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FROM :CALIFORNIA WATER SERUICE FAX NO. :2094640195 Dec. 02 2009 10:54AM R 2 <br /> AFPLIMTTON FOR WcROACMMNT PERMIT <br /> p�,E,�1SE PRI=: <br /> Date oBFZC2 IIS ' O +'Y <br /> To. Sao Joaquin County JOB # 2150G77 REF # <br /> Department of: Public Wor)w CR # <br /> VALM 12-9,-o To �C D=Mys: <br /> (Applicant Name) gp, jr +� <br /> Am SMCKTC) <br /> TYPE _ -f� qtr }-\01 F, + <br /> (Mailf ug; 344r;aas) FORMS ( TL29 <br /> UN NOTE <br /> (city, Strata, .zi,p code) <br /> c-R9 IMCM -%Z <br /> (Area Code - Telephone Xumber) <br /> Sketch (XN�tailed plans mar be submitted) , <br /> The undersigned hereby,applies for Permission to.excavate, construct and/or <br /> otherwise-eacroach•on County,R.ighway Right-off- r•�the �'• gid�..cf, <br /> �1rc.W t�q RV <br /> approximately <br /> N C� <br /> of AR's l\� WAV ,. , by ype'rformi.tg the <br /> following work (description of,work): <br /> \ " \C'f�, ' - <br /> Work will commence On k3Q4C'� <br /> or'abaut for approximately <br /> days. <br /> 1, the undersigned certify, that: l am the owner' of,the respective property, or am <br /> qualified to represeat the owner and'agree to do the work described above in , <br /> accordance with the ruI.e , regiilatio `at San Joaq County and suubject to <br /> inspection and approval. p\.~ e�,\ct�Al�y <br /> 6R <br /> gxxnt=e of ApPlicawt - Tula Date -. <br /> rarryoR.rE�f�ocsc�c, c6/oo) \. . <br />