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May 19 JI J <br /> 08 1 : 36a Pescadero 2098352337 P. <br /> VJ1GVUU y <br /> APPLXCATION FOR ENCROACMMPNT PRRNZT <br /> I,$ASR PRINK <br /> Date '� FSTR'EKT <br /> 0 :Cz ME ONLY <br /> To San Joaquin County P # <br /> Department of Public Works <br /> Mutual water company One DRIVIWAYS: <br /> 3650 W Canal Blvd. QUADTrary CA 95304 TYDR <br /> FORM <br /> NOTE <br /> (City, State, UP Vods) <br /> (Area Code - Telepbone Nunb•r) <br /> Sketch (Detailed plans may be aubmitte(.-- — <br /> vG l�ra,�v�p A✓F. .�."''' �, _ .L,..�ice'= <br /> C •'�•ra <br /> j r•�O � �J l,f <br /> G(A-1V? <br /> 32 AC. <br /> The undersigned hereby applies for permission to excavate,construct and or otherwise encroach on County Highway right-of-way an the <br /> South side of West Callfontla Avenue,approximately 5—10 feet of shoulder roadway,by performlrtg the repair of a leak In Domestic Well <br /> Water tine, We will be working under the supervision of our Certified Distributor,tom Mc Coy of Quality Services He is a General <br /> engineering Contractor License If 8344$gofryoe: Z09 839 7842 (Repair Is located near where street ends and has very little traffic) we will <br /> excavate approximately 4—5 feet down to repair broken line, We will repair between fend 10 feet of line. We willlace sal <br /> both side of project on the road.We are looking Into a road work ahead signthrow p sty cones on <br /> will take necessary safety precautions. through Quality Services. Work is on shoulder of Road.and we <br /> I have asked to be provided with any other signs we might need,such as Road work ahead. <br /> Work will commence on or about may 23,2008(sooner if permitgiven)for approximately,3 working days. <br /> I, the underialgned certify that Z am the owner of the respective property, Or xm <br /> qualified to represent the owner and agree to do the work deecribed above in <br /> accordance with the rules, regulations of San Joaquin County and subject to <br /> inspection and approval. <br /> Signature Of Applican Tit Date <br /> n.r+e.r:�rasa�r iFiooi <br />