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03/25/2004 16:53 209-94832 CAL ANS D10 PEIr a PAGE 02/07 <br /> STATE OF CALIFORNIA.DEPARTMENT OF TRANSPORTATION <br /> ENCROACHMENT PERMIT i <br /> TR-0120(FiEl/.2188) Pemi-ir hio. <br /> 100'4-6DP-0207 <br /> DistlS,alRte/pM <br /> In compliance with (Check one): <br /> ® Your application ofMARCH 16, 2004 1043)-12-16.43 <br /> Date — -• <br /> ❑ utility Notice No. - of MARCH 25,2004 <br /> !^eg F'nid �"' peppsit <br /> Agreement No. Of $ $328 <br /> Performance Bond Amount(1) Payment Bond Amount <br /> ❑ RM Contract Iia, — of $ $ <br /> Bend.^ompany " <br /> Band�umbor(1} Bond Number(2) <br /> TO: <br /> ADVANCED GEOENVIRONMENTAL, INC <br /> 837 SHAW ROAD <br /> STOCKTON, CA 95215 <br /> ATTN: DONNA SEXTON <br /> TEL : (209) 467-1006 <br /> I I <br /> PERMITTEE <br /> and subject to the following,PERMISSION IS HEREBY GRANTS to: <br /> To do work under Caltrans Encroachment Permit number 1004-6S V-0240 issuedlo the <br /> WJLLTAM GRAFFIGNA, JR. It is understood that the WILLIAM[ GRAFFIGNA, JI:. has <br /> famished a copy of said pertnit to Permittee. A copy f the Parent Permit shall be placed with <br /> this Permit in all vehicles involved in doing this work. <br /> In accordance with General Provision No. 6, TWO W13RKING DAYS PRIOR to the ataat of <br /> this work, Permittee shall notify the State Representati a MARCEL 11fE LA CRUZ, P.Q. Box <br /> 2048 Stockton, CA 95201, (209) 9483656, All woric under this permit must meet wil.h the <br /> approval of the State Representative. <br /> The following attachments are also included as part of this permit In additlon to fee,the perm ittme will be billed <br /> (Check applicable)- actual costs for: <br /> E Yes ❑ No General Provisions Yes ❑ No Review <br /> ❑ Yes ® Na Utility Maintenance Provisions <br /> Yes Na Special Provisions T �� �`� ❑ No Inspection <br /> ❑ �C� Yes ❑ No Field Work <br /> ❑ Yes ® No A Cal-OSHA permit required prior to beginning , <br /> # (7f any Caltrans efl`vl expended) <br /> Yes ® N p The information in the environmental documentatin has been reviewed a5J is considered prior to i rpproval of this <br /> rmit <br /> This permit is void unless the work is complete before IM ACCORDANCE WITH THE PAREIJT PERMITS, <br /> This permit is to be sfrictly construed and no other work other than specifically man'oned is hereby authorfxi.d. <br /> No pMjectwork shall be commancgq until all other nacw=ary Peits and envirol ental clearances have been obtained. <br /> 1 -Permittee APPROVED: <br /> 1-File <br /> 3-MARCEL OE LA CRUZ <br /> JULIE DUN ING, District Director(Actin ) <br /> BY: <br /> IXTI-YTAMAE Dis ' it Engineer <br /> FM 91 1436 <br />