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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Apr. 16 200b 12:15rri r z <br /> APPLZCATXON FOR WOROACMMT PRR=T <br /> PL�AS� plt�I�'P s p <br /> Dat y' a 49FICE USE ONLY <br /> To: Sari JOaqui U Cowaty JOS # 730?•?- REP # <br /> Department of Public Works APR � # <br /> up. I)ATP- <br /> VADA OYRWC19. TO wa y PI DRn-HUYS s <br /> sTRIMT -DEk- -R.ko ter.. <br /> .1554 V .YWY."tT F It-\M ���- �� ,,,w <br /> (Mailing Address) FORMS <br /> q�5 aa <br /> (city, State, .zip code) <br /> (Area Code - Telephone Number), <br /> Sketch (Detailed flans may be submitted) , <br /> T6 undersigned hereby.applies for permi.ssioa to.excavate const t and/or <br /> otherwis •en roach-on, co=try.gighway Right-of-Way(M pe 3. o..4'1D <br /> approximately �] ee amt <br /> of , ' ,, , , e'rforming the <br /> f'Qllowing work (descif. tion of work • YM - , <br /> mae <br /> Wor will. commence on or,about for approximately <br /> days <br /> X, the undersigned certify that X am the owner of the respective property, or am <br /> qualified to represent the owner and agree to do the work descried above in <br /> accordance with the rules, regulat�xts'of San Joaqu�n county and subject to <br /> inspection and approval. { • <br /> Signature of Applicant Title Date <br /> w�razt.4s�peecc�,cx, lc/oaf •, <br />