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11!05/2007 12:51 91.6-386-9139 R A HEAPS PAGE 02 <br /> APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT. <br /> Date; November 8,2007 <br /> OFFICE USE ONLI' <br /> To: San Joaquin County <br /> Department of Public Works 1013# //,)0 REF <br /> #_ <br /> CK # — <br /> Richard A. Heaps Electrical Contractor Inc. EXP. DATE �" `c 9 <br /> (ApplieantName) VALTD/1-11-u? To -/-ejE, DRIVEWAYS <br /> STREET4 L'<'/,�;�i� <br /> `-s� QUAD <br /> AREA .0 Qu°►D� <br /> 8909 Florin Road TYPE u=x-q T C�� <br /> (Mailing:Address) FORMS <br /> NOTE <br /> Sacramento,CA 95829 <br /> (,City.State,Zip Code <br /> (991 b) 386-8857 <br /> (Area Code-7elephonc Number) <br /> Sketch (Detailed plans may be submitted) <br /> PLANS, SPECIFICATIONS, 'TRAFFIC STANDARDS <br /> The undersigned hereby applies for permission,to excavate,construct and/or otherwise encroach on <br /> County Highway Right-d—Way on the NS-EW side of FRE &H CAMP ROAD <br /> approximately_ 530 `feet/mile of rNTERSECTIQN YMPROVEM- <br /> BOTH N/B&S ON/OFF by performing the following work(description of work): <br /> INSTALLING TRAFFIC SIGNALS/LIGHT.IN+G FOR BOTH ON AND OFF RAMPS OF I5. BQTFI <br /> NORTHBOUND QN/OFF AND SOUTHBOUND ON/OFF <br /> Work will commence on or about NOVEMBER 19,200 7 for approximately <br /> 40 WORKING days, BUT MAY NOT BE CONSECUTIVE DAYS <br /> 1, the undersigned certify that I am the owner of the respective property,or am qualified to represent the <br /> owner and agree to do the work described above in accordance with the rules,regulations of San Joaquin <br /> County and subject to inspection and approval. <br /> PPM l.'AGER 11/8/07 <br /> ature of .. Title <br /> Date <br />