Laserfiche WebLink
APPLICATION .FOR ENCROACHMENT PERMIT <br /> PLZUE PRINT <br /> Date May. 2 6, 2 0 0 6 OFFICE VSE ONLY <br /> To: San Joaquin County JOB # H605 REF # <br /> Department of Public Works APN _ CR # <br /> EXP. DAT B 13 0 <br /> Laymac CorporatJan VALID' Q t TO 8 DRIVEWAYS: <br /> (Applicant Name) STREET <br /> AREA /Pn h 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 /> 1:voLFE <br /> wo(As <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 OttaRadd. <br /> The undersigned hereby applies for permission to.excavate, co at t d/or <br /> otherwise encroach on-County Highway Right-of-Way-ori-the _ -side of • <br /> imately Qf E-ex:> e <br /> of 1r V► by "peY€ormiAg the <br /> following work (de cription of:work) : lav a three inch xtrucoat Gchedill a Ro <br /> natural qas pipeline to be buried sixty in h a hPlow tha <br /> ryof21.c iAutU! 7711 T <br /> Work will commence on or'about _Aug.n s t 1 ' 2006 for approximately <br /> ten days. - <br /> 1, <br /> ays.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, regulations 'of San Joaquin County and subject to <br /> i spect' and approval. <br /> J f Smith - president (� :2 Q� �� Z May 26, 2006 <br /> Signature of Applicant Title Date <br /> D UVM.PS\M=C=L (6100) +.J +t`1 t <br />