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3500 - Local Oversight Program
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PR0545347
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Last modified
2/6/2020 3:55:53 PM
Creation date
2/6/2020 3:15:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545347
PE
3528
FACILITY_ID
FA0003685
FACILITY_NAME
DBA CIRCLEK, REFUEL PETROLEUM INC.
STREET_NUMBER
419
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21938610
CURRENT_STATUS
02
SITE_LOCATION
419 S MAIN ST
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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ECA, PUBLIC WORKS Dlw IRTMENT <br /> Manteca= 1001 W. Center Street N2 5193 <br /> Manteca, CA 95337 <br /> ENCROACHMENT PERMIT <br /> Contractor: eoNpo2 rAp-n4 lAz. Project Name: 36yfZ AA.)TSCA <br /> iv sru, <br /> License No: es'? e5'4q6+ Project Location: -,11,7 _'S. Ai.0 5TP-& - <br /> Address: lssr /-nAuy- k/cs7 62,xc44 .5wrt L cIGIhc) AtiD Wf-TMoR.0 STQELT, 1NAQrZrA <br /> Date Issued: I o - 8 - 03 <br /> Pho <br /> License Verified [ assurance 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 /> SL/A440&j f3°Rf-wo`Es f,e di 61AIDAIA—L2 1A'1/GSr1C-4n0.CJ. fve fA144ZO4v 1301214)t- :5 ,deo POSS. <br /> o,ve- DEEP CP T- )30RIA;6- P,414 CTwo YIDZ 13Y f/D(,. SdF-1A-)6-5 ). 6.,eiNocc5 I-,-t- i3c 6�,rzo <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, phone 825-2309 or 239-8460, at least 48 hours prior to construction. <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 permit shall be void unless the work herein contemplated shall have been completed by <br /> dC710/34& -?Y. Xoo,3 , 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 /> rmittee or Authori4 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 /> J 6 J PRINTING(209)279341E <br />
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