Laserfiche WebLink
COUNTY OF SAN JOAQUIN Date:-:!�-I l 9 16", <br /> by � <br /> DEPART1,I OF PUBLIC WORKS CR# o`3),7- <br /> DRIVEWAY <br /> 3>9'DRIVEWAY AND PAVED FRONTAGES <br /> PERMIT APPLICATION <br /> _ OFFICE USE ONLY / <br /> SRIo TE <br /> PL <br /> APPLICANT <br /> LCAJOB#11005 2 FEE DUE-L <br /> Name APN -�— DRIVEWAYS: <br /> EXP.DATE <br /> STREET <br /> QUA— <br /> / C, Tb�SSi C 0 <br /> Cl ,State-Zip Code TYPE _ <br /> �2,©Cfi��'� 2 �" CI 2 2(.f FORMS <br /> (Area Code)Telephone <br /> i NOTE <br /> SITE INFORMATION <br /> �/G S Pres <br /> � G <br /> Parcel Owner—1 <br /> Site AddressDRIVEWAY WIDTHS <br /> S-2'l Z� TYPE QUANTITY @ FRONTAGE <br /> City,State-Zip Code^ ,^ �— AGRICULTURE- <br /> I `�2 qr � S=—T COMMERCIAL @ RIW____ <br /> (Area Code)Telephone INDUSTRIAL X Z <br /> RESIDENCE <br /> PAVED FRONTAGE <br /> CONTRACTOR GTH: Ft. X WIDTH: Ft. <br /> _ LEN <br /> Name <br /> y applies for permission to encroach on County Highway <br /> The undersigned hereb a Pde of <br /> Address Right-of-Way on the Sj_ °fn ��u�i l a(��`art <br /> . <br /> ee mile � -�-�---- <br /> approximately� <br /> City,State-Zip Code ,by installing <br /> (Area Code)Telephone <br /> Work <br /> for approximately days' <br /> will commence on or about <br /> SKETCH(Separate sheet may be submitted) <br /> Will this project be self-installed? NO <br /> YES Contractor's License <br /> AccessTer App\Form\DrivcwayPaved frontage <br />