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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 <br /> May- 15 200b 12;41jh'In r <br /> APPLICATX09 FOR ENCROAQOM PEMUT <br /> . nate � �� �`�'t�0�1 • <br /> — OFFICE USE ONLY <br /> To: San ao:<clu county aft #-...77 REP .._ <br /> Department of Public Worka APN <br /> CAL(TOl N1R MAI-Z 5, \Y a P DATE <br /> (Applicant Name) DRIVSWiI`XS: <br /> STnET Vw- <br /> ARRA QMD <br /> — - TYPE !L d <br /> (Mailing Address) FORMS <br /> (City, state. -Zip code) <br /> (Area Code - Telephone Number) <br /> Sketch (Detailed plans 'may be submitted) <br /> m ry cn <br /> �- c, D <br /> c- D <br /> cn c <br /> cn -� <br /> The unders:.gned hereby applies for <br /> pe <br /> of roachOn rmission to.e•xve,�cOnscft. <br /> ra/ora y, gwayRight-of-Wky.onChe <br /> approximately <br /> --• ' peYEormirig the <br /> f013-owing—work ork (descriptiby <br /> on of work) : <br /> t _ . <br /> Ito <br /> Wo:r w 1� commence on or'about <br /> WOM <br /> days.' for approximately <br /> I, the undersigned certify that I am Che owner of the :respective property, or am <br /> gUalified to :represent the OWnex and agree to do Che wiork described above in <br /> accordancerul <br /> inspection and <br /> the approval <br /> s, regulations'ot San aOaquin County and subject to <br /> inspection and appybrralLo -ka„4� <br /> Sigua►tura of APplican - Tit:Ce COT <br /> . Matte <br /> ►�0..iS\C�St�L f6/0o1 , <br />