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COUNTY OF SAN jOAQUIN rate: � Zo la <br /> DEPARTMENT OF PULIC W8RKS <br /> DRIVEWAYS AND PAVED FRONTAGES Received 6y: <br /> PERMIT APPLICATION CR=_��t7Lttf�3 <br /> ' APPLICAN T <br /> OFFICE US_v�iLYfame: IF --- <br /> I <br /> C+y,State,Z� Code: ------i ( A03#: ;'CC`s ISSUE DATE: ! <br /> p ma�CEon Ce q S' � ! APN (- #f 0 27 EEE DUE: _ + <br /> �u ea Code -Telephone Number: ,� <br /> I <br /> 71 • �� ! -XP.DATE: DR;VEWAYS. <br /> STREET: C,`1TCN�77- ; <br /> SIT=;NFORMATEON: -- — <br /> ---— --- — —� AREA: QUAD --- <br /> + Parcel Dwner's Name: ! i YPE: - — - -a <br /> t'�s 2 CaF T — —� <br /> Site=,ddress: C.EtEjf {� + EOKi�1S: <br /> C+�y,Stale,Zip Code: <br /> ! NO T ES: <br /> Area Code -Telephone Number: <br /> I <br /> DRIVEWAY <br /> CONTRACTOR ! TYPE: ! CLAN;ITY y"dIDTHS <br /> AGRiCULTURE: i — at PONTAGE <br /> Address. I L� � A, i COMMERCIAL: <br /> City.State.Zip Code: Via,-j'E�—LL lys-U ;NDUSTRiAL: + --— ---i — <br /> i 14rFa Cede -Telephone"umber: 2 aq_ � 3 rn -j RESIDENCE: ! ----i <br /> i PAVED FRONTAGE � <br /> LENGTH: Ft X vVID:H.: _ Ft. j <br /> he undersigned herebyapplies for permission to excavate;construct and/or otherV0se encroach o County Highway tRioi t-of-4Vay on the <br /> sidne�of Co., <br /> approximately— —_feeVmi!e_ht�" <br /> of �Y InSiaillnQo tP F"{' <br /> commence on or about_ tp - --_- —Work t^I! <br /> Q��" for approximately ------- <br /> _ i _days. <br /> SKETCH(Separate sheet may be submitted] <br /> 1 <br /> I <br /> + <br /> + 1+ <br /> 1 <br /> I <br /> I <br /> 1 <br /> i + <br /> r <br /> I <br /> I ! <br /> I <br /> i <br /> ! <br /> 1 <br /> t + <br /> + <br /> 1 <br /> 4'Vill this project be seiPrtstalled? _NO Contractor's License -ILI 57-10 -- <br /> Na�c -&f)y 4'4 (44-C.e ' Shcwte� be c�.}taC, �c7 a�w.�'f <br /> Y.10E�7Fpi ScR'e".CE3:ClE' Page t ci 2 <br /> r,ICAI:SUS-SJ.N'KtrdAi'CF�2.?SI�F;CK^ACnM'rq'??EP,11I.i CF,IVc�YRY.r9C 1?�.'�+y) <br />