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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date 3/26/2008 _ OFFICE USE ONLY <br /> To: San Joaquin County JOB # f/� REF # <br /> # <br /> Department of Public Works APN CR� <br /> EXP. DAT _ <br /> RME Incorporated. (Woodbridge VALIDT iSOL3 DRIVEWAYS: <br /> (Applicant Name) <br /> Winory) STREET /r ngi�'-�06E <br /> AREA QUAD /YE <br /> 5950 E. Woodbridge :Rd. TYPE leAfil!_n ����✓� �-- <br /> (Mailing Address) FORMS <br /> NOTE <br /> Acampo, CA 95220 <br /> (City, State, zip Code) <br /> (Area Code - Telephone Number) <br /> Sketch (Detailed plans may be submitted) <br /> (SEE ATTACHED PLANS) <br /> Location of work; <br /> * Work will tin at the northeast corner of the Woodbridge Road <br /> north bound on-ramp frontage road and the southeast intersection <br /> of the Woodbridge Road and the southbound off-ramp frontage Road. <br /> The undersigned hereby applies for permission to excavate, construct and/or <br /> otherwise encroach on County Highway Right-of-Way on the * side of <br /> approximately feet/mile <br /> of by 'performing the <br /> following work (description of work) : Widen the paving and the Shoulder <br /> af- <br /> the intersection returns to allow large frucks n 17GP - a <br /> Work will commence on or sLbout a1, 1 si 20OR for approximately <br /> 10 days. <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 Joaquln County and subject to <br /> inspection and approval. <br /> i ture of Applicant - Title Date <br /> MASTSR.PS\FB3SCHDL 16/00i <br />