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APPL CATION FOR ENCROACHMENT PERMIT <br /> Date l `� T�b 19 L <br /> To the San Joaquin County <br /> Highway Department <br /> Gentlemen: <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on <br /> County Highway right of way by performing the following work: <br /> /"rrr.¢ce, Grouvow,a -fn. /J1owi�02av� w/amu <br /> (Applicant will describe here fully what he wishes to do using reverse side if necessary) <br /> //"GAN.J amnio eyAw' . nIf A tl-4NE✓ .4No hAIV,cA-Ori'f Wi�-e- <br /> /JG J c.f" u� GLUY/�Isn t^O N�l'/6 v�JZ inr. /1LL ✓YI DNCTUr w/G LG✓' W�� c. <br /> h GD Cf?-t7Z� .�T C/"i9iT � i-/'aii, j`yt��..i' C //vr,- hr Oni ✓ir✓✓�'s. <br /> Space for sketch Submit detailed plans if available. <br /> ,S" A'�e`�Hlo O C.9itir �hlio mAP <br /> On County Highway VARlt1UC 90M {N STOG15-51W EAlMIOL A9-94- <br /> (Applicant will state here accurately the location of the work he desires to do) <br /> and agrees to do the work in accordance with your rules and regulations and subject to your inspection <br /> and approval. <br /> atuy of Applicant] <br /> d9� <br /> Phone Number <br /> LZ 2-3 0A= <br /> G.d Jaoc.o C.4 9z'0'9;2 <br /> Post Office Address <br /> (� <br /> Permit issued: 3 �� / �— <br /> a PW-24 (9/84) <br />