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10 <br /> PLEASE PAPPLICATION FOR ENCROACHMENT PERMIT <br /> RINT: <br /> Date �Z <br /> OFFICE USE ONLY <br /> To: San Joaquin County <br /> Department of Public Works JOB# 7 REF# <br /> APN CR# <br /> Pacific Gas and Electric Co. VA VALID <br /> , <br /> o <br /> P.O. Box 930 STREET DRIVEWAYS: <br /> AREA <br /> Stockton, CA 95201TYPE QUAD <br /> ---- <br /> FORMS / k <br /> NOTES <br /> (Area Code-Telephone Number) <br /> Sketch (Detailed plans may be submitted) <br /> See attached sketch. i Traffic Control Plan <br /> PM 30916332 Shall be as per <br /> Notif. current M.U.T.C.D. <br /> �oG ovv 5S5 f California supplement. <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on <br /> the Svurll side of �oSEL ��;,�,J County Highway Right-of-Way on <br /> of P�2S��i.vG ��� approximately ♦yB <br /> STDC1GTDi./ feet/ak LJ_L ST <br /> /-'11L3 �2USEL.4G,Jn1 / �-- by performing the following work(description of work): <br /> ��C C.q c/%1 T� C- vu�rfZ G,4 S /�'1�!!.c! �.�lt� !ZE- 2ci v S'�`'2vi <br /> NvL� TU B� EX L.v,.//r!T�'L.► �,c! i'�i4v ,� cam-- <br /> Work will commence on or about <br /> - y 2-3-1 Z for approximately 90 <br /> I,the undersigned,certify that I am the owner of the respective property,or am qualified to represent the owner days. <br /> work described above in accordance with the riles and regulations of San Joaquin County and subject to inspection and agree to do the <br /> n P and approval.. <br /> I/ 'f��y(JAfApp�iicant <br /> On � _Signature -Title S A` l�. 2 <br /> E:IPU&SV.WKIMASTER.PSIENCROACHMENTPERMITAPPUCATION.DOC (01,08) Date <br />