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FROM :CALIFORNIA WATER' SEPOICE FAX NO. :2094640195 Nov. 19 2008 03:58PM P 2 <br /> 2 P"3:CJ1.TI0N F0A MCROACM&NT PERMIT <br /> :PLiM _.PRINT- q <br /> Date «1 ' zl OF?= USE ONLY <br /> TO: San Joaquin County 008 <br /> Deparrtmleant�yof�Public works APN <br /> �p`�{ � # <br /> �{\1t1 l D� �C`� �\\. �� EXP. DA.%S •O — <br /> v�wm It•1 xo 2_� ,,_. <br /> (Apbaicant Nama) STP= _g2tG(.i0 'AI&I <br /> TYPE -$V l <br /> (�Etaild:aq Address) P'OMS X-29, <br /> �°�4'C�..• C, � NOTA <br /> (City, Staate, .Zip Codd) , <br /> (Asea Code - Telephono Number) <br /> Sketch (Detailed plazas may be sisbmitted) <br /> The undersigned hereby applies for permission to.exCavate,, construct and/or <br /> otherwise-enc=ach•ori <br /> � �.`D •County E�ighway Right-of�-wayt•ozi•tkse ,lrl•OF'�ti s'ide;.i�f,.. . .. <br /> NN <br /> ofF��1� approximately <br /> follo�Ying work {de'111,111, (111 IIEIII111111scription of;work) f by 3Pxo+ ' the <br /> 3�X j77= <br /> Work Will commenceon orabout <br /> days, - for approximately <br /> I, the undersigned cextify, tbIat I am the owneac of,the respective propertX, or am <br /> qualified to represent the Omer and'aigree to do the i'ork described above in <br /> accordance with the =a regulatio 'of San t7oa <br /> quiz County and subj ect to <br /> .i-uspeCtiou and approval p,l, la thq ' <br /> Signature of Applicant Ti.tle <br /> Date <br /> .t <br /> i <br />