Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date OFFICE USE ONLY <br /> Pis <br /> To: San Joaquin County JOB# �3REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE <br /> DRIVEWAYS: <br /> Pacific Gas and Electric Co. VALID ��� ���. < �0 2_11q&' - <br /> STREET l f1.. A V6. <br /> P.O. Box 930 AREAQUAD <br /> TYPE , 1gCLr. <br /> Stockton, CA 95201 FORMS a ;= e t ', � 1l /f <br /> • !u'tCit f'c�i a-7 <br /> NOTES <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 V/73A8 73 current M.U.T.C.D. <br /> Notif. /oG2o2604r1 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 side of Z.4iEge5YL /qvZ approximately 991 feet/40(- L_)e�sT <br /> of L�J/qQKr1Z L Al- _5-rn=K7'c:kn1 —by performing the following work(description of work): <br /> 51:26 if, <br /> L-AeA 197-2 /IDLE OuzFJ2 G4S /YlIIAI <br /> GIqs i4sPr1--1y' <br /> Work will commence on or about /S—/Z for approximately `Irk 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 /> 011 AL <br /> Q� Signature of Applicant-Title Date <br /> E:{PUB-SV.WKIMASTER.PSIENCROACHMENT PERMIT APPLICATION.DOC (OV08) <br />