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s� <br /> Date: �' / o <br /> James B. Giottonini, Public Works Director <br /> City of Stockton <br /> Public Works Department <br /> 22 E. Weber Ave. Room 301 <br /> Stockton, CA 95202 <br /> REVOCABLE PERMIT APPLICATION FOR GROUNDWATER MONITORING WELLS: <br /> I/we do hereby request that this letter serve as an application for a Revocable Permit for the <br /> following: ­7 -ro 7-/A c- � ACe C�(r5-T-1 N C� <br /> Use and maintain Groundwater Monitoring Well(s) in the City's right-of-way at <br /> the address listed below and as shown on the attached drawing: <br /> 2. 31 S &/oC�-rwr CALIFo2tviA ST(LemT <br /> The undersigned has received a copy of and fully understands the Standard Conditions <br /> governing the issuance of a Revocable Permit for a Groundwater Monitoring Well(s). <br /> G I vat- C-1rj , t�t1 E E (Z <br /> f /, t M I C r—t cb, C L L A C 4--'1 <br /> - f�a H I L L Eyv u 1A�)e—�e N C-- <br /> (Applicant Signature) $4y Y7 s�( Qlfy 9 D,:� C C",/A7 <br /> Business owner/Property owner P NTFLC Fe C A y s 8 3 <br /> (Please specify) -721 -51941 <br /> (ql�� 729 <br /> (Print Name) <br /> (Company Name) <br /> 7 <br /> 210 0 PC� M�r�i `ro2 <br /> (Address) <br /> yr(,, 7G -74 <br /> (Phone number) <br /> :ODMAIGRPWISFICOS.PW_Library:70370.1 (7121107) <br /> 3 <br />