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Date: Z / Z /02 <br /> " COUNTY OF SAN JOAQUIN Received by � <br /> DEPARTMENT OF PUBLIC WORKS CR# E � <br /> DRIVEWAY AND PAVED FRONTAGES <br /> PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> ISSUE DATE <br /> APPLIC JOB#11005 Ol <br /> FEE DUE <br /> C0 Vl -9 D APN -1 DRIVEWAYS: <br /> Name ATE <br /> SEDTG N✓[19 � QUAD�� � <br /> I Address S 7 � S?o Cit' <br /> L- TYPE W <br /> City,State ZIP L°dy T FORMS Lv <br /> 2^g /"j- « NOTE <br /> (Area Code)Telephone <br /> SITE INFORMATI01� <br /> Parcel Owners Name <br /> Site Address DRIVEWAY QUANTITY WIDTHS <br /> TYPE @ FRONTAGE_, <br /> City,State-Zip Code AGRICULTURE <br /> COMMERCIAL @ R/W__-- <br /> (Area Code)Telephone INDUSTRIAL <br /> RESIDENCE <br /> PAVED FRONTAGE Ft. <br /> CONTRACTORLENGTH: Ft. X WIDTH: <br /> Namession to encroach on County HiY <br /> ----- The undersigned hereby applies for perms side of <br /> Address Right-of-Way on the oC/T e mile FA I of 2u L r✓1�912 <br /> approximately b <br /> City, <br /> State-Zip Code by installing <br /> (Area Code)Telephone <br /> Work <br /> for approximately for <br /> will commence on or about <br /> SKETCH(Separate sheet tray be submitted) <br /> ct be self installed. _ <br /> NO _ ___YES Contractor's License <br /> Will this proje <br /> AccessTer ppp7armOrivewayPaved frontage <br />