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FIELD DOCUMENTS FILE 2
Environmental Health - Public
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3500 - Local Oversight Program
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PR0544686
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FIELD DOCUMENTS FILE 2
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Last modified
7/23/2019 11:18:00 AM
Creation date
7/23/2019 11:08:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
RECORD_ID
PR0544686
PE
3528
FACILITY_ID
FA0000916
FACILITY_NAME
7-ELEVEN INC #19976
STREET_NUMBER
1399
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21633034
CURRENT_STATUS
02
SITE_LOCATION
1399 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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'x'ECA ' PUBLIC WORKS DE ZTMENT <br /> Manteca`= 1001 W. Center Street N2 7414 <br /> � • . Manteca, CA 95337 <br /> ENCROACHMENT PERMIT <br /> Contractor: 5+&*t, (vn6uJA " '(M0WTAC Project Name: �'i/#1997(0 <br /> License No: 95 a 15 q S Project Location: _13R q A/04M NA6 6if& <br /> Address: 40 Il V 1 rr oad n5u, 00 N114kt , dA <br /> n hn "OVw U q5 70 Date Issued: - -P-q-/Y <br /> Phone: q 16- 39+0724 llbbij U Ukkpily,^g P <br /> ❑ License Verified (P Insurance Verified <br /> Pursuant to Section 12 of the City of Manteca Municipal Code and all the terms, conditions and restrictions <br /> written below or printed as general or special provisions on any part of this for, and/or attached hereto, <br /> PERMISSION IS HEREBY GRANTED TO: <br /> op'dwwor ntio,L-1-P yt k'yj' �o - up-- evxclud P66"4 <br /> (Attach Two Sets of Plans or Sketches, If Applicable) <br /> PLEASE READ THIS PERMIT CAREFULLY. KEEP IT AT THE WORK SITE. To arrange for an <br /> inspection, phoneme or?. , at least 48 hours prior to construction. <br /> 67(0 Z/ X23— 528 <br /> Your attention is directed to the general provisions printed on the back of this form. This permit is to be strictly <br /> construed and no work, other than that specifically mentioned above, is hereby authorized. <br /> This ermit shall be void unless the work herein contemplated shall have been completed by <br /> -1' Lc� .3P ,�o/y ) 20 <br /> Accepting this permit or starting work hereunder shall constitute acceptance and agreement to all the conditions <br /> and requirements of this permit. <br /> Signature of Permittee/Contractor Director of Public Works <br /> By: By: <br /> LO �� <br /> e qlota�'Wv � <br /> ttee or Autho ized Agent <br /> PERMIT NOT VALID UNLESS EXECUTED BY DIRECTOR OF PUBLIC WORKS OR HIS AGENT. <br /> WORK COMPLETED: <br /> Forms\Encroach.doc (Rev. 08/95) Date: By: <br /> vl►2�Dd-� C�S+1'1�1�i 01� p ivt" 4o &k_ 3 e�1Y.n�` �uSA, 111 11k bfR�c��(U r, �i nl(i)t�.4'f-ht r�j� <br /> �i 6J N ING(20)239-24tt <br />
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