Laserfiche WebLink
COUNTY OF SAN JOAQUIN Date: 7 /-Z1,,l 67 <br /> DEPARTMENT OF PUBLIC WORKS Received by ^r, <br /> DRIVEWAY AND PAVED FRONTAGES CR# 0322574 <br /> PERMIT APPLICATION <br /> APPLICANT OFFICE USE ONLY <br /> JOB#11005 ISSUE DATE <br /> 1/a�� f� N � APN 203 - OS-- 30 FEE DUE <br /> Y �C� ren Jet / es EXP.DATE DRIVEWAYS: <br /> Address STREET LhGL TOhG woad <br /> R,9, ,6 ax 5-799 4iGM`�iI�ci e QUAD SG— <br /> City,State-Zip Code TYPE <br /> CSI, 9,557 FORMS <br /> (Area Code)Telephone NOTE <br /> CZE) ,4-s�9s <br /> SITE INFORMATION <br /> // Parcel Owner's Name <br /> Ll9M .5 Wi1�/tr <br /> //Site Address <br /> /9 996 l/?Z 7oae Roaa' DRIVEWAY <br /> A11/91y <br /> �A / City,State-Zip Code TYPE QUANTITY WIDTHS <br /> /%ail (fA, 9 9.?� AGRICULTURE @ FRONTAGE <br /> (Area Code)Telephone COMMERCIAL <br /> INDUSTRIAL @ R/W <br /> RESIDENCE <br /> CONTRACTOR PAVED FRONTAGE <br /> LENGTH: Ft. X WIDTH: Ft. <br /> Name <br /> Address The undersigned hereby applies for permission to encroach on County Highway <br /> Right-of-Way on the ,S vif- side of_ .9a Trac /2o2,/ <br /> City,State-Zip Code approximately U.gib feet mil %l/vri of Lore <br /> by installing <br /> (Area Code)Telephone <br /> Work <br /> will commence on or about for approximately days. <br /> SKETCH(Separate sheet may be submitted) <br /> Will this project be self-installed? NO YES Contractor's License <br /> AccessTer App\FormTrivewayPaved frontage <br />