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�4u►k E.P. No. <br /> Cps <br /> y z< COUNTY OF SAN JOAQUIN ! _.r <br /> DEPARTMENT OF PUBLIC WORKS (Date Issued) <br /> P.O.80X 1810- 1810 E.HAZELTON AVENUE <br /> STOCKTON,CAUFORNIA 95201 <br /> 4 •....••�� 12091 488-3000 <br /> �►FpR <br /> HENRY M. HIRATA <br /> ENCROACHMENT PERMIT (Expiration Date) <br /> GMECTOII <br /> (Job No.) <br /> To: ] � Encroachment type: <br /> 9533t, Location: <br /> . <br /> In compliance with your request of 19` 7 , permission is her '-)y <br /> granted to do work in County right of way as shown on attached application and subject to <br /> all the terms, conditions and restrictions written below or printed as general or special <br /> provisions on any part of this form. See reverse side and attached sheet, if any. <br /> Trench excavations for service connections will not be permitted within ten feet (10') <br /> of pavement centerline unless otherwise approved by the Director. Surface of trench patches <br /> shall match in kind and be smooth and even with that of abutting surface. Special attention <br /> shall be given to depth of utilities through roadside area in anticipation of future drain- <br /> age facilities, road profile and/or frontage development. All underground utility facili- <br /> ties are to be established and accurately dimensioned on sketches from surveyed centerline <br /> of road right of way, not from right of way (border) lines. <br /> The Department of Public Works, Field Inspection Section shall receive a notice at <br /> least forty-eight (48) hours prior to beginning any work within the County right of way. <br /> All work performed under this permit shall conform to the rules and regulations pertain- <br /> ing to safety established by the California Division of Industrial Safety and Cal-OSHA. <br /> The jobsite shall be kept in a safe condition at all times by the daily removal of <br /> any excess dirt or debris which might be a hazard to either pedestrian or automobile <br /> traffic. All necessary traffic convenience and warning devices and personnel shall be <br /> provided, placed and maintained by and at the sole expense of the Permittee in accordance <br /> with the latest edition of the CALTRANS Manual of Traffic Control. <br /> After completion of the work permitted herein, all debris, lumber, barricades, or any <br /> excess material shall be removed and the jobsite left in a neat workmanlike manner. <br /> Immediately following completion of construction permitted herein, Permittee shall fill <br /> out and mail notice of completion provided by Grantor. <br /> I <br /> Est. Permit Fee: $ <br /> HENRY M. HIRATA, Director <br /> FORMS: Department of Public:Works <br /> r <br /> WHITE - Permittee <br /> GOLDENROD - PWD Central File Permit Section <br /> YELLOW - Field Inspection <br /> PINK - Permit Section <br /> PW 27 <br />