Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date l r OFFICE USE ONLY <br /> To: San Joaquin County JOB# REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE <br /> o r1 a ; . r+ , �rQ.0 VALID b !1 TO 11 ! !t DRIVEWAYS: <br /> I1111111111111111 STREET �1u,z-ry�t�,gy,�o gi) <br /> PG&E-FRESNO RMC AREA QUAD _,5_c <br /> DMD DEPT TYPE 'E�Lli-� e-SpLlgG - <br /> 8 RIVERPARK PL EAST FORMS 5'- w do 2S <br /> FRESNO, CA 93720 NOTES <br /> V V Cagy QIC1kA al 11U11w. yr wv- <br /> (City,State,Zip Code)j, r� <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) � L4 n <br /> i <br /> S 0 <br /> No R,=Ab c[.osUl2�s ALt.ov.��A . <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Hig Right-of-Way on <br /> the�TH side of /1/e,�-t s�Lr2t/� lez> approximately Z� pe rile <br /> of X l� , A&01 V72-5c79 , by performing the following work(description of work): <br /> Please refer to construction drawings for work locations. <br /> PG&E will be replacing the existing overhead conduct rs and from time tim4eplacinsqment <br /> and re Ip acing/removing/installingdown qued <br /> Work will commence on or about 1 l for approximately t 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 abovi a o ance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br /> Signature of Applicant-Title Date <br /> EIPUB&SV.WHIh1ASTER.PSIENCROACHME14T PERMIT APPLICATIONDOC (010) <br />