Laserfiche WebLink
+ fZZS(� COUNTY OF SAN JOAQUIN Date: /2 /p /o <br /> DEPARTMENT OF PULIC WORKS <br /> Received By: <br /> DRIVEWAYS AND PAVED FRONTAGES <br /> PERMIT APPLICATION 70 <br /> APPLICANT OFFICE USE ONLY <br /> Name: SA,t k to., Alie e /f �' -f r'0 <br /> Address: 4715 JOB#: 11005 ISSUE DATE: <br /> City,State, Code:f¢„ l 2/Z APN M5'-31®-/a FEE DUE: <br /> Area Code -Telephone Number. EXP.DATE: DRIVEWAYS: <br /> STREET: o�"AkAp * <br /> SITE INFORMATION: AREA: S�"c.jkrbo/ QUAD <br /> Parcel Owner's Name: Sc 4u .+-S fba 1, TYPE: <br /> Site Address: FORMS: -17 <br /> City,State,Zip Code: NOTES: <br /> ` Area Code -Telephone Number: <br /> DRIVEWAY <br /> CONTRACTOR TYPE: QUANTITY WIDTHS <br /> Name: AGRICULTURE: FRONTAGE <br /> Address: COMMERCIAL: <br /> City,State,Zip Code: INDUSTRIAL: RIW <br /> Area Code -Telephone Number RESIDENCE: <br /> e0opohf;� 4 774053 A:",, <br /> PAVED FRONTAGE <br /> 1 7d4 ,y:p5-3 GcZf" LENGTH: Ft. X WIDTH: Ft. <br /> The undersigned hereby applies for permissbn excavate,construct and/or otherwise encroach on County H' way Right-of-Way on the <br /> �� side of ,<a�p Nr' • approximately X250 A�7' <br /> of Kaa Y17 by installing <br /> commence on or about for approximately days. Work will <br /> SKETCH(Separate sheet may be submitted) <br /> Will this project be self-installed? YES NO Contractor's License <br /> IWWGOV.ORGSHARE&CENTRN.SERVICEMLERICgRS-SV.WKWAVM PSIENCRox"AENT MW DRIVEWAY.DOC (10109) Page t of 2 <br />