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COUNTY OF SAN JOAQUIN <br /> p DEPARTMENT OF PUBLIC WORKS <br /> P.O.BOX 1810-1810 HAZELTON AVENUE <br /> 0< STOCKTON CALIFORNIA 95201 EP No: P-06 122LV <br /> (209)468-3000 Date Issued: 3/22/2006 <br /> gGiFo N`P FAX#(209)468-9324 Expiration Date: 7/01/2006 <br /> ENCROACHMENT PERMIT Job No:UE/CR/PM NO: 11005 <br /> To: OHN JORDAN � <br /> Encroachment Type: SIDEWALK REPAIR <br /> 13252 POLK WAY <br /> Location: �R�NDONPL <br /> L.APPROX.@ INTERSECTION OF <br /> STOCKTON,CA.95219 POLK WAY <br /> In compliance witho <br /> y ur request of I 03/22/2006 —� ,permission is hereby <br /> as shown on attached application and su 3ec o a e terms,con tfion—s an—Jd restrictions written b I or print d as general or special provisions <br /> 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(101)of pavement centerline unless otherwise approved by the <br /> Director. Surface of trench patches shall match in kind and be smooth and even with that of abutting surface. Special attention shall be given to <br /> depth of utilities through roadside area in anticipation of future drainage facilities,road profile and/or frontage development. All underground <br /> utility facilities are to be established and accurately dimensioned on sketches from surveyed centerline of road right of way,not from right of way <br /> (border)lines. <br /> The Department of Public Works,Field Inspection Section shall receive a notice at least forty-eight hours prior to beginning any work within the <br /> County right of way. All work performed under this permit shall conform to the rules and regulations pertaining to safety established by the <br /> 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 any excess dirt or debris which might be a hazard to either <br /> pedestrian or automobile traffic. All necessary traffic convenience and warning devices and personnel shall be provided,placed and maintained <br /> by and at the sole expense of the Permittee in accordance 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 excess material shall be removed and the jobsite left in a <br /> neat workmanlike manner. Immediately following completion of construction permitted herein,Permittee shall fill out and mail notice of <br /> completion provided by Grantor. <br /> Special Instructions: <br /> I j <br /> f <br /> THOMAS R. FLINN, Director <br /> Est. Permit Fee: $0.00 Department of Public Works <br /> FORMS: SS/WW,R-29 <br /> B <br /> WHITE Permittee <br /> GOLDENROD -PWD Central File Permit Section <br /> YELLOW -Field Inspection <br /> PINK -Permit Section PW 27 <br /> AccesslPermitsTormslEncroachment Permit <br /> Revised 07/2000 <br />