Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date I. -2D - 12 OFFICE USE ONLY <br /> To: San Joaquin County JOB# ��?Up��(o REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE I� <br /> Pacific Gas and Electric Co, i VALID 25 2- TO DRIVEWAYS: <br /> STREET yyJq �fj/E, <br /> P.O. Box 930 AREASTaa,L / QUAD ' <br /> Stockton, CA 95201 TYPE ELGXI�L� <br /> FORMS <br /> NOTES r6 G i9 ms! 020 <br /> —4iI <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 `t�llo�1`�9:2 8 <br /> current M.U.T.C.D. <br /> Notif. IQ66 70 SSS California supplement. <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the .(/02T/.1 side of .7T[lm 4"Ll 41,45 approximately. .349,6 feeJ�ik- EAsT <br /> L� <br /> of JEBS 'E!Z /70—z.TvE. STDc�t�vn/ by performing the following work(description of work): <br /> 23y/ .Zt//YI.4.c1 i4e/E. <br /> >D <br /> OZ�fAi�ir2 1- 4; <br /> Work will commence on or about for approximately 1 days. <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 /> G-2v - /2 <br /> Signature of Applicant-Title Date <br /> E:NUB-SV.WKUAASTERPSIENCROACHMENT PERMIT APPLICATION.DOC (01108) <br />