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City of Lodi Public Works Department 531 S CHURCH STREET Permit Address TCE/PCE PROJECT IWORQ Systems Inc. Page 1 of 1 ENCROACHMENT PERMIT Date: 11/9/2017 Applicants Name WATER ROCK CONSTRUCTION Address 2363 MARINER SQUARE DRIVE ALAMEDA CA Phone 510-671-2095 Cellular Starting date 9/28/2017 Completion Date 2/28/2018 License No Phone Contractor Address Cellular Pursuant to the provisions of the Lodi Municipal Code, the undersigned applies for permission to excavate,construct,and/or otherwise encroach on City Street Right-of-Way or Easement by performing the following: NOTIFY USA (800) 227- 2600 48 HOURS PRIOR TO ANY EXCAVATION. MARKINGS MUST BE REMOVED UPON COMPLETION OF WORK. Work Description: The work consists of **EXTENDED PERMIT COMPLETION DAY TO FEBRUARY 28, 2018. installation/construction of approx. 65' extraction well in the parking lane along the west side of 531 South Church Street @ Tokay Street. Parking/bike lane to be closed for approx. six (6) weeks. Removal and replacement of approx. 75 lineal feet of 5' sidewalk as per attached plan. ALL WORK TO BE COMPLETED AS PER CITY OF LODI STANDARD PLANS AND DESIGN STANDARDS. "Sidewalk Closed" signs at work site; "Sidewalk Closed Ahead" signs at nearest crosswalks; barricades or construction tape at work site; no storage in public right-of-way.Backfill shall be per Std Plan No. 506; asphalt concrete replacement shall be existing plus 1 inch; minimum of 3 inches AC.; match finish grades. Landscaped and turf areas to be returned to a like or better condition. Applicant responsible for replacement of damaged plantings and sprinkler systems.No open excavations except at time of work; barricades required; traffic control per Caltrans Traffic Control Manual, current issue; one way traffic shall require flaggers.Access to driveways and intersecting streets to be maintained; proper notification of residents and proprietors required where applicable ALL CONDITIONS/DOCUMENTS ATTACHED ARE A PART OF THIS PERMIT. CONTACT THE PUBLIC WORKS DEPARTMENT (209-333-6706) 24 HOURS PRIOR TO START OF WORK AND FOR FINAL INSPECTION. Permit void if work not started within 6 months of permit date. 01 Licensed Contractor Required for this work Certificate of insurance in the permittee's name which names the "City of Lodi, its elected and appointed Boards, Commissions, Officers, Agents, Volunteers and Employees" as an Additional Named Insured is required for Comprehensive General Aggregate per occurance and Automobile Liability Insurance in an amount determined by Risk Mgmt. Primary and Non-contributory as required. The undersigned does hereby agree to insure, indemnify and save the City of Lodi free and harmless from any liablity as set forth in an attached City of Lodi Insurance Requirements and in accordance with the provisions of Sec. 12.04.040 of the Lodi Municipal code. Permittee is specifically aware of Sec. 12.04.290 thereof relating to the relocation or removal of said encroachment if future construction requires such relocation. If the work for which this encroachment permit has been issued has not been completed by the City Of Lodi shall have the right to complete the work, and to file a Cause of Action to recoup the City's Expenses in completing the work and for all other costs and fees in accordance with the provisions of Sec, 12,04,120 of the Lodi Municipal Code. Signed: REFER TO APPLICATION Required Improvement Security Certification of Insurance 1 This permit is granted subject to all provisions of Chapter 12.04 of the Lodi Municipal Code and to It general provisions and applicable special provisions as shown on the attached Permit Approved: CITY ByDen i se Wi ma n III Public Above Ground Date 11/9/2017 [21 Public Underground 0 Other Permit No. 20172174 Fee: 0.00 0 Paid Comp. Gen. Policy No Exp Inspected Date Completed Date http://www.iworq.net/iworq/permit/popupPermitEditLetterPrint.asp?sid=MKEPRPIPNRB... 1 1 /9/2017