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ltr lal tnnr In:Ob ZUJ­348-1232 CALIPANS D10 PERMITS <br /> PAGE 02/04 <br /> STATE Of CALIFORNIA&DEPAR-MENT OF-TRANSPOfff ATION <br /> ENCROACHMENT PERMIT <br /> 1 TR-0120(REV.2195) pen"d N& <br /> OtatrC,orRtelPM ---= <br /> In compliance wdh(L-t-ieck one): 10-STA-33-27 0 <br /> Your apocatiom of OCTOBER 20, 2007 <br /> Date <br /> Utility Notice No. of NOVEMBER !9,2007 <br /> Fr ea Paid Deposli <br /> Agreement No, of $82 <br /> _P76r—famiance ScrO Amount(r) Paymem Scond Aminuml <br /> P_NV Contract No. Of <br /> Octad C'Ofopany <br /> ' ..�.--_...� Bond Num�ef(1) Bond Number(2) <br /> TO: <br /> RSi DRILLING <br /> 1 220 NORTH EAST STREET <br /> WOODLAND, CA 95776 <br /> Attir) DON WINGLEWICH <br /> TEL (537)668-2424 <br /> PERMiTTEE <br /> and sub)W. to the following,PERMISSION 15 HEREBY GRANTED to: <br /> To do work under Caltrans encroachment permit number 1007-6SV-0568 issued to <br /> SAIC. It is understood that SAIL has furnished a copy of said permit to Permittee. <br /> In accordance with Geneiral Provision No. 6, SEVEN WORKING DAYS PRIOR to the <br /> start of this work, Permittee shall notify the State Representative RAHULLAJH 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. - -- ----- n�adoltiw to�fee,the <br /> The follovving attachments are also induded as part of this permR permittee will be billed <br /> (Check applicable): actual COSM'dr. <br /> gYeS No General Provisions YeS No Review <br /> F-1 Yes No utility Maintenance Provisions I Yes No inspection <br /> Yes No special Provisions T Yes No Field WorX <br /> Yes Z No A CI-OSHA Perim required Drlor to heonnina work; <br /> (If any Caltrans effort expendod) <br /> =—Yes- No Theinforrmavan in the environmental documentation has been reviewed and is cons to approval of Ihis <br /> This permit expires on or before PER PARENT PF-RMrr. <br /> This perrnit Is to be strictly construed and no other work other than"afically mentioned is hereby aut-wrized. <br /> Aq protect work shall be cummer4ad until all othei necessary Pe a"onvlfwmentai clearances have i:iean obtainod <br /> EPAOP�XZ�VED" <br /> I-Fite <br /> I_R.AFZALC -ko, <br /> KOMd, Distr/t Dire <br /> _0e o <br /> volz�- E3Y qq�� <br /> MAGSAY0,District Permit Engineer <br /> FM 91 14,16 <br />