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DEC. 11. 2H� 3: 29PM PG&E � � � NO. 28'3 2!3 <br /> A�gX,xQAT�O�T FOIZ BNC!'ROACML= <br /> PTti RR_. <br /> oFiVICE TYSS ONLY <br /> pate o <br /> 108 R3F #. <br /> To: San 7oaqu-in Cotmty APN CIV # <br /> pepartment of Public Works EXP. DATE <br /> ti .A VAT�In. ►2� c��t TO <br /> DRIVI�GPAYS <br /> - {Appl.i,tant lama} '-'�M't��bl.) <br /> til/ TYPE <br /> ' FORMS <br /> (Mailing Addres®) NOTE <br /> t'i <br /> City, Bate, p Gods) <br /> - - - (Area ads TelaPhone NtQaber). <br /> S]cetch (Detailed plays may be submitted) TRAFFIC CONTROL PLAN <br /> SHALL BE AS PER <br /> CURRENT M.U-T.C•b- <br /> ��, � IO2,-Ftz49 Q'5 CALIFORNIA SUPPLEMENT <br /> PME <br /> JOB'p � p Bl�i <br /> WrOMKT <br /> QNB cA 9004 <br /> The undersigned hereby applies for permission to.excavate, .caAruot and/or <br /> �-} ,• aide..oto <br /> otherwise encro 'Ch . n-,CO3=ty:1iighway Right-a£-w y OR-tile feet/mile- -' <br /> G— .� approximately <br /> Ey\f�-ter a• _ , by verformixig the <br /> of <br /> following work (deacxiptiori a£:work) : <br /> 1 for approximately <br /> Pork will commence on or $bout <br /> _ S chis. <br /> I, the undersigned certify that x stn the owner of, the respective, proBerty, or am <br /> in <br /> qualified to represent the owner anal agree to do the viork descri`b <br /> aecteto <br /> accordance with the rules, regulations 'of San Joaquin, County and aubj , <br /> spec n d a roval.. <br /> " � �,�y��•��.-gyp �t Q,7 <br /> D to <br /> Si at re of Applicant - Title <br />