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D EL <br /> 'I'GCO-L=tI J�J.0 ��W� IVCM� �r.f:' `ZI <br /> Y- <br /> Rte1c)-I-2.e Ii , <br /> I. p -- <br /> cy--ailing a.-d6—rsas} FORMS <br /> NOTE <br /> (city, stabar <br /> (mea code - Telephone Mier) <br /> si�Etc (DEtzi led pla3s may he s'bmitted} <br /> � ' <br /> `Kumdersigmed hxeby =pp a_•i`s for permission to,er�a� tet do s r�oL �dior <br /> oth��rrise-encroach•or. •�o�ty i;igh�ay �?ght-oy- Tey--•tea-`fie . silo:.�f <br /> . _ approrim<tel� meet j�•i?e <br /> o e r Ly -_t^1E�'�O c �rtQ the <br /> following work (aesersptioa of:work) <br /> .� C � /- . -Gr, 7zj.;-4 L 2 `X 2F e- <br /> ffork Will commence oa or'abo7st for approxirrsately <br /> U days. <br /> I, the =adersigned certify that I am the own. er' of,the 'respective property, or an <br /> uaZified to represent the owner azd' agree to do the work descril>ed above in <br /> accordance with tLe l ? es r rag-3_tio_Lsr 'of San goagsriri County and stzbj ect to <br /> inssnection znd approval .` . <br /> II J � f <br /> si _attsre of &Z> Zicaa - ' --� <br /> _P t _x�3.e bate <br />