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Environmental Health - Public
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2900 - Site Mitigation Program
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PR0517411
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Last modified
7/27/2020 12:51:53 PM
Creation date
7/27/2020 10:53:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0517411
PE
2950
FACILITY_ID
FA0013411
FACILITY_NAME
PAYLESS SHOE STORE
STREET_NUMBER
1160
Direction
W
STREET_NAME
YOSEMITE
City
MANTECA
Zip
95337
APN
21902033
CURRENT_STATUS
01
SITE_LOCATION
1160 W YOSEMITE
P_LOCATION
04
QC Status
Approved
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EHD - Public
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v r./ <br /> PUBLIC WORKS DEPARTMENT <br /> (DiManteca, <br /> 1001 W. Center Street N2 6948 <br /> CA 95337 <br /> ENCROACHMENT PERMIT <br /> Contractor: e�� Yl,' f O <br /> Project Name: rn e, 5,< ,// -51- '-- <br /> License No: /, 45 Ya'7 Project Location: 11,6 0 <br /> Address: I i(Y 5 ,�'Le< s; Dr /1' Ecr� <br /> Sr�r � 9 SY 74 Date Issued: `j-6/-c7-7 <br /> Phone: 7 0 7-r <br /> ,License Verified Insurance Verified <br /> Pursuant to Section 12 of the City of Manteca Municipal Code and all the terms, conditions and restrictions <br /> written below or printed as general or special provisions on any part of this for, and/or attached hereto, <br /> PERMISSION IJS HEREBY GRANTED TO: )) <br /> Dr'; // � vc So.l 4opl:•�,3 ! -� t.,srv'l' �oSen.:'t� .�41f . <br /> We !"�1"C� moo.�Cwf I~n/U/�L 6,1- IS' 200'7 <br /> (Attach Two Sets of Plans or Sketches, If Applicable) <br /> PLEASE READ THIS PERMIT CAREFULLY. KEEP IT AT THE WORK SITE. To arrange for an <br /> inspection, phone 825-2309 or 239-8460, at least 48 hours prior to construction. <br /> Your attention is directed to the general provisions printed on the back of this form. This permit is to be strictly <br /> construed and no work, other than that specifically mentioned above, is hereby authorized. <br /> This permit shall be void unless the work herein contemplated shall have been completed by <br /> De-kesel_ /S' , 20©-7. <br /> Accepting this permit or starting work hereunder shall constitute acceptance and agreement to all the conditions <br /> and requirements of this permit. <br /> Signature of Permittee/Contractor Director of Public Works <br /> By: By: <br /> Permittee or Authorized Agent <br /> PERMIT NOT VALID UNLESS EXECUTED BY DIRECTOR OF PUBLIC WORKS OR HIS AGENT. <br /> WORK COMPLETED: <br /> Forms\Enc roach.doc (Rev. 08/95) Date: By: <br /> -- <br /> J nJV FWIM ")23o-Me <br />
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