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�.:.. <br /> CITY OF STPUBLIC 64210 <br /> DEPARTMENT OF PUBLIC WORKS <br /> ZO APPLICATION FOR ENCROACHMENT ON PUBLIC RIGHT-OF-WAY <br /> Settling Dry Cleani Defendaaate February 7, 19 7 <br /> Applicant's Name I Ca 946pg <br /> (Owner/Contractor) 510-652-4500 <br /> Address 1800 Powell St. 12th Floor, eryville 'Phone - <br /> J APPROVED: PUBLIC WORKS DIRECTOR <br /> Location of Proposed Work, etc. Ema yn Stree ° �prox. 100 feet north of <br /> the intersections,oflnnersitarIrr,and Lincoln Road'Gr �, <br /> �al FCi • SLI_ I�p1-7 <br /> Owner/Contractor Address 950 Howe Road Martinez, .CA 94553 B <br /> March 3-14- 1997 2• days later Permit Expiration <br /> Estimated Starting Dale Completion Dais <br /> 1 <br /> I or We) hereby apply for an encroachment permit to carry out the following work : Ith tellati'dn of CPS PIPP bori <br /> (soil borings.. from ground surface to 80 feet 2-inch diameter, backfilled 'C+ t <br /> .The above named applicant hereby requests permission to PEFtM1T E................... <br /> $ 128 00 <br /> Additil at Footage Fee......... -- <br /> Se or Tap Deposit .......... ..... -- <br /> TOTAL DEPOSIT......... $ 128 00 <br /> Building Permit No. <br /> Improvement Plan No. <br /> / Supplemental Conditions: <br /> P <br /> Show sketch above or reiar to drawing submitted <br /> IMPORTANT:Applicant hereby agrees to comply with all provisions of this permit as well as all applicable City ordinances, resolutions, <br /> standards and specifications currently in effect, and to pay to City its actual cost for removal and proper replacement of any item which <br /> does not meet above requirements. Failure to comply will be cause for revocation of permit. Applicant agrees to indemnify and hold <br /> the City harmless against any and all lopses,costs,or damages resulting from injury to persons,death of person or damage to property <br /> occuring at the site of or as a re df work to be performed under this permit. A certificate of insurance shall be submitted to the <br /> City Risk Mah&ggr 6ri6r io...begirifiirlg cbo5lWction. <br /> PERMITTEE SHALL CONTACT UNDERGROUND SERVICE ALERT(1-800,842-2444) TWO WORKING DAYS BEFORE BEGINNING <br /> WORK FOR LOCATION OF UNDERGROUND UTILITIES. <br /> PERMITTEE SHALL CALL(209)937-841124 HOURS PRIOR TO START OF WORK FOR A CONTROL NUMBER AND TO SCHEDULE <br /> INSPECTION. <br /> Read General Provisions on reverse side of this permit before signing — Note <br /> requirement of notifications and Inspections. <br /> Sigrmao"..\ \\ YJ__--_. Phan- Z\�\\q -` <br /> lelined lee <br /> 2nd-File "" ., "'' 8rd.'-Finance 4th-Utilily/Slreel <br /> *SDCDe Defined. in the First Final Concent Decree,Orderl ,Judgement and Reference to Special blaster, <br /> I an...l od r,. ♦be 0-1111 nn ynn...ry 1R lgg6t Carl-lrin TV. PArnaranh F. . • , <br />