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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Apr. 04 2007 0'�:04PM P 2 <br /> APPLx�AT3= FOR ENCROAaOM PERMIT <br /> Sr,E 5 pRNT:- 1 WA <br /> nate Q� OF91cm =Z 02M% <br /> To: Saa Joaquin County JOB # b1 �' # <br /> I)epartment: of Public Works APR � # <br /> C��..1 ORi�l1P� F\Trc . SIM a vA, DATE <br /> 4 3 .o�� O -IS'-01 . <br /> \. - r (j►ppplica:nt U me) S' ET ✓K-. <br /> AREL <br /> ASSO W -'L..AOV S7 t,M —�– <br /> (Xailing address) FORMS Z9 <br /> tB G10 !:s NOTE <br /> (City, Sbate, .T,ip Code) <br /> (Area Code Talep6.om NUMber), <br /> Sketch (Detailed playas may be subudtted) <br /> The undersigned hereby applies for pe=issioa to.excavate, construct and/ox <br /> other 'se-encr ch on Couuby,Hiffhway RAght-of-Wfty-co the sift,..•o <br /> • a _ approximately L'ee 1 e <br /> of A �.,� • ., , by VqxEoxmiag the <br /> following work„(description of work) : <br /> SL <br /> • r <br /> Won will commence on ox'about Por approximately <br /> days. <br /> 1, the =dersigned certify that X am the owner of the respective property, or am <br /> qualified to represent the owner and agree to do the woxk described above in , <br /> accordance with the rat�ks, regulati 'of' San Joaquin County and subject to <br /> inspection and approval lo.ga, 0i <br /> �071 <br /> Signature of Applicant Title Date <br /> et►BxRk.Asl/ ti f6/e01 <br />