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FROM :CALIFORNIA WATER SERVII--E FAY NO. :2094640195 Jun. 25 2007 02:24PM N 4 <br /> APPLMATION FOR $NCIt4ACHMM PNMT <br /> tin -A <br /> Date:... tat <br /> 0073:C9.01C..To: saCounty BOE # 230-77 F # <br /> uepart��m11entt off�Public Works APR C # <br /> (Applietutt NaMO STREET SaMO&A TT, <br /> A S7Q� 4D <br /> TYPE N <br /> v (Railing Address} ry ! $C►RMS t.�1✓, ,L?•29' <br /> (City, sba`t-a' .zip Code) <br /> (Area Code , Tele$hous hex) <br /> Sketch (Detailed �Ians may be su6itted) , <br /> The undersigned hereby,applies for permission to.excavate, const ct =d/or <br /> otbarwise-eaeroach•on Courcby-Rig$way i 3, t-of-"y--aa.tjie , niddi bf <br /> approximately b fe8 <br /> of \\L. (1 1 1, " by Ve7rforming the <br /> allowing work (des tion of work) . yhla-t oo, <br /> it- <br /> 1 Q. w , .• <br /> O <br /> ♦ a 1 v ti <br /> r <br /> 'NOX Z commeu,ce on or'about for approximately <br /> days ` <br /> I, the undersigned certify that I ars the owner of the respective property, or am <br /> qualified to represent the owner and agree to do the 4ork described. above 3n, <br /> accordance with the s, regulati ns'of San Tdaga�= County and, m!bject to <br /> inspection and appromklv1 -wk,C i-) <br /> SigxuAture 09 Applicant T:Lb .a - nate <br /> bMzX=.asla2z0C= NAM <br /> • 1 <br />