Laserfiche WebLink
COUNTY OF SAN JOAQUIN Date:Z / 2� zde sr <br /> DEPARTMENT OF PUBLIC WORKS Received b <br /> CR# _ <br /> d� <br /> DRIVEWAY AND PAVED FRONTAGES �- <br /> PERMIT APPLICATION <br /> APPLICANT OFFICE USE ONLY <br /> _.141 , JOB# 11005 ISSUE DATE <br /> N APN - O$ FEE DUE <br /> c` EXP.DATE DRIVEWAYS: <br /> Address STREET g$7 wo. * <br /> �i 5 LS-lo c CAan _QUAD-Z27 <br /> / — City,State TYPE <br /> FORMS <br /> (Area Code)Telephone NOTE <br /> SITE INFORMATION ye 5 PP.e 12'0 <br /> Parcel Owner's Name S.o.,t, kep; tai ®to Ohe S/aft, <br /> ite Address <br /> DRIVEWAY <br /> '\ City,State-Zip Code TYPE QUANTITY WIDTHS <br /> 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 WeS_,4 side of )"ager Avenue- <br /> City, <br /> VC utCity,State-Zip Code approximately S&—) de--et-Y mileof rG/arn er <br /> by 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 <br /> AccessTer AppTormOrivewayPaved frontage <br />