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MAR-07-97 12: 51 FROM:GTE ID:2092391188 PAGE 2/3 <br /> ADPL TION FOR EI�'�'ROA PF,,.�i1'.ffI' <br /> 7 <br /> �7- a z s <br /> �'LF�SI� PRINT: <br /> OFFICE USE ONLY <br /> Date - .SOB# 7 3 0.5 i REF# <br /> IAPN' -- <br /> - <br /> To: San Joaquin County Highway Departzent. EXP.DATE 7=q,7 DPXVEWAYS' <br /> Z;Ts� OF C-4+�—11F. TYPE riC'E,Vc� G.eoss G�r� e I /ic!L <br /> (Applicant Mame) FORMS .s s � le--z y <br /> ,43D W, CC---AfTOJZ. -6-r. NOTE <br /> (D1lOiag Address) <br /> -1n+A1T25GA , �fA '15331:o <br /> (City, State Zip Code) <br /> Z..L5q - 23"1 -Ls34-Z- <br /> (Area Code-Telephone Nu ober) <br /> Sketch(Detailed plans may be submitted): <br /> The undamped hemby applies fbr permission to excavate,consWid and I or otherwise encroach an Cotmty <br /> Iway}light-of-way on the 5. * M. side of A44 IR VU-14 /Z D, approximately <br /> � feet I Mge _S• of /At OF AIRM 6 rf W, &P,0A( ,by pez�the <br /> following w)rk: (description of work): )9Z&W 0/);�LeG7'13 U2 Y CABLZ 3r-T F"M EDP 01V L�71-1 <br /> rA E 6. 61 D� .,OF M 4 M UGL JAI r?D ieZW lr7TA. 0f4l d 5 TJ4. /5 fJ/ r#8v Z)A/ <br /> 51 DE DP M G Af UL LI At KD FZn �;iM 15 t`31 r4 57,4, Z,6*9$. TH&,P ,C3) E026/AVSI& <br /> ,�-T 57As 15+91. 3l+44 4-A10 405�•49 LdILL Z ,6 ZEaIO. i ZL/1PUSN A 3GJAI VEPM, <br /> Work will cowmen=on c T about a— Iy _e,-7 for aPproxizlzatelY 4S days, <br /> I the undersippted certify that I am the owner of the respective property,or am qualified to represent the owner and <br /> agree to do the work described above is accordance with the iules,regulations of San Joaquin County and subiect <br /> to inspection and approval. <br /> - - ssrcl —:1~7 -�7 - <br /> ST�r;_ -RE OF PLICA -T - TT.L:£ DATE <br />