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FROM :CALiFORNIR WRTER SERVICE <br /> FHA NU. :2b'J4b4b1'CZ> I'Id.y. ejJ �e��o ec•acrii c <br /> APPTAbATIOX FOR MCROACM=T PERMT <br /> FLE E FRI'�TT: , <br /> Dace W ov?xcS USE ONLY <br /> To: San Joaexu Unty JAR # 7-24977 REP # <br /> Depart <br /> m <br /> ent of P <br /> ubl <br /> -ic, Woorka \I ADN T, _T,, m # <br /> l `1 Z;�..��t M. DA //5 Lxk. <br /> VZL,'D 513 12e T s o mimAYB: <br /> (Applicant mama) STRZET <br /> � �b L,! •F� .'�10 T" �aC \ ARRA fIZ22A/ QVAD . <br /> TYPE -pa-e4e <br /> (Mailing Address) MOMS ,g <br /> S C�''tQ CES 'CZ 190Ts <br /> (city, sat r Zip Code) <br /> &01, 'A61A-�331'� <br /> (Area Code - Telephone Number). <br /> sketch (Detailed plans my be submitted) . <br /> �+ 2 <br /> o t <br /> CDC) <br /> e:d G <br /> r- -o Z <br /> O Z <br /> G,) -{ <br /> The =dersigned hereby•an?l•ies for poxvission to, c�>adt •uat and/or <br /> othezwise c c o Cowsby•Highway Right-of-Way oa-the aldo'. of . <br /> `Ma .d approximately 1�„ Oma' eet _s t <br /> of , Y +. • byxformiing the <br /> fol] n. 6r_jc (descriaption of w rk) - IMM <br /> • i <br /> Nor will comrnejnce an or'��bout or approximately' <br /> ISQ ys• Y <br /> I, the undersigned cextify' that I am the owner,of the respective property, or am <br /> qualified to represent they owner and agree to do the %fork described above in , <br /> a,tcordanee with the rut ta, regiulattoms of Sari, doaqu,0 C6unty and subject to <br /> inspection and approvalCl~!0 -010 ` <br /> Signature of Applicant - Title Date - <br /> m►rxt>R.t.vm umc m= cc/oo> <br />