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i <br /> APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date OFFICE USE ONLY <br /> To: San Joaquin County JOB# � 7�_G REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE <br /> Pacific Gas and Electric Co. j VALID to-z2-Z-,/-Z-TO 2-d-2v> DRIVEWAYS: <br /> STREET _!-(1� tom-- A Ike- <br /> P.O. Box 930 AREA ✓SQUAD �}S <br /> Stockton, CA 95201 TYPEo .� <br /> FORMS <br /> NOTES <br /> I <br /> 9yz /y98 <br /> '(Area Code-Telephone Number) <br /> Sketch(Detailed plans maybe submitted) <br /> Traffic Control Plan , <br /> See attached sketch. ; ' Shall be'as per 1 <br /> PM 3 o9S"2.5�I current M.U.T.C.D. <br /> Notif. California supplement. <br /> I <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 SDUrl-/ side of 40E approximately 35 feedr4b W45,7- <br /> of 6—I&C, /D /�clE , ..STacKToAl ,by performing the following work(description of work): <br /> 170q ALA�5, <br /> EX CA UA TC /�v�L- Ovc:2 G/�S /�/��� /.l-,Uj] euT odl:pe E2✓! <br /> /a LL 6Jv2K. Tv BE _VU L')//ZT' <br /> Work will commence on or about > - - t for approximately 90 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 /> GAS (R.D.,E. /o -- - /2 <br /> Signature of Applicant-Title Date <br /> E1PN8-SV.WKWASTEPPSIENCROACNNENTPSWAPPLICAIION.000 (01108) <br />