Laserfiche WebLink
r COUNTY OF SAN JOAQUIN Date:1 (� <br /> Received by <br /> DEPARTMENT OF PUBLIC WORKS CR# Cle D 577. <br /> DRIVEWAY AND PAVED FRONTAGES <br /> PERMIT APPLICATION <br /> APPLICANT OFFICE USE ONLY <br /> .� tilt 7 awe ST�k Lr N c- JOB#11005 ISSUE DATE <br /> NameAPN O�- ZZv - _ 3 FEE DUE <br /> P C x Q(12c) EXP:DATE DRIVEWAYS: <br /> Address STREET ('alfa W&V Cl QUAD�_ ' <br /> �� '>2 CJS Steck t+v, <br /> City S ate-Zip Code TYPE Ca wn d y� <br /> Z cl 4-(,-2 - Z,is , FORMS <br /> (Area Code)Telephone NOTE <br /> SITE INFORMATION ,Di/✓C <br /> Parcel Owner's Name <br /> i 04-z-- <br /> Site Address r DRIVEWAY <br /> 0�e c 1.. l 9 i"i) TYPE QUANTITY WIDTHS <br /> City,State-Zip Code @ FRONTAGE <br /> 2� q e, ' <br /> AGRICULTURE <br /> '( COMMERCIAL � <br /> (Area Code)Telephone INDUSTRIAL @ R/W <br /> RESIDENCE <br /> CONTRACTOR PAVED FRONTAGE <br /> If n.r x; n�C,. LENGTH: Ft. X WIDTH: Ft. <br /> /`� Name _ �r*�2 k-,— Q�f�- <br /> ArL t Cl wJ PY PP P <br /> Address C T The undersigned hereby applies far permission to encroach on County Highway <br /> Zi Right-of-Way on the C�L 9y��- side of L w <br /> ti approximately ! Z ]_ Nv <br /> !__t✓e mile 5 �/ o yL <br /> City,State-Zip Code 7 ✓� by installing ' <br /> (Area Code)Telephone ' <br /> Work <br /> will commence on or about for approximately days' A v(tA ZcX7 t <br /> SKETCH(Separate sheet may be submitted) <br /> Will this project be self-installed? _NO <br /> YES Contractor's License 21 2"" <br /> Access\Per Apff orm\DrivewayPaved frontage <br />