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FROM :CALIFORNIA WATER SERUICE FAX NO. :2094640195 Aug. 22 2006 02:52PM P 2 <br /> APPLZCATJON Pop, $NCROAMONT PMWT <br /> PLEASE PIZI•NT• l 1 SLA <br /> Date �L3' \Q �•T✓O OFFICE USE oNk'I <br /> TO: San 170aquin Cownty 70B _ REF # <br /> Department of Public Works APX CR # <br /> EXP. DATE <br /> (ApplLe nt: Name) STRM <br /> (Xa.iling Addti ola) FORMS Sts w ' <br /> NOTE <br /> (City. State, .Zip code) <br /> (Area Code - Telephone Number), . <br /> Sketch (Detaa.l,ed plans may be submitted) <br /> The undersigned hereby, applies for permission to,exavato, construct and/or <br /> otherwise-encroach-on County highway Right.-of- ;the <br /> the NNE= ,. side.of <br /> AUX-EPRO� 1 C V E. approximately 1'l� �e�te �r3:e IIQL <br /> of ��_ - ..� j �. ,, , by pexioxming the <br /> following work (description of;work) : <br /> \\103 .5,•A.�l �Z,, fyV rte. I,a ' <br /> Work will comence on o:r'a3=t. for approx m8te:ly <br /> days. <br /> z, 'the undersigned cext:Lfy, that I am the ovnpr' of',the respective-property, or am <br /> al <br /> quified to represent the owner and-Agree to do the work descrikbed above In <br /> accordance with the rule , regulatia 'of San ioaqu�n c6unty and subject to <br /> inspection and approval. \�;_\T-ns <br /> Sig=atx=e of APPUCatnt Title Date ~' <br /> u�sx .rs'\r=x caloo� ` <br />