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11/21/2807 11:59 3108274938 RTMF PAGE 02 <br /> 11/21/2 00 7 139:30 2094699224 SJ00 PERMi I!� r gut epi/e <br /> A,p';,LxCATjON FOR M4CROACM(ENT pE1VST <br /> nate 12-1 o5l Gr7 orlTCli Vpa ONLY � [ <br /> T� Oren Joaquin CQur�tY <br /> FTeo, o.. — — REP 0- <br /> -"JaA tenant of Public Works APN <br /> Y1�Y faller Vxt'T <br /> A <br /> (Applicant iia al S'XAEM'f, <br /> jMHA Dc_ j QUAD _4YiG <br /> ze,, i2-$ A bbat V-rnne &Iva. TY-pg ::..';.Mr���_- :' <br /> Ven ce NoTR <br /> c A , Qo z j I - <br /> (City, State, Zip Code) � � - <br /> 3io $7.1 r sozq <br /> (Av'ee& Coda ':elsphaaa xtumbsr} - <br /> 5k®ts7ri (netawaed plana ;nay be oubm�tted} <br /> �JVe wilt be mWino) M octant poor cYdc LA? qrd dowvt bO <br /> Nor* of w�j cj)x , -'Ole)t w;tl be COL41e Of Vehides <br /> tt c�o,mpare 4-he $i 2E?. <br /> Toa undersigned hereby 4FV1i*$ fOr POr" reir+n to excavate, Cor,struaz and/or <br /> otherwise ersarpaCh on county gjghway Right-of-way on the aide d� <br /> _ appr©x�ma►tely IE ss �ti►ora pert ma <br /> by pez2or'ming the <br /> o f �'a 10►i r! ,�VL�tG►�� <br /> fcllowing work. (domari t an of Work) : t� ttsr— V <br /> -d,wl,% an -t-i�e ai' NSWr1Cox t ►fit -- <br /> vlark wj.l oOmmanCe on 1 about _ 12 5 101 for aggro <br /> — � may. <br /> tr.e undersigned certify that x am the avmer ::)E the rsapoetiva Propax-ty, or ati <br /> rk <br /> ed <br /> accr�rdancCtw�tnpCh e Lii dee r.gusa iat�aga <br /> otgan ,oaquinthe �:Ountysazrdbdun7ecren <br /> to <br /> inspection and approval. <br /> 9lgnatux4 £ ApplicAL� - Title Dake <br /> rU1�7Y,R,./7"Roleftt ?A/M <br />