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APPLICATZORT FOR ENC.ROACI�2EN`I' .PERMIT <br /> PLEAT PRINT: <br /> C> OFFICE'. us <br /> Date 5-2/ '19Q <br /> JOB # � ISZ"(o REF # <br /> To: San Joaquin County CR , # <br /> Department of .Public Works . APN <br /> BY-P. DATE v <br /> TO 24,09 DRIVEWAYS: <br /> STRFsFT L . <br /> PG&E AREA Lobi QUAD . _ <br /> 4040 WEST LANE <br /> TYPE <br /> ,src �Eu Nay : <br /> STOCKTON, CA 95204 rioTE <br /> (City, State, .Zip Code) <br /> - /y9 <br /> (Area Code - Telephone Number).., <br /> 1 <br /> Sketch (Detailed plans may be submitted) TRAFFIC CONTROL PLAN <br /> SHALL BE AS PER <br /> CURRENT M.U.T.C.D. <br /> CALIFORNIA SUPPLEMUN <br /> SEE ATTACHED SKETCH <br /> PM 3061302 �. <br /> NOTIF: /02 �535�23 <br /> The undersigned hereby•applies for, permission to,excavate, construct and./or <br /> . l��ST side..•of .. . ...: . <br /> otherwise--encroach 7 on �Coussty:'Highway Right-of-Way.ox.-the <br /> Ti-�o2 /T©�l RD approximately 7BO feet/fie a2L. 17/ <br /> Of W io 1>81211> 64EfZD C Old/ by per€ormirig the F <br /> w_ fal l nwi ng�y �cscription of•work) - <br /> REL�/S1'2/ZT , ���cs 7-DI? sf�oTrdic �viTf,<: <br /> �Z�LG/L p7Z7K sr�rtriocJ 7' c�Rr�ll /Zr,. <br /> Work will_commence.on._or-- _about Ca - DCT- Df� for approximately <br /> 90 <br /> 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 Joaquin County and subject to <br /> inspection and approval. <br /> 5-21 <br /> gnature of Applicant Title 7 Da6e <br /> MASMM.PS\MMSC®I+ (6/00) <br /> RETURN PERMITS TO- <br /> CCL) <br /> O:CCD <br /> PG&E <br /> P.O. BOX 930 <br /> STOCKTON,CA 95201 <br />