Laserfiche WebLink
209 9527381 8-mile enginerring <br /> 11:55:40 a.m. 01-11-2008 214 <br /> APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date (JI IQfj <br /> OFFICE USE ONLY <br /> To: San Joaquin County JOB # - .50 l J <br /> Department of Public Works REF # <br /> APN CR. # <br /> L ,T- EXP. DATE Z <br /> (A VALID ;-- TO r_.9 DRIVEWAYS: <br /> (Applicant Name) STREET ) z�. <br /> TYPE <br /> (Mailing Address) J FORMS <br /> —Lc�fq�r'�'�� �•�/'7 `i�(��`� NOTE ' <br /> (City, State, Zip Code) 4� <br /> LO-0-7 <br /> (Area Code - Telephone Number) w <br /> Sketch (Detailed plans may be submitted) <br /> The undersigned hereby applies for permission to excavate; construct and/or <br /> otherwise encroach on County Highway Right-af-Way on the <br /> ICProxi ..- side -of <br /> of aPmatel C���, y - r�QD—teG� -Seet/Avi-le <br /> following work (descriptionof wo—1 , by Performing they <br /> .i �. — �• T <br /> t <br /> Work will commence on or about <br /> days. for approximately <br /> I, the undersigned certify that I 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 /> S gnature of App As <br /> ant - Title _ <br /> Date <br /> HAS"Bp MYEESOML <br />