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, `'ti'%alk•..q,(-:t"TF` -PYYt f T <br /> PLEASE P_RZINKT�.- <br /> n1oc �� <br /> Da us- APML oG1201 1 <br /> To: 5aa Joaquin County JOB �# 73Gb 77 P r <br /> DepartmeLat ofv�orks AMT CY <br /> EXI�. DALUTT 7/1 q11 <br /> -LTO Rn- <br /> {AppZicasa ?�a�e) STREET ! µ <br /> AREA 52LC <br /> TYPE �Al QUAD <br /> (Mailing Add=esa) FOP149 � <br /> NOTE <br /> 5i LIWYqM3�� <br /> (City. state, .Zip Code) <br /> (Area Code - Telephone number) <br /> Sketch (Detailed Plans"May be submitted) <br /> COU-6 <br /> SEE MAP IT TACHE <br /> The rmdersigned hereby applies for permission to.excavate:, Construct 'and/or <br /> otherW'Se-encroach•on •Couaty•Highway Right-of_Way:.oa-the <br /> of <br /> approximately feet/mile <br /> . _ <br /> followin . b er€orMinc7 the <br /> g work (description of:work) : KALs_F G/l7E VALUF COYIRS lyC 1SINGS 7a G,PADF <br /> ON FJLB CRT ST F1F1�OM CH EE ' TO .SFINGUINF _ <br /> _J6CUTS TOTAL 'X ' 711-IO1.F FACf1 <br /> Work will commence on or"about MAYS a0J�" <br /> 6O <br /> days. for approximately <br /> I, the undersigned certify that I am the owner of• the respective property, or am <br /> qualified to represent the owner and agree to do thecork described above in <br /> accordance with the rules, regvlations 'of San Joaquin County and subject to <br /> inspection and approval <br /> C. Sell - TURFMAN AFFIL LU aoll <br /> Signature of hpplicant :Pitle <br /> Date <br /> NAS^3R.P5\YEFS®L I6/00J .. ._. • <br /> t <br /> 4 <br />