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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Oct. 09 2007 12:51PM P 2 <br /> .APPLICATXON FOR EYi MOAMMUT PE1?UXT <br /> ' I+LSAS�; PRINT a . <br /> Datey -�� OF$ZCB Usk OMY <br /> To= Sia aoacXvim co=ty JOB # 7_30?7 REF <br /> ]Department of Public Works APR p # <br /> C <br /> M. bA'I'7� --9-� To DRIVRWA'YS i <br /> (Applicant Hama) SZ Tyrge,Eo vE . <br /> ' AF-PA Si �-� <br /> ASSOW N� Mot�,T'F ATYPE � 1D � <br /> filing Address) OZ S�ww. .�'�9 <br /> - (C'ty, St Ato, .Zip Caere) <br /> 04ea Cade .- Telephone Number} <br /> Sketch (Detailed ilans may be submitted) . <br /> of; undensi�ed ��Y.appl3 es for pexmalssfoa to.excavate, coa,struct and/or _ <br /> of V ' e•erxcroaCh•oiu Cov aby Etighway Right-of-wa -03%•the <br /> of appxoximAtely - <br /> v <br /> foby Verfo=izlg the <br /> l.xawia Work ( s 17tx ti,ort of work) : � • <br /> Work will co=eace on Or'about <br /> daYs• for <br /> epproxtaately <br /> •, <br /> x, the Undersigxted certify that I am the owae�r, of the respective property, or am <br /> qualified to represent the oWaer and agree to da t�xe work descried above <br /> accoxdatxce with the Z.4 sr zegu�7.atiGas'of San soaqudn Co=ty and subject to <br /> inspection and appmvatl(S,c"�,�O+[•'D"C <br /> signature of Ap1*7.icAn4 <br /> Dalte <br /> ►asrsA.bsla�aama cs/oo) <br />