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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> r <br /> Date OFFICE USE ONLY <br /> To: San Joaquin County JOB# i13DQ ,�t—(, REF# <br /> Department of Public Works APN CR# <br /> EXP. DATE 4 <br /> Pacific Gas and Electric Co. VALID fo /p DRIVEWAYS: <br /> STREET ' <br /> P.O. Box 930 AREA QUAD n/ ` <br /> Stockton, CA 95201 TYPE <br /> FORMS . <br /> NOTES <br /> (Area Code-Telephone Number) <br /> Sketch (Detailed plans may be submitted) <br /> Traffic Control Plan <br /> See attached sketch. Shall be as per <br /> PM ? c; i 1Ji// 1, current M.U.T.C.D. <br /> Notif. California supplement. <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highwa Right of Way on <br /> the `�U=1�"y side of ,r .v �;7 f d ji", /- r , approximately .:5.'2 � fee Ile �>< <br /> of �l `��. % . - v �; - _ by performing tie following work( escription of work): <br /> G.i i `.�1 ��I1.7. fit-F�� ��,7t., `'`�_,� `"f^ `,1,C_ � �.•'�/' � I` ��`,�. � j�e-.�+ �?r /,/�� � '� <br /> Work will commence on or about_ 0 for approximately U days. <br /> I, the undersigned,certify that I am the owner of the respective property, or am qualified to represent the owner and agree to do the <br /> work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br /> Signa a of Applicant-Title - " Uate <br /> t" <br /> ::IP'.JR-SV WKIMASTERRS5 ENCROACHMENT PERMIT APPLICATION.DOC )01108) <br />