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APPLICATION FOR ENCR04C MMMT PERKIT <br /> PLRA93 PRINT:- <br /> OFFICE USE MLY <br /> To : San Joaquin County Jos <br /> De artment of Publi orks APN CR # <br /> / <br /> EXP. DATE --a <br /> ( � VALID TO _ - �07 <br /> (Applicamt blame) —�--� DRIVMMYS <br /> • 8TR$ST� ��. �ARZA Z-0,01 _ <br /> TYPE ' 1W&A->C'H t <br /> (Dail ng Lddress) <br /> NOTE — <br /> (City, ate. Zip Code) <br /> (Area Code - Telephone Namber) <br /> Sketch (Detailed plans maty be Submitted) <br /> .3s <br /> �e <br /> C� <br /> 11� � <br /> The undersigned hereby applies for permission to <br /> othexwie excavate, construct and/or <br /> eacr h ty Bighway Right-oP-may a ei 0 <br /> Of <br /> rcximately -- - e mile <br /> following work scrip OF 4on of p. the <br /> . 9 <br /> Work will mmence on or about <br /> --_ days. for approximately <br /> r, the undersigned certify that Y ani the- Owner of the r' <br /> qualified to represent the owner and a ePective property, or am <br /> accovdanc;a with the rules, re gree to do the work-described above in <br /> gulatio�e of San Joaquin County and subject to <br /> "ain�dval.- Tiblr <br /> _ Dat <br />