Laserfiche WebLink
STATE OF CALIFORNIA•DEPARTMENT OF TRANSPORTATION <br /> ENCROACHMENT PERMIT <br /> TR-0120(REV.2/98) Permit No. <br /> 1007-6SV 0568 <br /> Dist/Co/Rte/PM <br /> In compliance with (Check one): <br /> ® 10- STA-33-27.0 <br /> Your application of JUNE 4, 2007 <br /> Date <br /> ❑ Utility Notice No. of OCTOBER 10, 2007 <br /> Fee Paid Deposit <br /> ❑ Agreement No. of $492 <br /> Performance Bond Amount(1) Payment Bond Amount(2 <br /> ❑ RNV Contract No. of $ $ <br /> Bond Company <br /> TO: <br /> Bond Number(1) Bond Number(2) <br /> _ <br /> SACS <br /> 3800 WATT AVE.,SUITE210 <br /> SACRAMENTO, CA 95821 <br /> Attn : TOM HOPE <br /> 1 TEL : (916) 979-3747 <br /> 1 <br /> , <br /> and subject to the following,PERMISSION IS HEREBY GRANTED to: PERMITTEE <br /> Bore three sample borings to a depth of 40 below grade for water and soil samplings <br /> along State Route 33 at PM 27.0. Bore hole to be abandoned to State Standards <br /> immediately following collection of samples. <br /> In accordance with General Provision No. 6, SEVEN WORKING DAYS PRIOR to the <br /> start of this work, Permittee shall notify the State Representative RAHULLAH AFZAL, <br /> 908 N. Emerald Avenue, Modesto, CA 95351, (209) 576-6299. All work under this <br /> permit must meet with the approval of the State Representative. <br /> ' Failure on the Permittee's part to comply with any provision will be cause for revocation <br /> of this permit. <br /> The following attachments are also included as part of this permit In addition to fee,the permittee will be billed <br /> (Check applicable): actual costs for: <br /> ® Yes ❑ No General Provisions Review <br /> Yes No Utility Maintenance Provisions ® Yes ❑ NO <br /> F-1 ® ® Yes ❑ No inspection <br /> ® Yes ❑ No Special Provisions T ® Yes ❑ No Field Work <br /> F] Yes ® No A Cal-OSHA permit required prior to beginning work; <br /> # (If any Caltrans effort expended) <br /> ❑ Yes ® No The information in the environmental documentation has been reviewed and is considered prior to approval of this <br /> permit. <br /> This permit expires on or before APRIL 30,2008 <br /> This pennit is to be strictly construed and no other work other than specifically mentioned is hereby authorized_ <br /> No project work shall be commenced unfit all other necessary pe its and environmental clearances have been obtained. <br /> 1—Permittee APPROVED: <br /> 1 -File <br /> 1—R.AFZAL <br /> ' KOME AJISE, District Director <br /> By <br /> ' SwNELSON MAGSAYO, District Permit Engineer <br /> FM 91 1436 <br />