Laserfiche WebLink
�.• LJPN 17 '55 05:E3PM FUGRO WEST ROSE`1ILLE P.3/3 <br /> CITY OF STOCKTON <br /> DEPARTMENT OF PUKIC WORKS <br /> AlPL TION FOR ENCROACHMENT ON VUM�IC RIGHT-0I-,WAY <br /> N° 630500 <br /> a�IpiimsrY� 1IQ+ ,_. �C DRIN L-* Ai.9 1 gr✓}-Ie)j <br /> APPRONI D- DIRECTOR OF PUR+LIC WOM <br /> L amier of ft"Mld wwk,ate <br /> 0wwmrJCanfr'ae'tW Addren a, Int ,• <br /> FHiI"ated Storting Date Completion 1W6 4— permit Ellpito}br bole <br /> I for We) hemby apply for an encroachment permit to eari;y our the f0c ing work: <br /> ft OtHM"Brand applicant hereby re"Lmsre perntiuien 14• PM40 FEE $ <br /> Additlanel Foamoe Fre. . y <br /> Sewer Top bepesit .............................._.. <br /> TCTAL OEAMY ........................ I rw <br /> Building Permit No. <br /> improvement Plan No. <br /> Supplemental Conditions: <br /> show sub mirfsd <br /> IMPORTANT.- Applicant hereby agrees to Comply with all provisions of this permit as well as all applicable City ordinances, <br /> resolutions, standards and apecifications currently in affect, and to poy to City its actual cost for remavol and proper replace- <br /> ment of any item which dans not meet above requirements. Failure to comply will be Cause for revocation of permit. Appli. <br /> cant agrees to indemnify and hold the City harmless against any and all leeres, costs, or damages resulting frons: injury to <br /> parsons, death of person or damage fn property occurring at the site of w as o result of work to be perfernvW uMer this <br /> permit, Certificate of inaurance will be presented by applicant upon request. <br /> Read tAowal pnwhdeitwt On mom side of Me permit before si"Mg. `Note reauinment of notifleurtions end ftwo colons. <br /> Permit Enghteerlinspeeftr <br /> 9444=0 0 <br /> FERIilII MstE1Atf,ftLW4 1 <br /> 24 MMs 1e a�Awf�0ulitriakrlrMM OFF <br /> �sF-�nrnal*rea �M..rr'1e aro—F,raBcr 4ti��/nl,tvlih.sr ��l�Far�rswnsnlif.n�nlp�li <br /> MD <br /> TO SCHEDULE 1NSPEMOR <br />