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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Oct.. 10 2008 04:1IPM P 2 <br /> APPLICATION ICOR ENCR.OACMd=T PERMIT <br /> PLEASE PRINT <br /> n 7� - <br /> Date `-� d t , c� OFFICE USE ONLY <br /> To: San aoaquin County am $ '7 2 co?'7 REF # <br /> DepaxtrAent of Public Works APX ae <br /> W. DATS <br /> CAL��'t`SRt•�i '" .R S fZ� C VALID Io-Z-V TO —g2� 1 -� Dlt�►Ys: <br /> (Applicant Name) STRMT Mor're� /tI/ ;/E• ' <br /> AREA 57-KN QM0 <br /> �5 At�".� TYPE 1rLl HOLE <br /> (Nai.l.izg Addxoss) R'Ow$ <br /> NOTE <br /> (City s aat .Zip code) <br /> (Area Code Telephone Number) <br /> Sketch (Detailed platy may be sisbmitted) <br /> VIM I <br /> The undersigned hereby•applies for permission to.exiavate, construct send/or <br /> othexvrise-encroach•on County•Highway 7 iglXt-of_WWp•os•the <br /> _mss (i'�Y fit . ..._,. approximately 1S 1 e /trbe WES'I�" <br /> of _ \Z\F.\�._,A4 _ ,• _A y perfoxmirig the <br /> following work (descri tion of:wrork) <br /> '��LV�.. ' <br /> - 3fJU�,�1V.• �IT�Q�Y AVS:. �����i� � . <br /> 'W'ork will aomrneuce on or'about 1Q�O"Y -CS$ for approximately <br /> days. <br /> z, the undersigned certify, that 1 am the ownser• 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 aoag4 a C6=ty and subject Co <br /> inspection and approval <br /> Signatoxe of Applicant Title Bate <br /> Nusrnsr..pc%rXRBCEMr. cs/ooa <br />