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FROrI :CALIFORNIA WATER SERVICE FAX NO. :2094640198 Jul. 18 2007 12: 14PP9 P 6 <br /> AU�PLTCATION FOR IWCROACRMMT PMWT <br /> Date �1 O�`8'zC ISSN ON+�C <br /> To: San Yoa ty ao8 # 7.3077 _ REP # <br /> department of 1Public Works APN _ # <br /> d / <br /> -07 <br /> 15T-?N\14 VALIx o7 �ro a- a �. DktrMAYs: <br /> (A.pplicaxit Namaa) STMT 5 <br /> AM am <br /> ASSOW ST 'tAM TYPE <br /> (Mailing Udress) FORMS <br /> Qz as NOTE <br /> (City, Sbatte, .Zip C*de) <br /> (Area Code - Telephone Number), - <br /> sketch (Detailed �lanz"may be eubmitted) , <br /> w <br /> The undersigned hereby,applies for permission to,excavate, aoagtruat at�d/ax <br /> otherwise•encroach-011 County Highway I i_ght-of-way on-the <br /> approxtmately a <br /> s <br /> Of XAy a by•bexforating the <br /> following work (description of work) : r <br /> Work will commence on or'about ""(•1 I U"I - for approximately <br /> WQf days., •, <br /> I, the undersig-Aed, certify that I am the owner,of the respective property, or am <br /> qualified to tepresent the owner and agree to do the 'voxk described above in , <br /> accordance w3,th the rub s, regula,ti as'of Sart LTo&qu�n County and. sub j ect to <br /> inspection and approvat��9-VI-Q"t�� ` <br /> Signature of Applicant ;gitle <br /> Data <br /> �asr�a.vaumcs� cc/oo� , <br />