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ENCROACHMENT PERMIT Permit Number <br /> CITY OF EP20-1862 <br /> STOCKTON ON PUBLIC RIGHT-OF-WAY <br /> Applicant: <br /> Ninyo & Moore Date: 11/12/2020 APPROVED: BY THE DEPARTMENT DIRECTOR <br /> Z Subject to the General Provisions and Special Conditions,and all work must <br /> Address: 2020 Challenger Drive O conform to the project's approved Storm Water Pollution Prevention Plan or <br /> LU <br /> Ln the most current version of the City of Stockton Storm Water <br /> � <br /> Pollution Prevention Maintenance Staff Guide,whichever is applicable. <br /> Alameda CA 94501 <br /> City: State: ZIP: u 11/19/20 <br /> 510-343-3000 jwilcox@ninyoandmoore.com LL By: 'ADate: <br /> Phone: E-mail: O 1/20/21 <br /> ssociated Permit(s): Expiration: <br /> WORK LOCATION: 180 East Weber Avenue, Stockton, California PERMIT NOT VALID WITHOUT A <br /> Start Date: 11/21/2020 Completion Date: 12/21/2020 CONTROL NUMBER <br /> CALL(209)937-8366 TO REQUEST A CONTROL NUMBER NO LESS <br /> ATTENTION:Applicant/Contractor-you are responsible to replace all broken,damaged, THAN 24 HOURS,BUT NOT IN EXCESS OF 72 HOURS PRIOR TO START <br /> and/or raised sidewalk,curb and gutter from score mark to score mark adjacent to the <br /> OF WORK. <br /> parcel;remove USA markings upon completion of the permitted work. <br /> CONTROL# <br /> I(or we)hereby apply for an Encroachment Permit to carry out the following work: <br /> Advance six borings within the target site to collect environmental soil and groundwater samples for <br /> laboratory testing. This permit encompasses approximately 4 days of work. <br /> Show sketch or refer to attached Drawing Official Use Only <br /> Site sketch attached, work locations include all marked Base Permit Fee $ 523.00 <br /> boring locations with the exception of boring B-6. <br /> Additional Footage Fee $ 100.00 <br /> Misc. CRS FEE $ 37.38 <br /> County permit required Misc. TECH FEE $ 46.73 <br /> Field meet is required prior tostart contact Misc. OT Inspection $ 275.00 <br /> Jaosn Ender Public Works Consurtcion Total $ 982.11 <br /> Supervisor at 209-639-1282 Special Conditions: <br /> All locations in the city ROW subject to CALL FOR CONTROL NUMBER <br /> Public Works Approval 209-937-8366 <br /> All weekend work is scheudled in a davance CALL FOR INSPECTION <br /> with Public Works Inspection 209-639-1282 <br /> RESTORE TO CITY STD. <br /> WORK HOURS 9AM-3PM <br /> IMPORTANT: Applicant hereby agrees to comply with all provisions of this permit, as well as all applicable city ordinances, resolutions, Standards and <br /> Specifications currently in effect, and to pay to the City its actual cost for removal and proper replacement of any item which does not meet the above <br /> requirements. Failure to comply will be cause for revocation of this permit. Applicant agrees to indemnify and hold the City harmless against any and <br /> all losses, costs, or damages resulting from injury to persons, death of person or damage to property occurring at the site of, or as a result of,work to be <br /> performed under this permit.A certificate of insurance shall be on file with the City Risk Manager prior to issuance of this permit. <br /> IF THE WORK DOES NOT COMMENCE WITHIN 72 HOURS OF THE ISSUANCE <br /> OF A CONTROL NUMBER, THE CONTROL NUMBER WILL BECOME INVALID <br /> AND THE PERMITTEE SHALL CALL FOR A NEW CONTROL NUMBER. PRIOR TO <br /> ANY REQUIRED INSPECTIONS,AS IDENTIFIED ON THE REVERSE SIDE OF THIS Sign <br /> PERMIT,PERMITTEE SHALL CALL INSPECTIONS AT(209)937.8381. <br /> READ GENERAL PROVISIONS ON THE REVERSE SIDE OF THIS PERMIT BEFO E Print Jackson Flangan <br /> SIGNING. <br />