Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date 3-IL 12 OFFICE USE ONLY <br /> To: San Joaquin County JOB# f-3 _(o REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE <br /> Pacific Gas and Electric Co. j VALID Mm y To DRIVEWAYS: <br /> STREET kklgaej, <br /> P.O. Box 930 AREAQUAD L:25- <br /> TYPE <br /> Stockton, CA 95201 FORMS <br /> NOTES <br /> j <br /> 1091 q41-- 1 qq8 <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. i d 5.2 1 % I o- f California supplement. <br /> i <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the side of approximately feet/mile <br /> of by performing the following work(description of work): <br /> nor t-1a�� R2coc,�S Lne.,4-rio, .3s Tv crgzevit,,)oE hCprrfs <br /> �XLST'[�.l G- U�DESZ.GbZDc.cNL� F��[ L cTl E54Jo/Z!C 1 TC CLFi4lL <br /> Gr�,�F'L�G7—S [y a t�tf THE GocA^37-1's" Sc7Lc -L4 S-rp-c1 rop3 <br /> S l DELJ�LK P2o GT: <br /> Work will commence on or about 3—ii— a— for approximately <br /> -71 <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 /> Gets <br /> 3-16-1z <br /> Signature of Applicant-Title Date <br /> E1PU8•SV.WMVSIERPSIENCROACNMENTPERMRMPLICATION.DOC (01100 <br />