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HL0..a-ib-ALJ! iu: D_, tr0I'll:i 0:icfUjlibb'J,�-f,JL�fU i <br /> APA 7CATZON FOR ENCROACHMIwT pERMIt <br /> Date — S - 1(9 -0-7 <br /> - Qb'&'ICv Os& ONLY <br /> 'So: 9azi Joaquin .-ounty J09 #A295 REF �¢ <br /> Departmeent� of J LUbji workQ <br /> i5N S /�/�1 FSL7. D TL 6`7 <br /> VALID TO ARSV&f➢PAYB: <br /> (Applicant N 0) STREET <br /> qac(, . V ten , ARRA _. <br /> (Xall!Lng Ada age) FORMS <br /> fR sn�o CA � >�oss <br /> (city, sterna, Z coat) <br /> (AraA code - Talaph ne Nuniber) <br /> Sketch (D®talled plans m y be submitted) <br /> CF A �r ;4a c �( (7 6 <br /> The undersigned hercbyap Yier� for parm4psion t4 d�eGtiivat9, col�ugt and/or <br /> othexwiee encroach 01% Cau ter Highway Rigk1C-a *Ray on the /,I. X N q� <br /> L- _� ap rvximately 400 ve+: <br /> of ._ �►Y +,.a T [9 TdGKTooj-- ' performing the <br /> fcllow�.nq world (descz•iptio 0r worlc) : / G E ->Uti 14C <br /> __RC-AcACIAJ C� cEM En!-� PGf�N ASI N G tiJb A <br /> Q./,,J (T i 0�lJ 7 a N Fr �C f N Coo.) 190L a l4"n/W N 0 <br /> wank wj.l), aammeztee or: or out for appraxiMAtoly <br /> days. <br /> T, the undersigned gertify. that I am Cho towner of tht rQapeCtiva property, or am <br /> qualified to represent thol Owner +And agree to do tha work dq4:;crik;ad above in <br /> acnordano© with the rules, ': angulations of San Joaquin C012n.ty and eubjact to <br /> inspection and approval. <br /> I <br /> 81 nature of Applicant - T tle Date <br /> .'M,'ITRA.*9��RRRC3S7L (R��R) <br />