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APPLICATION FOR ENCROACHMENT PERMIT el, <br /> CF <br /> DATE <br /> TO: SAN JOAQUIN COUNTY HIGHWAY DEPARTMENT OFFICE U S E ONLY <br /> JOB j=--73 ,c)5-2-b --- REF ! --------- <br /> P G & E C 0. APN• ------ - // -- CRY I --------- <br /> (APPLICANT NAME) EXP. DATE T, <br /> 30 VALIO_3 °l_7 v �_ DRIVEWAYS: <br /> P. 0. B O X 9 STREET �Z------- ! ----------- <br /> (MAILING ADDRESS( AREA 5?r N_ gUAO ! _S ! ----------- <br /> 0 CA 95201 TYPE ..�-GL �LE - -- ! ----------- <br /> (C I <br /> Y. STATE ZIP CODE) FORMS wcr_ <br /> 942- 1528 <br /> NOTE ------------------------------------- <br /> ------------------------------------------- <br /> (AREA CODE - TELEPHONE NUMBER) _____________________________-_____________ <br /> THE PG 9 E. CO. HEREBY APPLIES FOR PERMISSION TO EXCAY TE. CONSTRUCT HND / OR OTHERWISE ENCROACH ON COUNTY <br /> _�' � = ] dam-�'-`-� -------------------APPROXIMATELY <br /> HIGHWAYSIDE Of JRIGHT-OF-WAY ON THE ----- <br /> ----1--T"--FEET / N L�,LP_--- OF-�,,,d-!J�- • <br /> _______________. BY PERFORMING THE <br /> FOLLOWING WORK: <br /> (2 INSTALL ❑ DEMOLITION _ ❑ MAIN i SERVICES <br /> ❑ REPLACE ® GAS f� SERVICE ONLY SERVICES ----- EA. <br /> ❑ REPAIR ❑ ELECTRIC U. G. ❑ MAIN ONLY TRENCH LENGTH_______,____FT. <br /> ❑ ABANDON C:] COUNTY PUBLIC WORKS PROJECT <br /> SURFACE TYPE: Cl NATIVE PAVEMENT <br /> DIRT ❑ GRAVEL ( <br /> TYPE OF TRENCH (� BELL HOLE EZ BORE--6' OR LESS (] SPLICE BOX <br /> ❑_GAS REGULATOR BOX <br /> Cl�� TRENCH - 1 _ -- `_ _ <br /> GENERAL OESCR PTION: LL_LK�� - f 't�.2 - - - ' <br /> :t �---------------------------------- <br /> --------� -- -------------------------------------------------- <br /> ----------- <br /> ------------------------------------------- <br /> ----------------------------:o- <br /> ______._ PROPOSED COMPLETION ORTE:_�_ 4___ _ ____________ <br /> PROPOSED START DATE___ '�P____1 ----------- <br /> SKETCH <br /> �co 11 <br /> -% <br /> c <br /> .............. ................ <br /> MA <br /> P.G. i E. JOB REFERENCE NUMBERS:11� S.0./J�2�.s�s=+�{?-�Z E- 11 II <br /> DIVISIN RAW <br /> SR ------ .---- BWO _1P_Q_c6A-T• BY ----- <br /> WO--GM -------------------------- GAS / ELECTRIC <br /> ACCOUNT----------------- SUB ACTIVITY --------------- CONTACT rERSON 'M011Cp� <br /> ACTIVITY SUB ACTIVITY _______________ <br /> ....:...-------------•-..................................................................-.......� <br /> RETYAN T0: ' ATTN: CONST. i MAINT. OEPT. <br /> ❑ ATTN: T/0 GENERAL FOREMAN ❑ ATTNT/0 GENERAFOREMAN P.O. BOX 931 (BLO'G 2) <br /> CA. <br /> 10901 E. HIGHWAY l20 53 E. 1STREETT STOCKTON CA. 95201 <br /> MANTECA. CA. 95336 TRACY. CA. 95316 OFFICE <br /> OFFICE OFFICE PHONE: 942-1401 <br /> PHONE: 923-0494 PHONE: 836-0440 <br />