Laserfiche WebLink
COUNTY OF SAN JOAQUIN Date: .5 l i_11 <br /> DEPARTMENT OF PUBLIC WORKS Received by <br /> CR# <br /> DRIVEWAY AND PAVED FRONTAGES <br /> PERMIT APPLICATION <br /> APPLICANT => PL OFFICE USE ONLY <br /> � r �2J�1��,1,i ✓'2 tiur� JOB# 11005 ISSUE DATE <br /> Name APN�A - 5.' /' FEE DUE <br /> zy iv�� -� <br /> EXP.DATE DRIVEWAYS: <br /> Address STREET //' ^ ��• <br /> AREA QUA <br /> City,State-Zip Code TYPE <br /> -3-i .3 AUS u FORMS��� — <br /> (Area Code)Telephone NOTE <br /> SITE INFORMATION <br /> Parcel Owner's Name �wSf Qw !e u�r�s �� pr cs C1e,4u�eW oq oe -1i <br /> Site Address <br /> DRIVEWAY <br /> City,State-Zip Code TYPE QUANTITY WIDTHS <br /> AGRICULTURE C FRONTAGE <br /> (Area Code)Telephone COMMERCIAL <br /> INDUSTRIAL @ R/W <br /> RESIDENCE <br /> CONTRACTOR PAVEDFRONTAGE <br /> ���%� ✓� ✓' ry' LENGTH: z Ft. X WIDTH: G ��. Ft. <br /> Name <br /> bum <br /> Address The undersigned hereby applies for permission to encroach on County Highway <br /> Right-of-Way on theSov'—t side of_.� .r�� L'.c>_)4-1 2 <br /> CityState-Zip Code approximately O ('feet/mile�,}?�S i of /L?j <br /> 7G�j <br /> -, S7 !�z, -� C� � i'`7 ,by installing <br /> (Area Code)Telephone ��' v✓2 <br /> Work <br /> will commence on or about k,; f "'t4< <`r' or approximately. 'J days. <br /> SKETCH(Separate sheet may be submitted) <br /> �I <br /> 1 <br /> 1 <br /> /1/r;�GL� LG✓� (� ) 2 7 <br /> ( U <br /> 1 <br /> Will this project be self-installed? NO YES Contractor's License <br /> AccessTer App!Forn'DrivewayPaved frontage <br />