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FIELD DOCUMENTS FILE 1
Environmental Health - Public
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EHD Program Facility Records by Street Name
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D
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DR MARTIN LUTHER KING JR
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620
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3500 - Local Oversight Program
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PR0544216
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FIELD DOCUMENTS FILE 1
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Last modified
3/4/2019 6:06:56 PM
Creation date
3/4/2019 2:05:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 1
RECORD_ID
PR0544216
PE
3528
FACILITY_ID
FA0003738
FACILITY_NAME
CHARTER WAY SHELL*
STREET_NUMBER
620
Direction
W
STREET_NAME
DR MARTIN LUTHER KING JR
STREET_TYPE
BLVD
City
Stockton
Zip
95206
APN
16504007
CURRENT_STATUS
02
SITE_LOCATION
620 W DR MARTIN LUTHER KING JR BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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CITY OF STOCKTON u <br /> BLIC WORKS DEPARTMENT 6 9 7 9'> <br /> cNCROACHMENT ON PUBLIC RIGHT-OF-WAY v- <br /> }§;Date l17 ,, APPROVED: BY THE PUBLIC WORKS DIRECTOR <br /> Cit#** CUSTOt9f Stockton * ne Sy0y?_G�339 Subject to the General Provisions.and Special Conditions, <br /> * qnd all work must conform to the project's approved Storm <br /> _Zip Water Pollution Prevention Plan or the most current version <br /> "� of the City of Stockton Storm Water Pollution Prevention <br /> Batch ID: tfiJESUS 10/12/05 01 <br /> �(eceipt no: 17263 r Maintenance Staff Guide,whichever is applicable. <br /> Y Amount <br /> Tp Sv Description Ot ,A� Date 10—f2_495, <br /> ; � Y <br /> T PERMITS OE f'0 -ENCROACHI9EN npletion Date /0 OSS Permit Expiration Date l�riS-Of <br /> 0 $320.00 1.0 <br /> STREET 8 CURB FERMI 04630273240400 t to carry out the following work: <br /> EP 369799 CAMBRIA ENVIRON. CiA.1 q- v IV 4 �-✓� <br /> Tender detail <br /> CK Ref#: 1604 $320.00 <br /> Total tendered: $320.00 rz, L,L� 4-�,y+� — <br /> Total payment: $320.00 <br /> Trans date: 10/12/85 Time: 11:33:24 <br /> PH - 5PP1 <br /> BUSINESS HOURS: 9 Aft - NOON, 1 esponsible to �Q <br /> walk, curb and PERMIT FEE........................... $ 3 <br /> gutter irom score niaFn L, _m j— .., o the parcel; <br /> remove USA markings upon completion of the permitted work. Additional Footage Fee .......... $ � <br /> The above named applicant hereby requests permisslon to: ^ <br /> Sewer Tap Deposit.................. $ <br /> TOTAL DEPOSIT ...... $ <br /> Ay a&6c, Building Permit No. <br /> Improvement Plan No. <br /> S {�� Supplemental Conditions: <br /> )ERVAtIT NOT VAUD VATHOUT A <br /> CONTROL NU ER. <br /> '.ALL (209) 937-8366 TO REQUEST A CONTROL <br /> 41JIVBER NO LESS THAN 24 HOURS, BUT NOT IN <br /> EXCESS OF 72 HOURS PRIOR TO START OF WORK. <br /> :.ONTROL#_ 0I L ,...- f <br /> �f <br /> Show sketch above or refer to drawing submitted i / <br /> IMPORTANT: Applicant hereby agrees to comply with all provisions of this permit, as well as all applicable city ordinances, resolutions, <br /> Standards and Specifications currently in effect, and to pay to the City its actual cost for removal and proper replacement of any item which <br /> does not meet the above requirements. Failure to comply will be cause for revocation of this permit.Applicant agrees to indemnify and hold <br /> the City harmless against any and all losses,costs, or damages resulting from injury to persons, death of person or damage to property <br /> occurring at the site of, or as a result of,work to be performed under this permit.A certificate of insurance shall be submitted to the City Risk <br /> Manager prior to issuance of this permit. <br /> IF THE WORK DOES NOT COMMENCE WITHIN 72 HOURS OF THE ISSUANCE OF A CONTROL NUMBER,THE CONTROL NUMBER WILL <br /> BECOME INVALID AND THE PERMITTEE SHALL CALL FOR ANEW CONTROL NUMBER.(FOR CAPITAL IMPROVEMENT PROJECTS OR �— <br /> SUBDIVISION IMPROVEMENTS,PERMITTEE SHALL CONTACT THE ASSIGNED CITY PROJECT ENGINEER AT(209)937-8411 FOR SPECIFIC ` <br /> INSTRUCTIONS PRIOR TO THE BEGINNING OF ANY WORK.)PRIOR TO ANY REQUIRED INSPECTIONS,AS IDENTIFIED ON THE REVERSE /} <br /> SIDE OF THIS PERMIT,PERMITTEE SHALL CALL(209)937-8381. \J <br /> READ GENERAL PROVISIONS ON THE REVERSE SIDE OF THIS PERMIT BEFORE SIGNING. <br /> Signed- onegl(j '�(20 3331 <br /> 1St-Permittee (white) 2nd-Inspection (pink) 131d-File (yellow) 4th-Finance (white) <br />
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