Laserfiche WebLink
APPLICATION FOR HNCPOACtH=T 'PEPMIT <br /> PLEASE PRINT: .; <br /> Date Gi �B'DB OFFICE' USE ONLY <br /> To: San Joaquin County JOB # 7 J0052- REF <br /> Department of Public Works APN CR �# <br /> EXP. DATE <br /> VALID -Z<<oS. TO It-1-019 DRIVEWAYS <br /> P6&E STREET ��.� ,en_ ------- <br /> AREA c.,aa�PQ __x__---- <br /> 4040 WEST LANE <br /> TYP73 oGE � <br /> FORMS fu�wf 'or <br /> - Z�1 <br /> STOCKTON, CA 95204 NOTE <br /> (City, State, .Zip Code) <br /> - /y99!5 <br /> (Area Code - Telephone Bomber)_ -' <br /> Sketch (Detailed plans may be submitted) TRAFFIC CONTROL PLAN <br /> SHALL BE AS PER <br /> CURRENT M.U.T.C.D. <br /> CALIFORNIA SUPPLEMENT <br /> SEE ATTACHED SKETCH <br /> PM 3D631 G4gV <br /> NOTIF: 103vrs 1.19 <br /> The undersigned hereby applies for permission to-excavate, construct and/or <br /> otherwise-encroach on County---Highway. Right-of-Way--on-the Z.�.0 Sf side_of <br /> PAIZ'SI- Xn. approximately feet/mi-IGof by -performing the <br /> __.,_following-woxk_(des-c-r:Lption of.work) <br /> C�4ysvTG /.3,eLG Qa412 fps ln.aAI /VAIA 1?CVZC snpkz_ <br /> Work will commence on or about 2/ -,7�Ly I for approximately <br /> ?D 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 /> ':.'43 <br /> gnature of Applicant - Title Al WV 6{ ( Date -. <br /> X&S18R.1?S\M=C'BD1 (6/00) ✓. y��of ?-j t ;4 z <br /> RETURN PERMITS TQCQ PJ 6 <br /> V,0 : Ca,(1rWr7- G',24/Z CCD <br /> C19it/L1/�© <br /> 9111-- IY_35 P64Edp � <br /> yi Al Y 0A1 P.O. BOX 930^ <br />