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FRO=9 :CAL I FOP?'d I A WATER SERVICE FAX NO. :2094640195 Au q. 09 20C17 12:19PM P 2 <br /> APPLICATION VOR ENCR4IiaMMT PMMIT <br /> pts 09-MMI <br /> oinrxG'S VS)Z ONLY <br /> viTo: San son County X748 #....(�i ..— # <br /> Department of public Works AIN CXR ' � <br /> M. DATE /5-07 <br /> 'V"ALM To D&rvmYSs <br /> (Applieaat Name) STMMT TUJtWW , <br /> QIIIID <br /> TX�I� <br /> (uai.iing Address) FaIRMs d✓I(J <br /> ITOTE <br /> (City, State"Zip Zip co`\d1e) <br /> (Area Code - Talephone Np&or). �, <br /> sketch (Detailed plans may be aubmi tted) , <br /> Che undersigned hereby'applies for parmi.ssioa to.excavate, construct and/or <br /> a se•eacroach•on County Highway fight-of-Wa ••Dant tlxe .' C'CCX' gidp..af . - . <br /> ��tti�C ^CbN QVC approximately ee "BAST <br /> of "�� F�'V • ' bx perEormf ng the <br /> following work (description of work) - <br /> 1°1101 FR,tl,L'C �1 i��S \ �` -bloom <br /> Work will commence oa or'about 'b�l for approximately <br /> 1vCa <br /> days. , <br /> I, the undersigned certify that x am the ovaer of the respective propemy, or am <br /> cqua.li£ied to represent the ownex and aga:ee to do the work described above in <br /> accordance with the rules, regulations'of sun aoavi n County and su`b'ject to <br /> inapecti.on and approval.�10 0"•-a-'�? <br /> Signature of Applicaut - Title Dater <br /> iPlL3'JOL.PII�RfBCC�L (i/d0) . <br />