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y1 2007 09:05 2094689324 SJCO PERMITS PAGE 01/01 <br /> APPLICATION VOR ENCROACHMZNT PERMIT <br /> PLEBE PRINT: I <br /> Date 0 1 19 I �� _ OFFICE USE ONLY <br /> To: San Joaquin County TOE 4 IIObJ~ REF # _ <br /> Department of Pub::.J.c Works APN CR r <br /> EXP. DATE <br /> STEVE CARTEQ , P.6,. AIID &-A-P-7 To /d-i5�a'7 Dx�vE�r�xa: <br /> (Applicant Name) S7T2EET fArWeSbQ <br /> 3330 CArnmo j Pgej(. ' ki ve X550 AREA`c�fl�y Qum sup <br /> 'TYPESClJL{�A�SQ-�5T'!AX.� * <br /> - (Mailing Addzase) FORMS -� <br /> CAM6konJ PA2K , C,Pr 8568? NOTE <br /> (City, State, Zip 'Code) <br /> (730) 616 600"� <br /> (Area Code - Telephone Number) <br /> Sketch (Detailed p7ann9 may be submitted) <br /> SEE RTs��v <br /> The undersigned hereby applies for permission to e;�-a4--, cerin and/or <br /> otherwise encroach on ^_cunty Highway Right-of-way on the SOVTN side of <br /> PATTE2S00 PASS KO p approximately Z50 feet/Fp+� N0e'T►+eft.r <br /> of -5$0 by pe'rtorming the <br /> following work, description of work) ; V-T1L12E £xS <br /> � "T'IN6,. vgft1.S MW-1 prNlD <br /> M�1-t5 i-oR A 5-DAI scit� VAP04 EI(TQAf:rIOrJ PILOT 7r r <br /> Work will commex�,ce on or about for approximately <br /> days . <br /> 1, the un.dezoign.ed certify that I am the ew,jer of the respective property, or am <br /> qualified to represent the owner and agree to do the work described above in <br /> accordance with the rules, ;:egulltions of San Joaquin County and subject to <br /> inspection and apprcva).. <br /> Signal re of Applicant - Title Date <br /> KMTFn.c!:\A'Rr.1cr?4L (r,/CCV <br />