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100/-Jun-09 03:31 PM Pacitic Gas and tlectric (;o b59-263-b426 Ll'i <br /> I <br /> APPLICATION FOR ENCROACHMENT PERMIT . <br /> aEASE PRIM, <br /> Date orrIcS V0E 0=Y <br /> To; San Joaquin County J08 # ,���Z' REF # <br /> rDspartmeiit of Public works, APN _ CR' 4 <br /> VA-0FiG�9 5�1 VAL=DA .2J L-/�-96 <br /> t S-O =IVEWAY9; <br /> (Applicant Name) STREET <br /> d AREAIMAAFMr_A QUAD W <br /> TYPE d i � <br /> j (Mailfng Ad sees) FORME <br /> NOTE - <br /> . <br /> (City, state'- Z p�-C.ode) <br /> (i&a Code -. Telephone Number) <br /> sketch •(Detailed plans may be submitted) <br /> 4 Al <br /> i <br /> The undersigned hereby applies for permission to excavate, con r t. and/or <br /> otherwise encr 4o on County Highway Right-of-Wa on the side of <br /> approximately feet/.M� <br /> of , —Xv , 1by"performing he <br /> following work((description o work) : 1 <br /> t AA f) <br /> I <br /> - I <br /> Work will commence on or about for approximately <br /> days. <br /> i <br /> 1, the undersigned certify that I am the owner of the respective property, or am <br /> qualified to represent the owner and agree to do the work described above in <br /> accordance with the rules, regulations of Satz Joaquin County and subject to <br /> inspection and Wic4n <br /> l. <br /> S Odra' f JP - Tit bade <br /> MASTER.AS ' 9CEDL (6/00) <br /> I <br />