Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date // /-/z OFFICE USE ONLY <br /> To: San Joaquin County JOB# 7 ,5,Z(� REF# <br /> Department of Public Works APN CR# <br /> EXP. DATE <br /> Pacific Gas and Electric Co. VALID D TO DRIVEWAYS: <br /> STREET// *,Af*-7" ' <br /> P.O. Box 930 AREA gMe/g"A/ QUAD <br /> Stockton CA 95201 TYPE <br /> FORMS T�tlw �29 <br /> NOTES <br /> �o� ) tY2 - /tig, <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 current M.U.T.C.D. <br /> Notif. 1d5531H5'6 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 Soz-,771 side of // T�'' ST approximately yD.S feet/rAk c.�EsT <br /> of "8" STREET STD«�n4 by performing the following work(description of work): <br /> i�v 1/e3 L� -nd A,4vf23 qR4-,4 To ::Zc.7— <br /> P,LC "1!)AJ6-"7- /45PAW 7- .�PL/�c��ic�.c�T 70 <br /> Work will commence on or about 10 -31-/Z- for approximately Bio 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 /> //- 1 -12 <br /> Signature of Applicant-Title Date <br /> E:IPUB-SV.WKIMASTER.PSIENCROACHMENT PERMIT APPLICATION.DOC (01108) <br />