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FROM :CALIFORNIA WATER SER'OICE FAX NO. :2094640195 Sep. 21 2007 12:59PM P 6 <br /> APPLIdATION FOR WCROAMUMT PF. WIT <br /> Ts <br /> .• Date � � O8`H'ZC9 USE ONLY ' <br /> TO: San Joaquin Cowaty SOB #--2302 ( REP # <br /> Department <br /> of Public works AEN <br /> L Z . DATE 1'L-1- C <br /> VAF;7.D• q-I ,� TO 11- 1-0-) DRZMAYS s <br /> ( 1?xieaaat Name) STRE T MlSrLVrdE Avie. <br /> AS80\4 �' RSM O V S7t\CYC ��C�� A <br /> `X'YP3 i4aUe <br /> A(Nailing <br /> �Addrood)� r� FORMS �S/�vw� k.-Z? <br /> IC11�3 NOT <br /> (City, S�taete, .Up code) ' <br /> (Asea Code - Teleyhorte X=bar). <br /> Sketch (Detailed plaas ' say be submitted) <br /> The uade Signed hereby.applies for perMiss;Wn to.excavate, rL%ct a=d/or <br /> ots•encroach,on Counby aigiaway Rtgtxt-4P,Way•oz�•the g3d� cf.. . <br /> approximately _ �� e ta#ia <br /> of ° 'Se <br /> following ark (descri ition of work I by <br /> •, aN <br /> work will Commence on, or'aboizt ;t or approximately <br /> IQQ days. <br /> x, the undersigned certify that I am the Owner of the respective property, or am <br /> qualified to represent the Owner and agree to do the Cork described above in <br /> accordance with the rul , regu24 ions'o£ San Joawd a Counter and scab ject to <br /> inspection and approvalbA 4-14-1 <br /> ' <br /> Signature of! Applicant - T;We Date <br /> iasrazc.ast�ccana WOO) <br />