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COUNTY OF SAN JOAQUIN Date:_ <br /> DEPARTMENT OF PUBLIC WORKS Received by <br /> CR# <br /> DRIVEWAY AND PAVED FRONTAGES <br /> PERMIT APPLICATION <br /> APPLICANT OFFICE USE ONLY <br /> JOB# 11005 ISSUE DATE l l 08 <br /> n�" &ame APN 229-�-05 FEE DUE <br /> 2Q�O l�ffu/f o Kd EXP.DATE DRIVEWAYS: <br /> Address STREET_alcoielz <br /> x AX-phIl- �f� ��3 6/ arm QUAD�E <br /> City,State-Zip Code TYPE <br /> ZUCI S3$ '7 6aG-, FORMS <br /> (Area Code)Telephone NOTE <br /> SITE INFORMATION <br /> /Yes <br /> �Onrr re 7 Q_ <br /> Parcejpwn isName <br /> / Site Address <br /> 6/5` a,f 3 DRIVEWAY <br /> X City,State-Zip Code TYPE QUANTITY WIDTHS <br /> ZO 9-5-05- - `f 3 Z 3 AGRICULTURE @ FRONTAGE <br /> (Area Code)Telephone COMMERCIAL <br /> INDUSTRIAL @ R/W <br /> RESIDENCE <br /> CONTRACTOR PAVED FRONTAGE <br /> LENGTH: Ft. X WIDTH: Ft. <br /> Name <br /> Address The undersigned hereby applies for permission to encroach on County Highway <br /> Right-of-Way on the side of 0,1 m�1,e// Cj,,.e <br /> City,State-Zip Code approximately 2 70 et mile S�e� of M n n/ra <br /> installing <br /> (Area Code)Telephone <br /> Work <br /> will commence on or about for approximately days. <br /> SKETCH(Separate sheet may be submitted) <br /> Will this project be self-installed? _ �� NO YES Contractor's License 7 y Z- <br /> AccessTer AppTormOrivewayPaved frontage <br />