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FPOM :CALIFORNIA WATER SERUICE FAX NO. :2094640195 Apr. 23 ;200 Uj:_S'Jrrl r <br /> APPLICATION Pop. ROCROAmMT pgMT <br /> Toa Saa JoagUTA County <br /> Department of Public works APN Cor <br /> C1�L,1�rQRt�1 A ' .R 5 . 1r va , AmdjZs �o v- -d-7 �x�rs= <br /> `• ! <br /> (Applicant Name) STP <br /> ERT A -A <br /> AREA S`t<M O CTAD <br /> TYPE "t o• � <br /> (Mailing Address) h FORMS .1 <br /> L\ 0 timet �� c NOTE <br /> (City, Sba,te, .Zip Code) <br /> (Axe& Code - Telephone Xtobex),— <br /> Sketch (Detailed glaw may be submitted) <br /> ' r <br /> The undersigned hereby applies for permission to.excavate, construct and/oar <br /> otbAmvi.se•encroach-on Couaty.Righwray. ilight-of-Way.•oa•the 4 t''1 • r�3dsi��f . <br /> approximately t o VV F.S7 <br /> of 1.SS 1 ti N -F+.1 ' .., . x�o .�ng the <br /> following work (desori tion of work) ; 'a1Gr <br /> C\ to �RI_P1hlE i�v �� -i�r ocs <br /> Work will commence os. or'about for approximately <br /> Lao days_ ' <br /> 1, the 'uadersigaed aeztify that x ant the owner of the respective property, or am <br /> qualified to represent the owner and agree to do ae or•ork described above im , <br /> accordance with the x las regulat of Saar Joaqudn County and. subject✓ to <br /> inspection and approval. . <br /> si quaCuze of Applicant - Title Date <br /> �ax�.asL rs/oar •t <br /> ' t <br />