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4 APP CATION FOR EIN"CROACH3 I T PERINII'T <br /> PLEASE PRINT: <br /> O CE USE ONLY <br /> Date 3 - 3 - 9-7 JOB N -7 REF## <br /> APN - - <br /> To: San Joaquin County Highway Department. EXP. DATE`l��G�`� DRIVEWAYS: <br /> G TE" AREA Afanfer <br /> A ' <br /> TYPE t'rPw_Arn? 4 3o/'I',9 <br /> (Applicant Nance) FORTS SS'Atiw <br /> q3O W. CENTER ST. <br /> NOTE <br /> (Mailing Address) <br /> MANTECA, CA. 95336 <br /> (City, State Zip Code) <br /> (Z51) 2390Z�I5 0 <br /> 1 V/c <br /> (Area Code-Telephone Number) ST2'OitJ <br /> Sketch(Detailed plans may be submitted): <br /> TZL)6 2� vis <br /> /3ti9� <br /> iLl <br /> LU <br /> E�P <br /> DISTIIU6 iq, <br /> 34 T Xj% SHq' <br /> lti <br /> Uj <br /> Q <br /> 4 <br /> Q o � <br /> � 0 <br /> The undersigned hereby applies for permission to excavate, construct and J or otherwise encroach on County <br /> Highwav RivJn-of-Way on the Non4 t ww side of TWO R� R S RbAZ approximately <br /> 49y feet /� L) of GAieDEN AL1E?ULJE �by performing th <br /> following work: (description of work): ZLIkY /93 2, O F 25/W Ie 7ZZEPf IVAC Gi9104-E 3D" <br /> AL0,V 6 77JD R I VZ-� e,0,9,0 LJ/Tll !1 JV F- �PORD A1 .6 1,,V FX t S 71A)ev DLiz r TD <br /> REPLALE k)RrnZ Dr9✓YIi4aM e,*aLg' <br /> Work will commence on or about 3-13 -17 7 for approximately z-o days. <br /> I the undersigned certify that I am the owner of the respective property, or am qualified to represent the owner an <br /> agree to do the work-described above in accordance with the rules,regulations of San Joaquin County and subie. <br /> to inspection and approval. <br /> DSP f- 9 9 7 <br /> SIGN'AT[.PF OF APPLIC:VNT - TITLE DATE <br />