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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date t q <br /> -a - I/ OFFICE USE ONLY <br /> To: San Joaquin County JOB# � - o REF# <br /> Department of Public Works APN CR# <br /> EXP. DATE +� <br /> Pacific Cas and Electric Co. VALID TR7 DRIVEWAYS: <br /> STREET j y" � <br /> P.O. Box, 930 AREA QUAD� , <br /> Stockton, CA 95201 TYPE <br /> FORMS <br /> NOTES <br /> 20$ `>��.2 <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> Traffic Control Plan <br /> See attached sketch. Shall be as per <br /> PM current M.U.T.C.D. <br /> Notif. lD�..,*�l8�la California supplement. <br /> The undersigned Iiereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the SOurl- _side of Lyyrhis RL) approximately 14238 feet/ 4 t JEST <br /> of &J. /-&J'y 99 ' ZDAIMT 64 .rTDC,�C1Z).t! by performing the following work(description of work): <br /> .¢AJiO <br /> Work will commence on or about /a - / -1t for approximately 90 days. <br /> I,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 /> AOS ��t2rl <br /> Signature of Applicant-Title Date <br /> EAPUB-SV.WRIMASTER.PSIENCROP,HMENT PERMIT APPCICATION.DOC (01/08) <br />