Laserfiche WebLink
f <br /> COUNTY OF SAN JOAQUIN Date: <br /> DEPARTMENT OF PULIC WORKS <br /> Received By: <br /> DRIVEWAYS AND PAVED FRONTAGES <br /> PERMIT APPLICATION CR#: <br /> APPLICANT OFFICE USE ONLY <br /> Name: &Ctpja G Gf o k-) Izev. US <br /> Address: qA JOB#: 11005 ISSUE DATE: <br /> City, State,Zip Code: p APN /,1�3–� �'� FEE DUE: <br /> Area Code -Telephone Number: 04142, EXP.DATE: DRIVEWAYS: <br /> STREET: <br /> AW <br /> SITE INFORMATION: AREA: % f QUAD <br /> Parcel Owner's Name: TYPE: <br /> Site Address: p <br /> HAP-Ai IF FORMS: ,Vj✓ <br /> City, State,Zip Code: c6DII C-14 11,5Z O NOTES: <br /> Area Code -Telephone Number: <br /> DRIVEWAY <br /> CONTRACTOR TYPE: QUANTITY WIDTHS <br /> Name: AGRICULTURE: @FRONTAGE <br /> Address: COMMERCIAL: <br /> City, State,Zip Code: INDUSTRIAL: @ R/W <br /> Area Code -Telephone Number: RESIDENCE: X <br /> PAVED FRONTAGE <br /> LENGTH: Ft. X WIDTH: Ft. <br /> The9�ndersigned hereby applies fq�permission to excavate,construct and/or otherwise encro ch on County Highwa Right- f-Way on the <br /> /►�o.2Y1N side of approximately approximately Z5*1— <br /> of by installing :Zai�I/ <br /> Work will <br /> commence on or about for approximately days. <br /> SKETCH (Separate sheet may be submitted) <br /> Will this project be self-installed? YES NO Contractor's License <br /> IISJPWGOV.ORGISHARESICENTRALSERVICESICLERICALIPUB-SV.WKIMASTER.PSIENCROACHMENT PERMIT DRIVEWAV.DOC (10109) Page 1 of 2 <br />