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FROM :CALIFORNIA WATER SE=RVICE FRY, NO. :2094640195 Jul. 12 21JU r' 11:4yNM H 6 <br /> APPLICATim-T ?OR mHa RQAC N'.0 pM3:T <br /> Date V OVOICS USE ONLY <br /> To: Saul Joa"tY JOB #_1101 RV # <br /> Department of Public Works APN <br /> • �.A�t�OR1�11I�'� A�'�'F� S'�f�V M. D3l • <br /> VALM 7 0 • TO r o DRIVEWAYS: <br /> (Applicant Name) STREET i <br /> TYPE -R66LL HoGf <br /> (Mailing Address) FORMS /a✓r(!. L�' <br /> Cao CS NOTE <br /> (City. State, .21p Code) ' <br /> (Area code - ''elephome Miner) <br /> Sketch (Detailed plans may be submitted) <br /> The undersigned heresy applies for permission to.excavate, co .tet and./or <br /> otherwise <br /> 8 W o�tY•8i5rhWay fight-of-Way•on the Q si <br /> � da,,-bf <br /> approxi mtely t g t1 f ae <br /> of .r ' hy'Pex'tOxtttS.ng the <br /> owin work (descry, t: oa of work) s <br /> tt.s,�1A�.�E.. <br /> -40 <br /> Work will commence on or'about U <br /> ay <br /> - l - tax approximately <br /> Sys. <br /> x, 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 ruilgag xegulati nA'of San Joaqu0n County and subject to <br /> inspection and alapxo ��y�4"Q ' <br /> SaE7sstvrxe sf <br /> AppXicaa - Title Data <br /> +o►sx�.val�ax�c woo) <br />