Laserfiche WebLink
[100-O'?-2007 12:08 CAMBR I A 1787 9-5 6649 P.a,-21'83 <br /> APPLICATION FOR ENCROACEMIXT PEXXIT <br /> ��t� Z.a� �7 4F$IdE t]SE oxrx <br /> To. San Joaquin County L70B ku � <br /> Department of publl,c Works AP14 _ CR <br /> Cv EXP. I)A E <br /> VALrT7 Gam-Chi_ x0 7-7-17 rRxVEWAY9: <br /> (Applicant Nasse) �v ,} � STREET — <br /> L'3 Q ?XA .__ QUAD <br /> (Mailing Addreda) FORMS <br /> f NOTE <br /> —S �fft <br /> +� <br /> (City, State, Zip 'Code) <br /> 3 3 <br /> r -36 <br /> (Area Coda - 742aphorse Number) <br /> sketch (Detailed plans may be submitted) <br /> The undersigned hereby applies for permisalcn to excavate, COnStruct and/or <br /> OthexwiSe encra ch on County Highway Right-of-Way on the _,_-CLr side of <br /> ST-r4L�r approximately _Gr��._ fee /mile Sc1�_-+r�_ <br /> Of .. 1 -1G" 0 h7 _ , by Periormj_rg the <br /> following wcr)c (deecrip*ion of work) : w <br /> work wi�l commence on or about 2-0 d-7 for a.pproximate:.y <br /> L days . <br /> the urdersigned certify that z am the owner of the resPectdve property, or em <br /> quali,tied tQ repreeen+: the owner arid, agree to do the work, de8eribed above :T,. <br /> accordance with the rules, regulations of San 7oaguir, County arid. subject to <br /> insPgction and approval. <br /> 8ignaeure df App Scant - TitZe <br /> Date <br /> r�5s•rea ���,reracxaG !cion <br />