Laserfiche WebLink
>.INICI: GCI'".',:';.L.0 'NP. tYt.i. ,=__•-rO-r�1=.� SCF-'. �� .=Jx:' _� _._r„ - <br /> APPLICATION° FOR ENCPOACffiWT PEIRMIT <br /> DEtte 1 `tip OFFICS US3 C1NU <br /> —T— <br /> xo: Say. t7oagn.in County <br /> Department Of Public Works APN W.� CK � <br /> tApplicant same) STR 'fi 2 <br /> 14 'S <br /> TYPIZ 2 s <br /> --- Ma.3.liZasr Address) FORM <br /> NOTE <br /> (City, State,–zip Code) <br /> (Area Code - Telephone N mtber), <br /> Sket6h (Daza.iled plans may be sixbmi.tted) <br /> The utdersig"aed hereby applies for permission to.excavate�, conE ;uct and/oar <br /> otherwise-encroach•oxz 4�0nnty•Ri.ghway JtJgrht-t>sr-- -Che j OY•{ k�+ ' gide..of <br /> approximately t%W4,e feet/mile <br /> of Qt1• u 4�02 10t by Vewformiq the <br /> follyW149w rIC (cesca:ipti.on Of:work) <br /> "51 X61 <br /> Work will commence On or'about I/G, for approximtely <br /> (20_ days.,. <br /> I, the =dcixsigraed certify that I am the owner' of•the respective -property, or an <br /> qual.i.fied to represent the owAer and agree to do the 4ork described above in , <br /> accordance with the rules, a io 'of San Jobqui.a C 6=ty sad subject to <br /> inspection and approvral. ��' 10 <br /> Signature of AppZiaant - Tlt:16 D to <br />