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. 1 <br /> • P <br /> APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: ' <br /> Date 1.2- 21 - 12 OFFICE USE ONLY <br /> To: San Joaquin County JOB#- REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE 3 /.� <br /> Pacific Gas and Electric Co. -i VALID TO /„� DRIVEWAYS: <br /> i STREET 2EL ti/ AY ' <br /> P.O. Box 930 1 AREA -!�VzAc%ToA/ QUAD 03 <br /> TYPE ALL µoL.E .• <br /> Stockton, CA 95201 FORMS �"'�' <br /> NOTES <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> . I <br /> Traffic Control Plan <br /> See attached sketch. Shall be-as per 1 <br /> PM 20q525"75- current M.U.T.C.D. <br /> Notif. 1,o,-. 22,.-29Z3 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 SUuT// side of HI:I�ELTyn! 1g0,6 _approximately 2Sq feetlmde tyEsT <br /> of F/IESMO /?(JE I . .STocXToAI by performing the following work(description of work): <br /> LJ. /-14Z� 5LTO.tl AVE-, <br /> EX C-A U/a TL H(-7L C ovZLee 6lg S In4141 14At/Q G uT oFr� SE2y/GLS <br /> 111-L 4JD1ZX Tv BE L)oI4E .tel h127' /VZE�q. <br /> Work will commence on or about 2- -/3 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 /> r /AS (4.D.L`. 02- -21- 12 <br /> Signature of Applicant-Title Date <br /> E,IPUB-BV.WIMAASfERPSIENCROACHMENT PERMITAPPUCATIOMDOC (01108) <br /> • I <br />