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ip COUNTY OF SAN JOAQUIN DEPARTMENT OF PUBLIC WORKS PeEE mdtNo: PS-2002010 P.O. BOX 1810.1810 E. HALTON AVENUE Date Issued: 07/14/2020STOCETON, CALIFORNIA 95201 Stan Date: 07/14/2020ENCROACHMENT PERMIT APPLICATION REQUIREMENTS:(209) 468-3000 Exp. Date: 09/012020 FAX N (209) 468-9324 Project No: PWP7130005 Acompleted San Joaquin County Encroachment Penult application signed and timed Application can be Quad: found on the Public Works website at: himr//www.s'nnv.ort/dena"mt/owk/rznnits ENCROACHMENT PERMIT • Application must include work schedule; dazes and all pertinent information. To: ELSIE 320 FLINT ST • A wmpleted "Survey Monument Preservation Form", which can be found on the Public Works RENO NV 99501 website at: himr//www nra/denammrnUnwk/mm�its Encroachment Tiste `^ f the Bore (up to 12 inch Die) Fom sets of anuelotraffic control pleas prepared m accordance with the latest edition UTC Californiaon Manuel on Uniform Traffic Control Devices (CA MU-fCD). The CA MUTCD can be Location: foundonlinear. hrm:' wwu dal bn?cn rrrfnr WS S WELTY RD 650' N/O HWY33 (II nc elderly In compliance writ f071d6020 , permission is hereby granted to dowork in County right- pwayasshownonanachol • Fom (ing in4) sent formation: improvement plans (11" zl7", if clearly legible, otherwise 24" x36') with the p you cell One following information: application and subject to all Ne terms, conditions and restrictive; wrinen below or printed as gencml or spatial provisions on anypart of ties forth. See reverse side andavachedshem, ifany. a. Site Plan (Vicinity Map) Trench "curadons frrservice wnnecdons will nothe permitted within can feet (101) of pavement centerline on]= otherwise approved by the Director. Surface ofi ench patches shall match in kind and be smooth and even with that ofabutdng sur!. Special attention shall be given Is. Right-of-way lines, centerline, edge ofpavement, curb, gutter and sidewalk and all to depth ofudlities through; roadside area in anticipation offinure drainage facilities, road profile and/or drainage development. All existing utilities labeled and dimensioned. underground utility facilities are to be established and accurately dimensioned on sketches from surveyed centelin t of road right ofway, or from right of my (border) lines. c. Type of work and location clearly identified. Most include dimensions relative to the Pero ttee shallall the Department of Public Works. Field Engineering Division (Permit Inspections) at (209)953.7421 at least right-aft-way, centerline, edge of pavement, etc. forty-eight hours prior to beginning any workwithin the County right ofway. Allwwkperfomadunderdl spermitshallcmfornm the odes and regulations penainingro safety established by the Calif is Unities oflndustrial Safety and Cal-OSHA d. Typical mess- sections. Thejobsite shall be kept in a safe condition at all times by the daily removal ofany tows; din or debris which might be a hazard to either e. Typical back-fill detail per the San Joaquin Cowry Public Works Standard R-29 (use San pedesman or automobile traffic. All necessmy traffic convenience and warming devices and personnel shall be provided, placed and Joaquin County Standard Specifications and Special Provisions as a guide located on the maintained by and at the role expense ofthe Pemdttee in accordance with die latest edition of the CALTRANS Manual of Trade Control. Public Works website). After completion of the work permitted herein, all debris, lumber. barricades, ashy excess material shall be removed add thejobshe left in a f Show/label City/County/State limit line near work area, where applicable. neat worlanardike manner. Immedlandyfallowingocmplown ofeompuetion permitted herein, Permuce shall fill out and mail notice of completion (seeattachedpasty ) providedby Grantor. g. North Arrow and Scale. 1"-20' Scale min. S trial Commenu: Track Control Per MUTCD Note: FORMS: ISSiVW. R.29 1 1. Complelesubmflfals shall be madedorhand-deliveredro the San Joaquin Cosmry Publfc )Vrks Esc Permit Fee: 5802.00 fce (atm.: encroachment permil counter). KRIS BALM, Director Department of Public Works GOLDEMOOD pwd uspccice gY aw �w -Fati-vmnuxmon Permit Section Pebmaryrot➢ Update