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APPLICATION FOR ENCROACH = PERMIT <br /> Date — ��� -0-7 _ _-_ OFFTCZ Vex ONLY <br /> '110: gan Joaquin County nig ff /zoos' <br /> oepartment of Pu Iia Workp APN CR' # <br /> f� t- l 1 F,Xp. l]ATE 6, 0.7 <br /> ;VALID OZTo OG DRTVgWAYANasq) 3 ��TAveQTJAZI <br /> E F+ti- 17 YP't _ ryd-T v re <br /> {Xftillag Addreaa) FORMS � <br /> f`zu.SN p,� G4 `�37?-5 <br /> (Ciy, stace, Zip Mdo) <br /> (559) ,3� 5 r - q3- 0 <br /> (Araa Cod* - T4jephonc Vv=bdr) - <br /> ,i <br /> SketCh (getail*d yjaa€l may be submitted) <br /> 5 •� 7- r�4 c f� 6 <br /> I <br /> n't undersigned hereby applies for pormission to exeavatc, eoueCx,uqt and/or <br /> othOrW.cqa en.axOrteh ors, Co=ty aighWay Right-of-Wmx on the ��. X tU � <br /> OU HARK&O AVE approximatal,y - .. � av4 �fW <br /> of �Ot)NT, W` -� lvmul'd o �SC�41o�v Gh rry `par8orming t4a <br /> following work' (description of work) : _Kjl%jrl /3 Z'O"' AC- RC `SQRFACG t? bV <br /> C,5M►jTw-T PLAjJj, S' R[-6 Is-VA r7F*-AcK Daub PA\11N r, c�cW, <br /> JAN r►Q 70 �LA5- YtN_r. 0 FOP. (PQAL-tom( <0#J Trot_ 4 E" TRE1N,;;'k"Jo <br /> c- £,� <br /> I _ <br /> wurh will Commeatae on or about 07 ry,RU 9r_Af --07 for approxirmtaly <br /> 7- I days <br /> 7, the undersigned c4rtLfy that T an the owmar of the rtampect-ive pro,yezty, or am <br /> qualified to r�presene the owner and agrees to do tha work deporijied above in <br /> acdordanom with the rules, regul,ationa of seas Jca.qu.in County and eublact ea <br /> i.napectian and approve.l, ' <br /> i <br /> '9 nature G£ Applied,z't - Title Date -� <br /> MRAt7m.D;\FRRq�L fR/9{IGS <br /> I <br /> i <br /> III <br />