Laserfiche WebLink
FRJM :CHLIFLRNIA WATER SERVICE FAX HO. :2094640195 Jul. 18 200 12: 1.'HM H <br /> APPLxCAT:rdN 1?oR E cROA,CSM',i,' PON= <br /> r <br /> Date t OO� OrVI S vsIC OMY <br /> To: San -70a <br /> Dapartm=t of Public Works <br /> C1��.1�rORNIP� A;C' R f V �; & e�TO , �o-r=�7 ,. DAYS z <br /> (Applicaaat Names) QQ AREA, Q=D <br /> sTR�E�' ••� J�,'.- - '� <br /> Sy <br /> (mailing Address) POI <br /> Stmw ov\. 1 q�san-�S NOTE <br /> (Cityr Stajt_o, ,Zip Code) <br /> (Area code - Telephone M,mber)� <br /> Sketch (Detailed plans may be submitted) <br /> The undersigned hereby,applies for permission to,excavate, construct and/or <br /> otherwise•encroach•on Country.Highway Right-of-Way.•oa.-the W -•- ', ; , nide -bf— • . <br /> of hYoqe <br /> following work (description of work) ; <br /> �NSTA LL 1,1 \N Zl" STE NMVE . <br /> • KtANAY AT W F\L1— __ <br /> cNMM tomo tv -NEZraDl UEU t� ,,,,1 t �f1v.`t�YTt� • 3'� .a. <br /> Work will commence on or'about .C�� �11'C1� for approximately <br /> t days, + <br /> 1, the undersigned certify that x am the owner of the respective property, or am <br /> qualified to represe=t the owner and agree to do the work described abowe in . <br /> accordance with the xul9s, r0paati 'of San. t7oaqu�n County and subject to <br /> inspection and approvai7 '\I "O , <br /> J <br /> 0"1 -\14 Q11 <br /> Signature of Applicaut - Ti.t3.o Data <br /> YO►PRZiG.DS\n'■e«+-•moi+ �i/00) '4 <br />