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SCITY OF <br /> ENCROACHMENT PERMIT Permit Number <br /> STOCKTON ON PUBLIC RIGHT-OF-WAY <br /> WSP USA 1/02/24 APPROVED: BY THE DEPARTMENT DIRECTOR <br /> Applicant: Date: <br /> z Subject to the General Provisions and Special Conditions,and all work must <br /> 1281 E. Alluvial Ave. Suite 101 O conform to the project's approved Storm Water Pollution Prevention Plan o <br /> Address: N the most current version of the City of Stockton Storm Water <br /> Fresno CA 93720 J Pollution Prevention Maintenance Staff Guide,whichever is applicable. <br /> City: State: ZIP: Q <br /> 559-577-2369 daniel.mccuan@wsp.com LL By: Date: <br /> Phone: E-mail: O <br /> Associated Permit(s): Expiration: <br /> WORK LOCATION: 198 East Poplar St. PERMIT NOT VALID WITHOUT A <br /> Start Date: Feb 2024 Completion Date: March 2024 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 STARTOF WORK. <br /> and/or raised sidewalk,curb and gutter from score mark to score mark adjacent to the <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 /> WSP USA on behalf of UniFirst Corporation will supervise the drilling of a groundwater monitoring well to be <br /> installed between the sidewalk and curb on the south-east corner of Eden park, approximately 198 E. Poplar <br /> Show sketch or refer to attached Drawing Official Use Only <br /> Refer to attached drawing. Start date depends on permit <br /> approval and driller availability. Base Permit Fee $ <br /> Additional Footage Fee $ <br /> Misc. $ <br /> Misc. $ <br /> Misc. $ <br /> Total $ <br /> Special Conditions: <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 TOANY REQUIRED INSPECTIONS, AS IDENTIFIED ON THE REVERSE SIDE OF THIS Sin / <br /> PERMIT, PERMITTEE SHALL CALL INSPECTIONS AT(209)937.8381. <br /> READ GENERAL PROVISIONS ON THE REVERSE SIDE OF THIS PERMIT BEFORE Daniel T. McCuan <br /> SIGNING. Print <br />