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r STATE OF CALIFORNIA•DEPARTMENT OF TRANSPORTATION <br /> • ENCROACHMENT PERMIT <br /> TR-0120(REV.2198) Permll Na <br /> 7013.6UE-0031 <br /> OktfCdRt m <br /> In compliance with(Check one): 10-VAR-VAR-VAR <br /> ® Your app"c"on of JANUARY 14 2013 <br /> Dote <br /> ❑ Uti ly Notice No. of JANUARY 18, 2013 <br /> Fee Pa <br /> C] ll <br /> Agreement No. of $ <br /> $ 820 <br /> Perfamanee Bond Amount{1) Payment Bond Amount{2) <br /> ❑ <br /> RN Contract No. Of $ $ <br /> Bond Company <br /> Band Number(1) <br /> Tb6mTO: Number(2) <br /> COMCAST <br /> BLAKE BRUHN <br /> 3055 COMCAST PLACE <br /> LIVERMORE,CA 94551 <br /> ATTN: ANDREW PECK <br /> TEL.: (650) 670-0530 <br /> I <br /> , <br /> and subject to the following,PERMISSION IS HEREBY GRANTED to: PERMITTEE <br /> Perform routine and emergency maintenance on Petmittee's facilities within various State <br /> Highway right of ways on all conventional State highways in District 10 Counties. Permittee <br /> shall be allowed to install, maintain, remove,repair or replace aerial service connections, except <br /> over the traveled way or on structures. All work shall be done in accordance with the State <br /> Standard Specifications. A copy of this permit shall be placed in all vehicles involved in doing <br /> this work. Permittee shall notify the State Representative of the area before doing any work <br /> under this permit. This permit shall be renewed before the expiration date. <br /> The following attadtments are also included as part of this permit <br /> (Check applicable): an addition to fee,the permittee will be billed <br /> actual costs for. <br /> ® Yes ❑ No General Provisions <br /> ❑ Yes ® No Utility Maintenance Provisions ® Yes E] No Review <br /> ® Yes ❑ No spedal Provisions T ® Yes E] No Inspection <br /> ❑ Yes ® No A Cal-OSHA permit required prior to begnning work; ® Yes C] No Field Work <br /> # (if any Caltrans effort expended) <br /> Yes No The Information in the environmental documentation has been reviewed and Is considered prior to approval of this <br /> permit. <br /> This permit is void unless the work Is complete before DECEMBER 31,2014. <br /> This Permit is to be strictly constnred and no other work other than specifically mentioned is hereby au*Mzad. <br /> No project work shag be commenced until all other n errnIts and environmental clearances have been obtained. <br /> Original-Permittee APPROVED: <br /> I-File <br /> 2 ea.—All Field Inspectors <br /> I-Maintenance CARRIE BOWEN.Distr1ct Director <br /> I--PIO BY: <br /> 1-1g-Zo�3 <br /> Betty Tamae NELSON MAGSAYO, strict Permit En sneer <br />