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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Jun. 30 2006 12:3ePM P 2 <br /> APPLICATION FOR ENCROACH` PERUIT <br /> Date AM <br /> OFFIC2 USH ONLY ' <br /> To: San LToaguia County '1OH # 77 F # <br /> Department of Public Works APN CR ' # <br /> EXPNLA 7G?N"k � \N AR[`L.'C�, SU�Z�C, . DATE <br /> VALID !v o TO -Deo DRIV'SW]IYS <br /> (Applicant Name) STUnT _,�„(L_ :!3rARZA +� <br /> V W • � 1\���C�x`11 � �`� �.rC�/ aVAD ,•,�_ <br /> TYPE w <br /> �(WA31ing Addresa) FORMS <br /> 110TE , <br /> (City, State, •Zip Code) - <br /> &0"k' WVA-Z3 <br /> (Area Code - Telephone Humber), <br /> Sketch (Detailed plaas 'may be submitted) <br /> .o 0 <br /> -{ Cm <br /> C: ct) . <br /> ' m <br /> ZE <br /> M O <br /> The undersigned hereby applies for permission, to.excavate, construct and/ol ; N � <br /> othe a roach on County,Highway Right-of•-Play-on-the aide •af <br /> _ approximately fe"' /t►ti18 <br /> of .. . bVge orad the <br /> followipq Work (description of work)i <br /> Vt <br /> Worr, will comutence on or'about b1o�� �bS�,, Pox approximately <br /> days. • <br /> I, the undersigned certify that X am the owner of the respective property, or am <br /> qualified to represent the owner and agree to do the cork described above in . <br /> accordance with the rul , regulat ns'of San aoa", n County and subject to <br /> inspection and approval. $- '� <br /> Signature of Applicatut -:,Title itle Date <br /> l0�6'iRP..Ps\4�IIf�' A 56/001 - •I y <br /> _ I <br />