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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Apr. 10 2006 08:23AM P 2 <br /> APPLIdATION FOR ENCROACMUM PERMIT <br /> PLEASE PR ; <br /> Date �-+ s• � 'OFFXCE USE ONLY <br /> To: Sam Joaquin County Jo$ #_ 730 77� IMF <br /> ** <br /> ]Department of Public Works Q`� ApN � # — <br /> �i1�,��i11�i�11 V N �, <br /> � r1i>Y i V.14x,IbA ? / +D <br /> nRr��rvAs <br /> (Applicant :Sam&) STREET . <br /> AREA Sr&&( QUM usTUVE <br /> • w - <br /> (WlingpAddress) vows <br /> IZZ as 110TI, <br /> (city, state, .zip coda) <br /> '64-2Z <br /> (Area <br /> — <br /> (Area code - Te:..epkona Number), <br /> Sketch (Detailed pJ. Ms 'uay be suSmitted) CA <br /> . <br /> O D <br /> Cm <br /> r O <br /> C <br /> �• C <br /> The undersigned hereby,aM)lies :dor permission to.axcavate, cOnstrilp t andr �n <br /> a k�ers se•enaxoach on County•Nigghway Right-of-Wer am �ha a., <br /> approximately 1 fe mife . <br /> of <br /> allowing ru (descripticax of work , OY Vex£ormixtg the <br /> ��s, 'C111e w •� <br /> .Work will commence on or•aCbout IN « " <br /> 122 days. , or appzoximatelr <br /> I, the U=%ersigned certify that X am the owner ..o£ Cha respective, Property, or 'am <br /> qualified to represent the Omer and Agree Co do the work desox�ed above In <br /> with the s, regmlations'of San Joa(lu�n'co=ty and sub jact- to <br /> inspection and'appro C)) ..O't.4Q� <br /> Signature of Applica=1 Title <br /> Data <br /> w►�r�,.�sls�ssc�z (s%oo) . <br />