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COUNTY OF SAN JOAQUIN Date: �� <br /> 11014 <br /> DEPARTMENT OF PULIC WORKS <br /> Received By: A <br /> DRIVEWAYS AND PAVED FRONTAGES Com?9 S�� <br /> PERMIT APPLICATION CR#: <br /> g a APPLICANT OFFICE USE ONLY <br /> Name: A C2-w \., ��- <br /> Address: c JOB#: 11005 ISSUE DATE: <br /> City,State,Zip Code: C•, C=11 16 APN 74$ 0- t? FEE DUE: <br /> Area Code -Tele hone Num er: 'Low--'S t C�to23`�. EXP.DATE: DRIVEWAYS: <br /> STREET: e/1/Ee I?'p, <br /> SITE INFORMATION: AREA: T'l fbl^j QUAD !jS <br /> Parcel Owner's Name: TYPE: <br /> Site Address: FORMS: <br /> City,State,Zip Code: ., Ca, L \. NOTES: <br /> Area Code -Telephone Number: <br /> DRIVEWAY <br /> CONTRACTOR TYPE: QUANTITY WIDTHS <br /> Name: AGRICULTURE: FRONTAGE <br /> Address: z- COMMERCIAL: <br /> City,State,Zip Code: INDUSTRIAL: R/W <br /> Area Code -Telephone Number: RESIDENCE: <br /> PAVED FRONTAGE <br /> LENGTH: Ft. X WIDTH: Ft. <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise egcroach on County ' ay Right-of-Way on the <br /> A10z7i-? side of kV66 RA approximately 6' fe t sF' <br /> of A~-Ay g , by installing <br /> Work will <br /> commence on or about for approximately days. <br /> SKETCH(Separate sheet may be submitted) <br /> 4 <br /> Will this project be self-installed? YES NO Contractor's License <br /> 11SJPWGOV.ORG1SHARESICENTRALSERVICESICLERICAL%PUB-SV.WKIMASTER.PSIENCROACHMENT PERMIT DRIVEWAY.DOC (10109) Page 1 of 2 <br />