Laserfiche WebLink
CITY F LOD1 C: ENCRO:IENT .-PUBLIC WORKS DEPARTMENT �� <br /> 221 W.PINE ST. 333.6706 <br /> CAL L SOX 3006 <br /> LQIDI, CALIFORNIA 95241-1910• <br /> 5 <br /> il. <br /> ' I <br /> Permit Address 20 <br /> t" Address ....._. _._. . <br /> Applicant's Name ADIIRNCE�1 �a11yX � <br /> t� l9E[4fAL, '"C18I�f �, March Ln., -Ste., A,. StOckt <br /> APR <br /> (awneriCr>rttractor) —_..- r <br /> Starting CJate Completion Date r , License No. panne_ <br /> Bob Marty Address...., Prion <br /> II for rmission to excavats,aoristructr arrdlor otnerwlse.enrrpueh on <br /> Pursuant to rhe provisions of the L*di Aiunicipat Code,the undersigned app ' Pe <br /> city Street sigtrl-ofway or easement by Performing the following work: <br /> NQTIF.Y USA{800) 642-24" 48 HOURS PRIOR TQ'ANY EXCAVATION- <br /> The Work consists of instal lation of. Sfiargln4_%ell_-in �N0,71:" <br /> any wi dirt-.p. / ttt5-._ _ _ ,, � ,� <br /> y. :.I: i 3. .,o <br /> Ba+tkfi li urry_to be 3" blalow finish grade then ackfi l ed .M1',l:F,�s'. , _ -f�i - <br /> f x'71 <br /> GOA <br /> - _bacM eta ;:1 3,v9=1327 4 <br /> I lef3 ...day__M&tCb__eXjSt, gradesGi AL <br /> lr5tmi Clos d" s gns.and barricades-_roguired at limits <br /> of alley at east and west entrance. at timeofwork. <br /> NpTIF1r CITE.. I <br /> .START OF iii RK. <br /> GOp�r Of_..r <br /> slujts of rmediation alctiw t#e _at- tot be <br />` <br /> forwarded to the Public Works Dept. <br /> Permit'void if work not started within 6.months of pefmtt date- (Specs FOF8ketCh) <br /> 0 Licensed Contractor required for this work. <br /> KX Certm6ste of instirance In the owner's name which names ttte City of Lodi as an Additional Named,irtsured for Com- <br /> prehensive General and Automobile insurance in the amount of$1,001],000 combined single limit is required- <br /> TI1e undersigned dotes hereby agree.to indemnlly and save the City of Loo free and harmless;frarn any liability,in aeeordance tarlth fire pravia#ona of Sec. <br /> i2_0A,()4Qgf the Lodi Mtinlcl pal Q940.Permittee is specifically aware of Sac 1$:04.290thereof reiating to the ralocatlon or removsi of:said encroachment it <br /> future construction squires such relocation. <br /> It the work for Which>his encrocchmani permit has been Issued has not been eornpleted by the City <br /> of W01,shall have the right to cflmplets the work,and 10 fl le a Cause of AGtigplcyrecoup the City's,4xpenses in completing the work and too all Curer voets <br /> and lees in aCCdrdancq winr•thm provisions of Sec.'12.W 1E@'DTVj'4 i Nlunici at Code. <br /> Elate. —$'fgned r <br /> G . <br /> lm vement Security Thia pe►mit fa granted subject to all prpviaipna of Chapter 12.04 of the Lodi <br /> R aired pro y _ <br /> � M rel 1 I Cada and to all general rovlslans and applicable apeeiai pravl , <br /> R.Bavid Bulett (insurance t, opo <br /> . .. .----.--•___-_-- suns as shown on the rawess8 side. , <br />' Certific'aw of Insuranta gC 4676-gr 911,21.95 p,armit Approved' TY OF LQDI <br /> Comp.Geri.Policy No. <br /> Automat' q y ._.____Exp... 9/12195 <br /> v Polio iVa. Rif <br /> t Referred to GILL MCMICKER _ .Date - CI publicAttvveGrotrncl Date--- <br /> '1 <br /> at <br /> li 333-6835 Date <br /> lnspected: -- 0. Publ€c Underground <br /> Cvrnpleted Cate 0 Private,to 4e marnieided or.rWloCBf6d'by owner 84 reQulred: <br /> isf;�f <br /> Revie�tred,. Date P Other permit h►o. <br /> 5180-500 white-In,,pKtoi Yeilori'Fle Pink-Peirniltee, Agral�arn9enPRrq,nq <br /> F, •d- ! :OOLO 956 6OZ ON 30V HOS NVOE ;=1 1 5661-51-5 <br />