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COUNTY OF SAN JOAQUIN Date: �2 0 <br /> DEPARTMENT OF PULIC WORKS <br /> Received By: <br /> DRIVEWAYS AND PAVER FRONTAGES <br /> PERNT APPLICATION <br /> AFPLIC `T — --� ( OFFICE USE ONLY <br /> Naff <br /> Address: C` r JOB#. 11005 ISSUE DATE: j <br /> City,Staff, Code; APN / FEE DUE- i <br /> Area Code -T Nu r. - H EXP.DATE: DRIVEWAYS: <br /> STREET: .rr/L,Q I <br /> SITE INFORMATION: f AREA: <br /> 9 Al QJAD ��_ _� .� <br /> Paroel Owner's Name: v�— i TYPE: w�— — <br /> Site Address: ANLA ! FORMS: <br /> City,State,7a Code: <br /> Area Code -T FNumber: 2 �- - , <br /> 1 NOTES: ; <br /> j DRIVEWAY ' <br /> i <br /> CONTRACTOR TYPE: QUANTITY WIDTHS—� <br /> Name: AGRICULTURE: ; o FRONTAGE <br /> Address: COMMERCIAL: i <br /> Ci ,State,zip INDUSTRIAL <br /> Cock: ___ <br /> .per___—_ <br /> Area Code -TelephoneRESIQENC - i �� -"--- <br /> PAVED FRONTAGE I <br /> ( LENGTH: Ft. X WIDTH: _ FL i <br /> The undersigned hereby applies for permission to excavate construct and/or otherwise encroach on County H" ay Right -Way on the <br /> side of WOWW Ar?, app wim q--2 f <br /> of <br /> by installing __.�------------- <br /> --- _Work will <br /> commence on or about for aPProxirrc�ely__ —--- days. <br /> SKETCH(Separafie sheet may be submitted). <br /> I <br /> i <br /> s t <br /> I <br /> fi <br /> i <br /> i <br /> l j <br /> Wrll this project be setf4nstallled? YES NO Contractor's License <br /> WXE i PAI SERVTCE=LERK AL'pumV.wK'�4KSTE2e p$S ENCROI-riWN^'P:Rt T 4PdJEWAY.DOC .;70tTXXri Page 1 of 2 <br />