Laserfiche WebLink
City of Public Works Department <br /> USA 11"19�� 390 Towne Centre Drive <br /> Lathrop Ca,95330 <br /> Main (209)941-7430 <br /> Fax (209)941-7449 <br /> Permit No. 2012-17 <br /> ENCROACHMENT PERMIT <br /> Applicant Information: <br /> Applicant Name: Advanced GeoEnvironmental Date: October 11,2012 <br /> Mailing address: 837 Shaw Road City: Stockton, CA Zip: 95215 <br /> Encroachment Location: 15615 South 7'h Street/Langston's Market <br /> Contractor Information: <br /> Contractor: At-Well Abandonment Construction Manager: Brian Millman <br /> Address: 9245 Beatty Drive, Suite A Contractor Phone# : (209)482-8556 <br /> City: Sacramento, CA_Zip:-95826_ License No.: 848359 <br /> Bond Required Yes No <br /> AMOUNT CHECK/BOND# Release of Bond Approved By: <br /> Two(2) 24-HOUR CONTACTS - NAME & PHONE NO: Brian Millman (209)482-8556 <br /> (MANDATOR)) <br /> Robert Marty (209)969-3239 <br /> PERMISSION IS HEREBY GRANTED TO: <br /> Destroy for(4)groundwater monitoring wells by over-drilling the wells to their total depths using a hollow-stem <br /> auger limited access drilling rig. Wells MW-1 and MW-2 are 4-inch diameter wells, and wells MW-7& . IV1 8 are 2- <br /> inch diameter wells. Compliance with San Joaquin County Department of Health is required.All work to abandon <br /> well MW-7 shall be performed from street ROW No vehicular access to Skate Park is permitted. <br /> CONTRACTOR MUST CONTACT PW INSPECTOR AT LEAST 24 HOURS PRIOR TO <br /> CONSTRUCTION AT(209)992-0701. <br /> To do work in the City right of way as shown on attached application you are subject to all the provisions on any part of this form, <br /> and or attached hereto. <br /> Your attention is directed to the general provisions attached to this permit.This permit is to be strictly adhered to <br /> and no work other that specifically mentioned above is hereby authorized. <br /> This permit shall be void unless the work hereunder contemplated shall have been completed by: January 11.2013. <br /> Accepting this permit or starting work hereunder shall constitute acceptance and agreement to all conditions and requirements of <br /> this permit. <br /> Director of Public Works: Signature of Applicant: <br /> GLENN GEBHARDT <br /> Office Copy—White Inspectors Copy—Yellow Applicant's Copy - Blue <br />