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APPLICATION FOR ENCROACMMgT PERMIT <br /> PLEASE <br /> PRINT: <br /> Date May- 26, 2006 OFFICE USE ONLY <br /> To: San Joaquin County JOB # H005 REF # <br /> Department of Public. Works APN CR # <br /> EXP. DATE 8 1 0 <br /> 61 <br /> Laymac Corpnra t i nn VALID 8 r TO 8 DRIVZWAYS: <br /> (Applicant Name) STREET . , <br /> AREA Pe'%,A el QUAD <br /> 1601 H Street, #200. TYPE <br /> (Mailing Address) FORMS <br /> NOTE <br /> Bakersfield, CA 93301 <br /> (City, State, .Zip Code) <br /> ( 661 ) 327-4031 <br /> (Area Code - Telephone Number). <br /> Sketch (Detailed plans may be submitted) <br /> i vo�A tr�LFE <br /> Starting on. Road approxima ely 2, 500 feet South of French <br /> Camp. Road, thence South along W= Road approximately 4, 500 feet <br /> to Ott Road, thence West along .Ott Road approximately 6, 000 feet <br /> to a point on the South side of Ott^Rodd. <br /> The undersigned hereby applies for permission to .excavate, construct a d/or ,,, / <br /> otherwise-encroach on County Highway Right-of-Wagon-the _ _. sid¢..of....welpq <br /> imately <br /> of -Yc by "performing the <br /> following work (de cription of:work) : lav a three inch xtrucnat GchPrli,l A An <br /> natural gas pipeline to be buried sixty inches hPlow tha c„rf�Cc , <br /> GVO�Ic. [.UtTh+l RI 7Jr'leT <br /> Work will commence on or'about Au q.0 G t 1 2006 for approximately <br /> ten days. <br /> I, the undersigned certify. that I am the owner' of,the respective property, or am <br /> qualified to represent. the: owner and .agree to do the work described above in <br /> accordance with the rules, regulitions 'of San Joaquin County and subject to <br /> i spect' and approval. <br /> �, <br /> J f. Smith - president :2 � � May 26, 2006 <br /> Signature of Applicant Title der Daae <br /> Mhmm.ps\MMCML (6/00) <br /> 0 <br /> - <br /> i �✓ <br />