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E.P. No. <br />COUNTY OF SAN JOAQUIN 6_.:4--05 <br />DEPARTMENT OF PUBLIC WORKS (Date Issued) <br />PO BOX 1610 - 1610 E. HAZELTON AVENUE <br />STOCKTON-CALIFORNIA 95201 7 <br />(209) 466-3000 <br />HENRY M. HIRATA <br />ENCROACHMENT PERMIT (Expiration Date) <br />DIRECTOR <br />L <br />(Job No.) <br />To: Encroachment type lx"=' <br />5"))3 <br />Location: ;,. tssh? p.;ta,:eY `,Y. ,a� }"yRs:)110 P1.`Jfw'. <br />In compliance with your request of `{"'~4' 19 ' <br />_ permission is hereby <br />granted to do work in County right of way as shown on attached application and subject to <br />all the terms, conditions and restrictions written below or printed as general or special <br />provisions on any part of this form. See reverse side and attached sheet, if any. <br />Trench excavations for service connections will not be permitted within ten feet (10') <br />of pavement centerline unless otherwise approved :by the Director. Surface of trench patches <br />shall match in kind and be smooth and even with that of abutting surface. Special attent_i-on <br />shall be given to death of utilities through roadside area in anticipation of future drain- <br />age facilities, road profile and/or frontage development. All underground utility facili- <br />ties are to be established and accurately dimensioned on sketches from surveyed centerline <br />of road right of way, riot from right of way (border) lines. <br />The Department of Public Works, Field Inspection Section shall receive a notice at <br />least forty-eight (48) hours prior to beginning any work within the County right of way. <br />All work performed under this permit shall conform to the rules and regulations pertain- <br />ing to safety established by the California Division of Industrial Safety and Cal -OSHA. <br />The jobsite shall be kept in a safe condition at all times by the daily removal of <br />any excess dirt or debris which might be a hazard to either pedestrian or automobile <br />traffic. All necessary traffic convenience and warning devices and personnel shall be <br />provided, placed and maintained by and at the sole expense of the Permittee in accordance <br />with the latEst edition of the CALTRANS Manual of Traffic Control. <br />After completion of the work permitted herein, all debris, lumber, barricades, or any <br />excess material shall be removed and the jobsite :Left in a neat workmanlike manner-. <br />Immediately following completion of construction permitted herein, Permittee shall fill <br />out and mail notice of completion provided by Grantor. <br />syr r✓ <br />Est. Permit Fee: $ �.•.i/ <br />FORMS: <br />WHITE - Permittee <br />GOLDENROD - PWD Central File <br />YELLOW - Field Inspection <br />PINK - Permit Section <br />HENRY M. HIRATA, Director <br />Department of Public Works <br />By i <br />Permit Section <br />PW 27 <br />