Laserfiche WebLink
Jan- 26, 2012 2: 30PM Pacific Gas and Electric #. No. 0213 P. 2/3 <br /> APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date 01-24-12 <br /> TO: San Joaquin County-Highway Department OFFICE USE ONLY <br /> JOB# OeSL-S REF# <br /> PG&E APN_- - CRV# <br /> (Applicant Name) EXP.DATE <br /> 3t � <br /> 31$5 M Street. VALID g �� TZ /Z DRIVEWAYS: <br /> (Mailing Address) STREET L <br /> AD <br /> AREA A/QUAD 5g <br /> Merced,CA.95348 TYPE yoL E FORMS <br /> (City, State,Zip Code) NUTS <br /> 209-726-6328 <br /> (Area Code-Telephone Number) <br /> Sketch (Detailed plans may be submitted) <br /> 'PNI�' 30883�oS9 <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on <br /> County Highway Right-of-Way on theNorth side of River Rd. approximately 490 <br /> West feet/mile Wesof Durwood Rd. - by performing the following work: (description of—work—): <br /> Excavate 4'x4'X4' bellhole for 2"tie-in for service to 28651 River Rd,Tie-in to the existing4"TP main <br /> in River Rd. 5'south of the north property line and bore to property line(See Sketch) <br /> Work will commence on or about 2/15/12 for approximately Z <br /> days. - <br /> i the undersigned certify that I am the owner of the respective property, or am qualified to represent the <br /> owner agree to do the work described above in accordance with the rules, regulations of San Joaquin <br /> County and subject to inspection and appy <br /> X. n McCullick Gas ADE 24 Jan`12 <br /> SIGNrATUME OF APPLICA -TITLE , DATE <br />