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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Apr. 19 �2OIJf 12:0(FM r 2 <br /> APPLICATION FOR 1w=0AC=Q= PEMIT <br /> Date-, VA alm-1 0s�x�.��..o�,�...._._.To: 9= JoaTAn County JOg # 77 Res <br /> Department of Public Works ADS <br /> C��.1�r0 NSR'\NA` U" SIRY 4 MDA <br /> (Applicant game) STREET _!5)1'A164A_ ✓; <br /> TYPELl s <br /> (Nailing Address) POW <br /> (City, sbatat .Zip coda) <br /> Mrea Code - Telephone Number). <br /> sketch (Detailed �laus may be submitted) <br /> The undersigned hereby.applies for permission to-excavate, construct and/ox <br /> oth2mae-encroacft.On couaty-MLghway Right-of-Way•ou•the �1.t `:C' aids,of - <br /> S1NC.1..A�� 1'�V� approximate�.y �„ fid' �,,f'a�'� <br /> of t0 �, I -- d. . ♦ b o the <br /> following work (description of work) : _ <br /> '�.., ►" �'�.�`t SLE� �"���[' 3�X�' ���� 4aA1_`:�«.. - <br /> � S., 1 N L 1 AV'T., <br /> Work will co=erce on or'about C1L! ` l9`t�'Z fox approximately <br /> L (4 _ days. ' <br /> I, the undersigned certify that X am the ovaex of the respective property, or am <br /> qualified to represent the owner and agree to do the aiork described above in , <br /> accordance with the rules p;egalatiaxe of SJoacju�n county and subject to <br /> inspection and approPal. pb 1 1410 <br /> Sigmturei of Applicant - TiE1e Date <br /> lols'l'+k.4Arifolte�mL ti/00) <br /> • i <br />