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06/10/1998 06:26 20946829 SKOPUBLICWORKS PAGE 01 <br /> APPLIAI <br /> _PLEASE, PRIIY : ION FOR ENCROACHIlENERMIT 1,9,2 <br /> Date OFFICE USE ONLY <br /> JOB# //dos- RF1Fy <br /> APN CRVN <br /> To: San Joaquin C_o;u�n_ty Hi way Department. EXP. DATE -j_ ��_ J ------- <br /> c�'eJT h . h CSDCDi) VALID 7 8T0 DRIVEWAYS: <br /> 7o Oats r .Q_.., LP .e F.; .Oe Rftn STREET]*,y /4uGr s <br /> (Applicant Name) AREA Sri.✓ QUAD G V + <br /> ���� Doul rpp /o7 F�r• FORMSSS •'c s <br /> (Mailing Address) NOTE <br /> Fm p nny; O ,Cly- 9eno g, <br /> (COJ, State Zip Code) <br /> S/o -(oSo7- -7 O0 <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be Submitted) <br /> 2 <br /> •• = T <br /> j co <br /> LL. M <br /> o Post-it•Fax Nae 7671Oete "p.yac► Q t� Q <br /> fW �O�iiJQ'i6 W diC,�,s <br /> P"• PhD"9 <br /> Faa*6 Q ?fa> 3 FW*42r4.& <br /> The undersigned hereby applies for permission to excavate,construct,and/or otherwise encroach on County <br /> Highway Right-of-Way on the M00-Y side of /k47• Agile approximately <br /> �C,___ /mile fAsT of _G,c7rvs� /o).Aee _,by performing th <br /> following work; (descriptionofwork j:_ Aav�-ce...o,+-r �-1 / ceic pA,oaK <br /> --P <br /> Work will commence on or about Jv Ne /7 , / 9 ,P* for approximately / days. <br /> I the undersigned certify that I am the owner of the respective property,or am qualified to represent the owner m <br /> agree to do the work described above in accordance wrth tho rules,regulations of San Joaquin County and subje <br /> to inspection and approval. �` <br /> SIGMA T 1 �jF AMICAr�TI' - TITLE 0 DATE <br />