Laserfiche WebLink
COUNTY OF SAN JOAQUIN Date: /0/ 19 l b7 <br /> DEPARTW ENT OF PUBLIC WORKS Received by <br /> CR# O <br /> DRIVEWAY AND PAVED FRONTAGES <br /> PERMIT APPLICATION <br /> APPLICANT OFFICE USE ONLY <br /> JOB#.11005 ISSUE DA <br /> Name APNaL- (q6) - (31v� FEE DUE�'L7T <br /> C W,, Arcs - C G>2f A16• EXP.DATE D AYS: <br /> Address STREET ,\ R# t� act <br /> �o DC <br /> /r1h AJ QUAD 5S • <br /> City,State-Zi Code TYPE &Lt,4W tL 4 <br /> (— .4 ?2- FORMS <br /> (Area Code)Telephone NOTE <br /> 2 7 ( — ©7 76 <br /> SITE INFORMATION <br /> PKv�,��srr►�a" cor >tir��yr�r 6,F1v'7--1 <br /> Parcel Owner's Name <br /> d <br /> Site Address <br /> S i b C <br /> I<-f-0 NC',-h- 9 5 2-0 !o DRIVEWAY <br /> City,State-Zip Code TYPE QUANTITY WIDTHS <br /> ©_s 9 ct AGRICULTURE @ FRONTAGE <br /> (Area Code)Telephone COMMERCIAL y._Z1_ <br /> INDUSTRIAL @ R/W <br /> RESIDENCE <br /> ------------- <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 <br /> City,State-Zip Code approximately feet/mile of <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 /> D�l ✓� /� �P�Cj�C I-f D N � S+r /g r`/►] �e2 I 1//' /����C�/�C H O /./ <br /> L9 s <br /> Will this project be self-installed? NO YES Contractor's License <br /> AccessTer ApfformOrivewayPaved frontage <br />