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h.`i4-11-2o10(FRI:; 13: 22 <br /> Kx llate/TtAtC A?'x-LJ-�uuy4lnUJ U7:75 P. 002/003 <br /> LUy772f1y79 Y. UUZ <br /> 2095781974 M St.,Modesto Ca 08:55:32 a.m. 04-23-2009 2!2 <br /> APPLICATION FOR ENCROAcBmENT PBRMTT <br /> PLEASE P •r*rr. <br /> Date <br /> OFPXCR Q38 ONLY <br /> To: 'San Joaquin County JOE 3 <br /> U0Pa=m=t of Public WorksCRr # <br /> APN # <br /> vALTD J (� DYB: <br /> i7►ppiicaut Manx) STREET <br /> CK AREA.L�eron�r pvan ti�v <br /> TYPEA 4442 <br /> (Mailing Address) FORMS <br /> NM <br /> (City, state, Zip Code) <br /> (Area Code - Talephone Dhnnb•r) <br /> 7-Sketchtailed plans may besUbmltt:eA-T� t <br /> The undersigned hereby applies .for permission to excavate:• ccnt3trttet 'and/oz <br /> _ othexwiC. se�croach•cc Cflunt:y•7igbway Right_of_Way on, -- �S"'� <br /> Co Q 0.7r W � � aide -of <br /> of XLt..ic J <br /> approximately _��_ __ feethth-er <br /> following work (description of w`7$tt,9 <br /> P work) : y.44aw.}� y n by performing the <br /> �tibCWat. R.Gt^lavt„ 1 4=Lt.G, <br /> work will commence on or about T is <br /> '4i_ days. for approximately <br /> I, the undersigned certify that l am the owner of the respective property, or am <br /> accogualrdantfied to represent the owner and agree to do the work described above in <br /> aGCOZdanCC wit:2s the x�slaq, regulations of sen Joaquin County and subject to <br /> jction and nova <br /> Signature of Applicant - Title <br /> Date <br /> MLWMk-F9%7UB=L 16/00] <br />