zs�oo o� Ioduatrial Safety and Cal-OSHA. <br /> The jobsite shall be kept in ana�. <br />| e o»oditi»n at all times by the daily removal of <br /> any e�neon dirt or debris which might be a hazard to either pedestrian or automobile <br /> convenience and warning devices and personnel shall�ra��ic' all necessary traffic be <br /> o by and at the sole expense of the Permittee in accord <br /> provided, placed and maintained <br /> �a�zaam3 Manual of Traffic Control. auc* <br /> with the late�� edition of the <br /> After completion of the work permitted herein, all debris, lundber, bazrio d <br /> Imm d� ---eshall" =�� oc removed and the jobai�e le�� i ' a es, or any <br /> excess <br /> �e �a�ely �»llowiog completion of cnoatzontioo permit <br /> o a oeat *»rbmaolike manner. <br /> »u and mail notice of completion provided by Grantor. <br /> ce� �ereiu' Permittee shall fill <br /> uat' Permit Fee: <br /> FORMS: HENRY M. UIRAT&� Director <br /> Department of Public Works <br /> � <br /> wezcE - Permittee <br /> � <br /> GoLoEmaoo - pwo Central File B '. <br /> roLLow - Field Inspection permit Section ---- --` <br /> ezmK - Permit Section <br /> PW 17 �� <br />