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APPLICATIONFOR EOR INCROx•►iCMaXT PtRMIt <br /> PLF <br /> - �P 28Z_3w <br /> Date AUGUST 3-1) 2007 pMM USE ONLY <br /> To., San Joaquin County JOB � �l� - RE.V $� <br /> Depa;;tme'at oi- Public Warks APN <br /> EXP. DATE /2--!-o.7 <br /> EBMUD ATTN: DOUG FREIER. V'ALZD TO /2-/-07 DRIVRWAY9: <br /> (Applicazat Mama) STREET yNL.gN'P P410 <br /> AREA TW7N _-_ QUAD �^ � <br /> PO BOX 228 TypE 7'&eAjc <br /> (Mailing Address) Fol <br /> NOTE <br /> STOCKTON, CA 95201_ <br /> (city, State, -Zip code) <br /> (209) 946-80QQ <br /> (Area( Code Telephone Toil ear) <br /> Sketch (Diatailed plana may be Bubiftit:ted) <br /> r-. <br /> Drawing Detail Attached <br /> F <br /> Tf a un&!rsigned hereby applies for permiopion to ,excavat=e, construct and/or <br /> otberwige••encroach, on Highway Right-of�-wa o the <br /> INLAND DRIVE -- approxj.cztately <br /> of; 19G ^ <br /> o ,ep, -_=- - , , by performing the <br /> rollowing work (description. of work) : F.xcava�p and re�ja�e a�r�Kjmatel3� � �n'n fapt <br /> of header cable and_15 ano es along the We5t s de _fn the TnI nd ' rive county road <br /> right of wn <br /> Work will commence on or about �'�;�-- Zaa7 � _ —�� for approximately <br /> - -- - days. <br /> Utility installation <br /> 1, the underaigned certify that Z am the •owner of, the reapaativeXpxXVMXyy, or am <br /> qualified to represent tba owner and agree to do the work described above in <br /> accordance with the rules, re4u.lations of San Joaquin, County amd subject to <br /> ection and approval.. <br /> ASS-ISTANT SUPERTNT ,NF DFNT.A UEDUCT is <br /> �3�g��1 . <br /> gign are of Applicant Title O <br /> Date <br /> FtRsrsk.v9\r'Rsxr..GTb., (n/ae1 . <br />