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MPORINUMAC <br /> OFFICE USE ONLY <br /> To: `San joaquirvownty JOB REF <br /> NpMment 0ublic Wo&s APN CR <br /> p EXP.DATE <br /> VALE DRfVEWAYS: <br /> ,.. ; STREETJ# AM <br /> YW Ad_ <br /> r AREA <br /> TYPE r U <br /> FORMS <br /> NOTES <br /> } <br /> Re 1x*mjjgpe.d, <br /> S�(f �tl°�mY bes� titted} <br /> fior.pe excr ; ,constructthe ardor otherwise encroach on County Highway Right-of-Way o <br /> �rJ approxim dely doe fee /Z <br /> of FAt <br /> 4 by perfamting the following work(desfttion of work): <br /> Ali <br /> Wv wi _cmrr or'or-about for approximately/ days. <br /> 1,the urklersigned,cerffy that l am the owner of the respective property,or am qualified to represent the owner and agree to do the <br /> work described above in with nAes and regulations of San Joaquin County and su*d to inspection and approval. <br /> Of r -Me Date <br /> WOVWM <br />