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y CITY OF L ODH FENCROACHMENT PUBLIC WORKS DEPARTMENT � 221 W.PINE ST. 339-6706 PERMIT CALL BOX 3006 LODI, CALIFORNIA 95241-1910 � J 1 -r. - - i' Ftan Address 47L i...L� s Name Icy;_ r 'sn r , rci_ ^t Kd 1cr r1 'y -a; "stCrtr - Addr•e s .. wj, " Tr__ t��"�:ar• ontractor) -- ._. _ `,• . !i- Starting ste =rr 'I — Completion pale '' "`' License No. ntractor ��_� - Address Phone . nttothe proosionsof the Lodi Municipal Code, theundersigned applies for peim ss on toexcavate,construct.and/orotharwise ch on City Street Rlght-of-Way or basement by performing the following work. NOTIFY USA (300) 642-1444 48 HOURS PRIOR TO ANY EXCAVATION. ki The work Consists of --r r .l?.. �_—I, ,,•nom 3 -,fir r _.r.�i. , i.. 1, -n.- r i monitoring i.1r rI% E , lP_113 i1� r)c-, TJ (s..1 ''<= ll�' 'l11 +1; _ TfdY !]ornitDlC+. `ee ?1 L3 Ly ` 1988 V %t11 5,q cot'�r »t:-1 't ca r; 11u. inum +t 'li v )ox p_C/Mlrj` i2 j s Lry a'c-L in ccn4cetc- uurrouldin � :rY'tdc,. L _ �• ._ :.�'��..�� •" .. t +4a1.d if work not started within 6 months of permit date. (5paca For Sketcht 1 t l 44[afi ltl duet, and mud to be controlled by Permittee or City has the right to ao the work anp bill Owner • Cortif�cate of insurance In the owner's name which names the City of Lodi as an Aldi;ionai teamed Insuriao •pt Compre- n. r�.,Cve Genoroa ani? A, •nobile insurance in the amount of $1.000,000 combined Single limit as tegvired. e undergi ned dof.) hereby . 0 to indemnify snot save the Ciiy of Lodi tree and harmless frorn any Nabi •ty in accoroarf s with the yvisiong of Sec 12,G4.040 of .e i-❑di Municipal rode. Permittee iS npecificaliy aware of Soo "2.04 290 thereof rk,ating to the relocation or " oval pf ;aid ennroachment if f�Aure Cor';trLCtigrt requires such relocation, i he cork for which this encrr ,nrtment permit hast Ge.en SSLued has not been c:crrpieteci try � the City Lodi shall have the r.gnt to camp!ete the work and to file a Cause of Action to recoup the City s axppri3es,r7 completing the work ano fpr otrier costs and fees in acccIrrs.irsce with the prpviSions of Sec 12;;a 120 of the Lou. Wn.clpai code te: 1 i �! ;�s — - - - --- � Signed: ,. F�redd This permit is granted subject to all provisions of Chlt;oter 1?.04 Improvement of the -odi Muntcipai Code and td ajl general provisions and _ dppllCab.e specral provisions as shown On the reverse Sir1e Insurance date __ Permit Approved: CITY OF LODI .rt Referred to �` Sy.d w _ Public Above Ground pateQate. Public Undergrqund ed. . ©ate Private, r0 be maintained or relocated by ownpras required, Uther Permit No. � a t 1,87 sod t a ' -in�ptcivr 7nrt•Pia 3rd-Pmirtte L4QI ARIrITlfJG CO.