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=)8x18/2006 15:47 2094689324 <br /> SJUU I-tKMJ.15 rr�IaC. U.LI UI. <br /> p,pPLICAT140M .FOR HUCROAENT PERMIT <br /> Z! ZAC7 6PP-1cm USE Oiax <br /> 'REV <br /> V6. San. Joaquin County JOa # # -- - <br /> Oepax tmexab of Public Works APN <br /> EXE. DA'I'Fs /O 2 <br /> 09Ir � ¢ To PRxvWAYr <br /> (App3.ioame dame) STRRET <br /> S �'f <br /> lob Typa <br /> •(aiailirg Addr�aBs) FORMS. <br /> NOTE <br /> . ,,�'=Pei, �� ��6G • . ' <br /> (City, Sbate, .zip Code) <br /> (,' sea Code Tee ephonno NUMber). <br /> Sketch, (no-tailed Plass may be subttlitted) <br /> • S�� �'!7'.�k��D � 2�"SSFP "GSTY ,�PPRavr'o PA ovS <br /> PhRRA SY Q�1taSo�, B,4Rdg'E t S;0,0 047eD �u'•,�F2 , <br /> T.RhFF)G CWJ'TiBOL PUN .9y ;F: D4TE1� <br /> The undersigned hereby applies for. permiso'jonx to.exeavate, countruat and/or <br /> of erwise-encroach-on­C0Unb-V­Highway Right-of-wa; os -the ���_• a'�.d�..of <br /> 'T POie•T V-4 Y approximately 0• feet/mile NO/ET� <br /> of ., �'t ll✓ENtlFAAe F 'pe7r8orming the ^ <br /> following work (descriptjoa of:work) <br /> 2�JS?v4LL' .4i��tnlriM�ft�V 2314iw.�V .�iu�,Id �L ,w fit <br /> . , <br /> Work will commence on or'abouC �N� ' 0 for approximately <br /> ,? days. <br /> z', the :wcidersigned certify, that z am the ,own'er' of. the respective•pr6pexty,. or -an <br /> qualified to represent the owner and, ,agree' to do .the r6ork described 'above in <br /> acoordamce with- the rules, regulation's•of San Joaquin County and subjecti to <br /> inxspeation and approval. <br /> 9i ture of Applie Title 16ale <br /> cl <br /> ►G�C:�3A.V9\ACL (6/4a� .` <br />