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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date February 15, 2011 OFFICE USE ONLY <br /> To: San Joaquin County JOB# REF# <br /> Department of Public Works APN CR# <br /> EXP. DATE 6 � <br /> Knife River Construction VALID 0 *'" DRIVEWAYS: <br /> (Applicant Name) STREET <br /> AREA �/yJ i%,� &AD C <br /> 655 W. Clay Street TYPE <br /> (Mailing Address) FORMS <br /> Stockton, CA 95206 NOTES <br /> (City, State,Zip Code) <br /> (209) 948-0302 <br /> (Area Code-Telephone Number) <br /> Sketch (Detailed plans may be submitted) <br /> Please see enclosed Improvement Plans. <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right-of-Way on <br /> both sides of _Union Road approximately 4,100 feet north <br /> of Lathrop Road by performing the following work(description of work): <br /> Widening the existing roadway width to provide necessary transitions to a fully improved roadway section in the <br /> City of Manteca. The existing pavement will be overlaid, 4' rock shoulders and roadside drainage ditches will be <br /> constructed. <br /> Work will commence on or about_Junes 2011 for approximately days. <br /> 1, the undersigned, certify that I am the owner of the respective property, or am qualified to represent the owner and agree to do the <br /> work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br /> Signature of Applicant-Title Date <br /> L WUH SV.WKIUASTER.PSICNCROACI IMEN T PERMIT APPLICATION.DOC (01/06) <br />