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11/27/2007 11:52 2094689324 SJCO PERMITS PAGE 01/01 <br /> APPLICATION FOR ,ENCROACHMENT PERMIT <br /> �-'_LEASE, PRINT <br /> Data � �� <br /> O"XCR V99 ONLY <br /> To: San, Joaquin Cour.Ity TOB # l/ , <br /> Department of ,Public Works REF � <br /> APN CR' $ <br /> EXP. DATE -40 8 <br /> VALID - 0 - _ DRIVEWAYS <br /> (Applicant ,Name} STREET UAI7 <br /> 'j AREA yl1 A�w TYPE <br /> 44 <br /> ` �'P"�(AO� (Mailing Addresp) FORMS <br /> 1 W2-1 q 32A)5 NOTE <br /> (City, State,. Zip 'Code) <br /> 418 2�b <br /> (Area Code - Telephone Number) <br /> 20 114 b <br /> Sketch (Detailed plans may be uBmit ed <br /> Sundance Running Cl(c#of Stoc�ton ts�es �o sponsor and hold the CALIFORNIA-10 road 10 mile and <br /> 10K running races on Sunday, January 2 'The starting time is 9:00 A}vf-and a duration of three (3) hours <br /> expected. The proposed race courses would begin and end on the grounds of San Joaquin General Hospital and <br /> utilize sections of Manthey, Manthews and Howard Roads. The basic course layout is shown on the attached <br /> diagram and will require limiting cross traffic on Manthey, Mathews and Howard Roads while racers are present. <br /> the two(2)water stations will be set up along the roadside on Howard Road at the 3 and 5 mile points of the race. <br /> The Sundance Ruining Club can provide necessary signage to be placed at designated intersections indicating that <br /> a road race is in progress. <br /> All proceeds from the event (after expenses) will be donated to Hospice of San Joaquin. <br /> The undersigned hereby applies for permission to exca'vat'e, construct anal/ox <br /> otherwise encroach on County Highway Right-cf-Way on the <br /> side of <br /> approximately feet/male <br /> T <br /> following work (desc,ra.ption of work) : by performing the <br /> Work Wil commence on, or about <br /> :j mss . for approximately <br /> Z, the undersigned certify that t am the owner of the respective property, or am <br /> qualified to represent the owner and agree to do the work described above in <br /> accordance with, the rules, regulations of San Joaquin County and subject to <br /> inspection and approval, <br /> Signatu of Applicant - .ride <br /> Da e <br /> �Al3T6k.r.s\rDQBCFmL (5/001 <br />