HomeMy WebLinkAboutItem 4.03 Banner Install American Cancer Society (2) �0 �0
CITY OF DUBLIN
AGENDA STATEMENT
City Council Meeting Date : March 10 , 1986.
SUBJECT: Banner Installation - American Cancer
Society
EXHIBITS ATTACHED: Encroachment Permit Application
'From Dublin Chairman Dated 2/15/86
RECOMMENDATION: ( Approve installation of banner ,
�)) consistent with City policy, from April
14 through April 23 , on the San Ramon
Road banner poles .
FINANCIAL STATEMENT: Minimal cost ; a few hours of Staff time
will be required to issue the permit ,
assist with installation, and provide
followup inspection.
DESCRIPTION: .
The American Cancer Society, a non-profit organization, is
conducting a county-wide door-to-door campaign from April 26
through May 5 , during which time volunteers will distribute
educational material and solicit funds . Though technically not a
locally-based organization the volunteer drive in Dublin will be
under the direction of a local chairman who is a Dublin resident .
The banner poles are available during the requested period,
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-.....FEB 18 1986 . APPLICATION FOR PERMIT NO. ,
CITY OF DUBLIN
PUBLIC WORKS 6500 Dublin Blvd. .
Dublin, California-94568 A
ACNE: :829-49�,j oArs
APPLICATION for PERMIT TO DO WORK
(IN ACCORDANCE WITH CHAPTER 1 OF TITLE 5 OF THE ALAMEDA COUNTY ORDINANCE CODE
as adopted by the City of Dublin)
i ordinance providing for the protection of public highways and rights of way thereof; regulating the use thereof and the manner in
,,Ch the some may be altered, excavated under, obstructed or encroached upon; and providing penalties for the violation of the provi-
orrs thereof. '
t. undersigned hereby applies for permission to «-
J '
'_ength of Excavation Lin. Fr. Width Ft. Depth Ft. Permit valid until
ROAD NAME
List other permits required by IoW.
V/2G/ivi/A Wo� , Ci;y C�/�iP�N,�i✓
NAME OF APPLICANT CITY ZIP CODE
ADDRESS TELEPHONE NUM9EA SIGNATURE OF APPUC
Investigated By Date
Remarks:
LIST OF CHARGES
Permit Fee
310.00 Each Permit 510.00
Where a field investigation Is necessary before Issuance of permit.
a minimum charge of 520.00
For Inspection of work after permit is Issued, where such In-
Inspection Fee
spection is necessary,a minimum charge of $20.00
Where the charge for inspection exceeds the minimum amounts
Bond Required shown, lh° charge shall cover all the necessary expenses of the
j Inspection. .
TOTAL Receipt No.
Where no mops or plats are furnished with this application, a sketch of the proposed work, showing location, name of road and other
necessary information, must be mode on a separate sheet, in triplicate.
APPROVED FOR ISSUANCE x ,'
CITY ENGINEER
---- DATE