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FRnM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Sep. 24 201Jr 12:t>UM H 2 <br /> APPUCA.TTON FOR MCROA,MMT PFRUXT <br /> pTr,��E pRINTs. � • ' #7936 <br /> 936 <br /> DateA V�J OFSZC CJS 07C <br /> To: Sat10. Joagviacounty Oros <br /> # ��y17 REF <br /> Aepaztment: of Public Warks AM C� # <br /> � A�'��► 5�..�V� n�cr. DAT$ <br /> CA ..1 � Nli�' <br /> VAX,zn��2so-� To iz-�-a� n�xvBraa�s= <br /> (Applicimt Nawaa) STUW L"0j•t/ <br /> p ow t-\M LYPE� - S�GG <br /> f1�L6S <br /> (Wling Address) rogm <br /> skMWLO�A U\ --%Sao-�s 110T2 <br /> (City, Strata, .zip code) <br /> (Area Code , Telephone Dfimber), <br /> Sketch (Detailed plans may be sul mitted) <br /> The undersigned hereby,applies for permission, to.excavate, constmct and/or <br /> otherwise-encroach-Cka County-Mighway Right-of-vay-. a-tbaMAM Sb'l 1. sick.-bf.,. <br /> K\-PkU1q— IMM approximately ' ' ee \t�l� <br /> of ,` �r" �� � a. , by peVforg igg the <br /> foil owi n, work (description of work) : <br /> wor Will commence on, ox•about .. "`, '�]'� for approximately <br /> days.' <br /> S, the undersigned certify that r ant the owner of the respdctive property, or am <br /> qualified to represent the owner and agree. to do the work described above in . <br /> accordance with the rile regulations'of Sart Jbaqu�= county and subject to <br /> inspection and approval. <br /> \"' •�'� . <br /> Signatura of Applica n - T:Lt:le Date <br />