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APPLICATION FOR ENC OACHME PERMIT <br /> Date >1f?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 /> C-I& mei <br /> (A�pfplicant will describe here fully what he wishe,9'+to do using reverse side if necessary) / <br /> AIL <br /> tz:1 C-0 A4.2r 11-/1 U[-G Qrll <br /> �I fli' _ �L l_ r.i�l i._ c Js''�r__7='G�� /c'Z✓ r"�. - ��rC ax= I <br /> f _G `i �/Ti �I �76G':: i7 �J C"[JN6 <br /> d�• <br /> Space for�sketch Submit detailed plhns if available. <br /> 21C'<t > <br /> i <br /> elJ�/� <br /> � -` rG,°' =l�,:r..��/ t`C:C-:r�-c-.i t:r .7:.C:.vi1"C'•Y�i 4c.'l�! <br /> On County Highway %.i: r ;�•,cicJ ( ., t—i' r!r ? y =Li...1rr ^,Y �( tJ77�4 f <br /> ('+41.01 �- �i .Jfxti. +.LL1_- ,�'�'- ���- �-�..� .:t c- �� !-:.`.7 .��•.`:fC-'(+ /`�.<G�J'r• �i:LU�r tom!) `.�: <br /> (Applicant/willstate here accurately the location of the,work he desires to do) <br /> !: % ! �u;.C. <br /> and agrees to do the work in accordance with your rules and regulations and subject to your inspection <br /> and approval. <br /> Signa ure of Applicant <br /> Ir` <br /> -37 ' <br /> Phone Number <br /> C7rc;uJrcl��rc27��T 1e.c. r�Ul�G'y! ?C. <br /> Post Office Address <br /> Permit issued: <br /> ® PW-24 {9/84) <br />