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_'•("j,.1.1.E -�...�' Itia �i...i1 a� �....7,''!_ —r...�E...11_"•._ !.�`w1``•{SI`i` <br /> L..S 'I. a 0 /.•t7" 1�I.S.�.S...L.' 123^ ��'.'�f,a,. <br /> C-012-20 CY 'JOB <br /> Depa_rtm -?t of ?II�7 i z Works APIT <br /> VTA'A u i_ v <br /> •APP 'scent Mme) STIP�`4 s - <br /> _ � <br /> QUAD <br /> (Mailizu sse) r Q SS Z <br /> KICK <br /> (City, $gnats, .Zin cods) - <br /> (Area Code Telephone Neer) <br /> sketch, (Detailed plate may be s 2bmitted) <br /> 6� C� C�� Q ck o <br /> The undersigned hereby applies for pa=nil scion to.w= vale, 'Oonst.--at and{or <br /> Otherwise-encroach. an County..mighvay Right.-of Ka=Y•CSA-wha <br /> proritely 5 �` zed jmzle' NO <br /> . ?-n <br /> following work (aesoript;on of.*work) <br /> i, - <br /> k F L� <br /> Wit- 3• x + 0, Ac-r ICS '�g5Ci_5�= <br /> Work will commence on or' t 15— ' for approximately <br /> �U n days' ' '1`i� <br /> I, the Lndersigned certify that. I am the Ow-?er' of,the. respective property, .or an <br /> qualified to represent the owner and' agree. to.do .the work described: above in , <br /> accordance with the xulles, regulations'of Sat: Joan,;n C6urty and subject to <br /> inspection and approval <br /> Sig=aturs of Aplica=t - °t`i4 a Bate <br /> f�S•?"i3.aS\PESSC^�L [5/07 - .. �. - 4,�t. . . <br />