Laserfiche WebLink
i <br /> APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: ' <br /> Date /O-/D -// OFFICE USE ONLY <br /> To: San Joaquin County JOB#- 44 REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE Z !S <br /> Pacific Gas and Electric Co. VALID r � o DRIVEWAYS: <br /> STREET ')&SEMirF- .416- <br /> P.O. BOX 930 AREA �ATfl,eoP QUAD ::5,5 ` <br /> TYPE t-Fawc ne .b(,2T <br /> Stockton, CA 95201 <br /> " NOTES <br /> I <br /> 2vg� rya -/y9B <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> i <br /> Traffic Control Plan <br /> See attached sketch. ; Shall be as per 1 <br /> PM 3018457 2 Y YB current M.U.T.C.D. <br /> Notif. /vs-yyy1 California supplement. i <br /> f <br /> The undersigned hereby-applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the A/y2>// side of_ 14-). yysEr��TG AVE , approximately 750 feet/fAk AE/?-'q7' <br /> of E' "9!L C-/ An1ZKL4-) i y ,_ L i9T,UKDP ---,by performing the following work(description of work): <br /> 3356 I-J, yvSE1P71r • t4v�. <br /> ,FX CA LJ/q i E 17"y- -VI ROLc oLiER- 6AS M41AJ 4^JZ) eal oFF Gi+S SEl2ylGE• <br /> 14LL 6JU2/C Tv BE In./ 7-H6- 27121 14R454- <br /> Work will commence on or about />-ih'-�/ 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 /> Signature of Applicant-Title Date <br /> F-PU6SV.WKWASTERPS%ENCROACNMENTPERMITAPPLICATION.DOC (01108) <br />