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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Sep. 10 2007 12:t,4PM N 2 <br /> AppLICA,TIQN FOR 4;CM0A.C` ` pEaWT <br /> 'OT���7 PRr�S_ • ' <br /> REF <br /> pat 2,, <br /> San Coaquia County ,708 . �'"?�?— --'� <br /> Department of Public 'WorCR <br /> ks <br /> P.iCP. DA'f'g <br /> VALID• _ 4 To �//s=ue . bRxVLVAYSs <br /> sTr ii dU� <br /> (Applicant name) AREA 52 <br /> � �5 <br /> � opt 7VMM0 7 57 tAW TYPE <br /> (Mailing Addrass) <br /> (City. stato, .rip Code) <br /> .a W 'AWA- rr <br /> (Area Code Telephone Number), <br /> sketch (Detailed plans may be submitted) <br /> The undersigned hereby applies for percussion. to,excavate, construct and./or <br /> otherwise•encroach•on County.Highway Right-of-Wa on•the .VV' ,.5"T NO�'C _ <br /> V CIA•'N Cy S'L• approximately <br /> O fir .. +• , by 7perfo=4ag the <br /> following work (description of work) : <br /> iC 1G."L'4 S1�1I[ S tL" .. WT WORK ,� ''CAMY- <br /> BWU PaM' <br /> Work will commence on ox'about QC1•\O`�� for approximately <br /> loC� days. <br /> I, the undersigned certify that I ant the owner of the respective property, or arc <br /> qualified to represent the owner and agree to do the 4ork described above is , <br /> accordance with the zmles regaati of sar: U'oavu = County and subject to <br /> inspection and approval. 6k.to.b"'1 <br /> sigraatuxa of Applicant Title Date <br />