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COUNTY OF SAN JOAQUIN Date: i S'o8 <br /> nGDAQTnnGn1T OI : DI it Ir IA/rRllC <br /> Received By: w=' <br /> DRIVEWAYS AND PAVED FRONTAGES <br /> PERMIT APPLICATION CR#: e-66 02,3 <br /> APPLICANT OFFICE USE ONLY <br /> Name: <« o,,k r ', <br /> Address: j ,,,, L JOB#: 11005 ISSUE DATE: <br /> City, State,Zip Code: 1LI,,kcz, ;33 c. APN fZ�_ .4so-01 FEE DUE.- <br /> Area <br /> UE:Area Code -Telephone Number: V y�-5Lf EXP. DATE: DRIVEWAYS: <br /> STREET: F9&&3GR GA CAf Rb <br /> SITE INFOR TION: AREA: M A QT&.e_j% QUAD ` <br /> Parcel Owner's Name: o 11 >, TYPE: N1 ' <br /> Site Address: F4C Y,L 1, Ce, 2 FORMS: <br /> City, Mata Zip Coria_ rn � - j fo NOTES: <br /> Area Code -Telephone Number: 2cam. y Z <br /> DRIVEWAY <br /> CONTRACTOR TYPE: QUANTITY WIDTHS <br /> Name: AGRICULTURE: @ FRONTAGE <br /> Address: COMMERCIAL: <br /> City, State,Zip Code: INDUSTRIAL: @ R/W <br /> Area Code -Telephone Number: RESIDENCE: .� <br /> PAVED FRONTAGE <br /> LENGTH: Ft. X WIDTH: Ft. <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Hi hway Right-of-Way on the <br /> � C � ;:DCf W <br /> Sour.✓ side of eA. ,y c-q P . approximately b e >fti n- .CA=r <br /> Of A/,epi IAMYr 19 c-A by installing 7e�i <br /> Work will <br /> commence on or about for approximately days. <br /> SKETCH (Separate sheet may be submitted) <br /> Will this project be self-installed? YES NO Contractor's License <br /> Y\FORMS 8 TEMPLATESIENCROACEIMENT PERMIT DRIVEWAY.da (08108) <br />