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1!v COUNTY OF SAN JOAQUIN <br /> o. o0 <br /> DEPARTMENT OF PUBLIC WORKS <br /> ? �Z <br /> P.O.BOX 1810-1810 HAZELTON AVENUE — <br /> t0 EP No: <br /> STOCKTON CALIFORNIA 95201 *P-06 37TSW <br /> • Date Issued: 11/15/2006 <br /> (209)468-3000 � <br /> FAX#(209)468-9324 Expiration Date: 11/19/2006 <br /> Job No: 11005 <br /> ENCROACHMENT PERMIT UE/CR/PMNO: L�K 3v� <br /> To: TEICHERT CONSTRUCTION Encroachment Type: IROAD CLOSURE"SIGNAGEONLY" <br /> 265 VAL DERVIN PKWY. i Location: ALONG GRANT LINE RD.FROM MOUNTAIN HOUSE <br /> STOCKTON,CA 95206 RD.TO HANSEN RD. <br /> In compliance withour request of <br /> Y 9 11/08/2006 permission is hereby granted to do work in County right of way <br /> as shown on attached application and su pec to t e erms,con t tons and restrictions written below or printed 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(10)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 <br /> way(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: 1.) PUT CLOSURE DATES ON THE SIGNAGE 2.) <br /> MOUNTAIN HOUSE COMMUNITY SERVICE SHALL USE COUNTY ROAD MAINTENANCE FOR ROAD <br /> CLOSURE NOTIFICATION PROCEDURE SO THAT ALL EMERGENCY SERVICES ARE INFORMED ABOUT <br /> THIE TWO DAY CLOSURE. <br /> THOMAS R. FLM, Director <br /> Est. Permit Fee: $115.00 Department of Public Works <br /> FORMS: SS/WW, R-29 By <br /> WHITE -Permittee <br /> Permit Section <br /> GOLDENROD -PWD Central File <br /> YELLOW -Field Inspection <br /> PINK -Permit Section PW 27 <br /> Access\Permits\Fortns\Encroachment Permit <br /> – – — -- Revised 07/2000 <br />