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FROM :CALIFORNIA WATER. SERVICE FAX NO. :2094648195 Jun. 04 2008 12:18PM P 2 <br /> APPTAXCATION FOR IWCROA,COMT Pg=T <br /> ' pr��S PRTN'E`s •••�C� <br /> Date <br /> 073PU � arm ONLY <br /> l7 <br /> To! Sa= LToaqujz County 30S <br /> A nepartm=t of�Public Works APR Cid � <br /> VAL10 11+4&a fOv / DRXl'MYS: <br /> (Applicant Mame) S + <br /> ARIM <br /> ASSOW -7MA0V S7 TYPE <br /> (Mailing Addreae) FORM "L <br /> S C• C��\ C\ `15 ao mora <br /> (City, State, .xip Codo) <br /> (Area Code - Telephone Number). <br /> Sketch (Detailed p).v= may be submitted) , <br /> • r <br /> Tie =Ulevsa gned hereby,applies for permission to,excavate, construct a=d/or <br /> othemi,se-encroach•on County-Bighway Rigbt-of-Wayon•the �N' .S:Y'" • ' si '-o��.�_ <br /> 'Vti Q-K._ 1.,% ap�rrox Emate7.y � � f e _ � <br /> of NQARLX' SA t by 3aexiormjng the <br /> fol owing work (description, of work) : ..ti <br /> Work will commence on or-about , icor approximatelyto 4 <br /> days. •, . <br /> I, the undersigned certify that X am the owner of the respective propexty, or am <br /> qualified to represent true owner and agree to da the iark descried above iu <br /> accordance with the rules, regu ati 'of San Joaqux m county and subject to <br /> inspection and approval.0111-30~48 <br /> S;Eq=t►uro of Applicant Tithe - `—'— <br /> xlate <br /> mismm%mmoam Waal <br /> • 1 <br />