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• -� APPLICATION FOR ENCROACHMENT PERMIT <br /> DATE <br /> TO: SAN JOAQUIN COUNTY HIGHWAY DEPARTMENT O F F I C E U S E ONLY <br /> JOB /___ 2Ai_7_�____ R <br /> (APPLICANT NAME) RPN--------- ----- CRY I --------- <br /> EXP 1E_ r�_ <br /> P. O. BOX 930 VAL,to �ft� os �j�j __ <br /> DRIVEWAYS: <br /> (MAILING ADDRESS) STREET All E _ <br /> STOCKTON, CA 95201 AREA _--�__ ^� DUAo z ___________ <br /> (CITY. STATE ZIP CODE) TYPE -- j ----------- <br /> FORMS <br /> 942- 1528 NOTE ------------------------------------- <br /> (AREA CODE - TELEPHONE NUMBER) ----------------------------------------___ <br /> -------------------------------------------- <br /> THE PG I E. CO. HEREBY APPLIES FOR PERMISSION TO EXCAVATE. CONSTRUCT RNO/ OR OTHERWISE ENCROACH ON COUNTY <br /> HIGHWAY RIGHT-OF-WAY ON THE_N:i__ ------SIDE Of _E MAJN_ T--------------------------------APPROXIMATELY <br /> __________FEET / MILE ______ ----------- BY PERFORMING THE <br /> FOLLOWING WORK: <br /> ❑ INSTALL ❑ DEMOLITION. MAIN i SERVICES <br /> N -REPLACE a GAS ❑- SERVICE ONLY SERVICES _.Zo_ EA. <br /> p REPAIR ❑ ELECTRIC U. G. ❑ MAIN ONLY <br /> ❑ ABANDON ® COUNTY PUBLIC WORKS PROJECT TRENCH LENGTH__ Z 3 sR___FT. <br /> SURFACE TYPE: NATIVE DIRT ❑ GRAVEL PAVEMENT �apaRn.c <br /> TYPE OF TRENCH BELL HOLE ❑ BORE--6' OR LESS ❑ SPLICE BOX 2-7B0 sq.Fr. <br /> 10 TRENCH ❑ GAS REGULATOR 801 <br /> GENERAL DESCRIPTION: __ __fiAS ii1�J i ,s_�-A,� A�F4ft cocnr`L_�ZLiFW-r---_____: <br /> -- N T���T_SQµ_-_Mc��h1 r_•�A�I E�R�TR Q�66 _ .R--------------------------------------------- <br /> --------------------------------------------------------------------------------------------------------- <br /> --------------------------------------------------------------------------------------------------------- <br /> PROPOSED START DATE___-e2=H-_6=L_____________________ PROPOSED COMPLETION OATS:_ :z :9 Z__.__-_____ <br /> SKETCH <br /> v C'' <br /> G w rn <br /> m <br /> 5f?E aTTA.GNED PV�I>W 1NGS c� <br /> m <br /> �o C7 <br /> C, .. <br /> x %0 <br /> ...-•.....................................................•-----•-•--------------................. <br /> P. G. i E. JOB REFERENCE NUMBERS: �,0�R_ 31�c�qF�J s E. 80UTTL DIVISION IMMIAM <br /> SR ----------- BWO ----------- <br /> WO- 4N_jreq yZ--------- 8Y .�'' or_-LklCAC_"i --- <br /> ACCOUNT----I3k 4OREM <br /> --____- SUB ACTIVITY ________.______- GA$ / ELECTRIC 000AL FAN <br /> ACTIVITY --------------- SUB ACTIVITY --------------- CONTACT PERSON PNONE t!L2 :(?J.*--- <br /> ....i.............•.-....-....-...........-...............0.4.............-...New......a.........• <br /> RE1I4RN TO: <br /> ❑ ATTN: T/0 GENERAL FOREMAN ❑ ATTN: T/0 GENERAL FOREMAN ATTN: CONST, t MAINT. DEPT. <br /> 10901 E. HIGHWAY 120 33 E. 10TH STREET P.O. BOX 938 (8LO'G 21 <br /> MANTECA. CA. 95336 TRACY. CA. 95376 STOCKTON CA. 93201 <br /> OFFICE OFFICE OFFICE <br /> PHONE: 823-0494 PHONE: 836-0440 PHONE: 942-1401 <br />