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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date OFFICE USE ONLY <br /> To: San Joaquin County JOB# f 3d��Z-� REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE 3 VN <br /> Pacific Gas and Electric Co. VALID i -3 i TO 3 15 13 DRIVEWAYS: <br /> STREET �:as {�►� Qe <br /> P.O. Box 930 1 AREA '�rocTct�QUAD WS <br /> Stockton, CA 95201 TYPE �� o� <br /> FORMS .'55110W, le :29 <br /> NOTES <br /> M RAE � <br /> (2o 9) 9y2,-1'193 <br /> (Ara Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> ITraffic Control Plan ti <br /> See attached sketch. Shall be*as per 1 <br /> PM 3o9S9yyo current M.U.T.C.D. <br /> Notif. 00/-3:2/ 731/ � 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 E/4s7' side of L.vs 3T. approximately 13;x feet/mile So4z7-11 <br /> of Alia 2ELTQt! .4c/E SroCKT"0A1 by performing the following work(description of work): <br /> 61L S. LvS .AA11,'6L6S .977 /fDuSE Tv t3E ©E�iiaLes��F�D, <br /> ExC�v17 r-c /SOLE 04AE2 �§AS M e41/kJ 4AJ6 C[./7~ <br /> l�LL L JAQ1?K TJ Bf- LDAJE .Zn! c�iILT �i2E.�1, <br /> Work will commence on or about !,2-3-12 for approximately %O 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 /> n e-1 AA <br /> - GAS ,�. /0-/lo-42 <br /> Signature of Applicant-Title Date <br /> E:IPN&SKWXU SnUSIENCROACHMENf PEW APPUCA110N.000 101/08) <br />