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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date 11/19/2014 OFFICE USE ONLY <br /> To: San Joaquin County JOB# REF# <br /> Department of Public Works APN __ CR# <br /> EXP.DATE /d / /7 <br /> Zabih Zaca, City of Tracy, Dept of Development Services VALID 3 r t t 0 !U I DRIVEWAYS: <br /> (Applicant Name) STREET sm <br /> AREA ?,eR�y QUAD 5J <br /> 333 Civic Center Plaza TYPE Citi cAG 1e45.--'4,hICE44eA7r <br /> (Mailing Address) FORMS <br /> NOTES <br /> Tracy, CA 95376 <br /> (City,State,Zip Code) <br /> (209)831-6452 <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> See Attached Detailed Draft Plans (100%) <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the east side of City of Tracy limits, along 11 th Street :,apprexireatel7 f®et/miJe <br /> extending from the City/County limits to Cabe Road 1350'to the east by performing the following work(description of work): <br /> replacing the portion of the existing 11th Street East Tracy Overhead Bridge in County Right-of-Way with MSE retaining <br /> walls and approach fill. The work includes constructing a temporary detour south of 11th Street; constructing a new <br /> roadway structural section; placing a 2"AC overlay; constructing new sidewalks, raised median, driveways, dikes, <br /> access road, curbs and gutters; placing new street lights; placing new storm drain pipes and inlets, and replacing the <br /> south side sloped wall of the open WSID irrigation canal with a vertical retaining wall. <br /> Work will commence on or about.E>al +4__1 for approximately 2 1/2 years days. <br /> K0,rcln IJ 2X5 15 <br /> I,the undersigned,certify that I am the owner of the respective property,or am qualified to represent the owner and agree to do the <br /> work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br /> 12_01261y <br /> Signature of Applicant-Title Date <br /> MICENTRALSERVICESICLERICALWUB-SV.WKIMASTERPSIENCROACHMENTPERMITAPPLICATION.DOC (09113) <br />