Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date 3 - /3 OFFICE USE ONLY <br /> To: San Joaquin County JOB# �„ �_ �, REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE <br /> Pacific Gas and Electric Co. VALID i TO DRIVEWAYS: <br /> STREET 'TIjp,- <br /> P.O. Box 930 AREA Z:,PL W QXv- <br /> D _A1W <br /> Stockton, CA 95201 <br /> TYPE 'B I <br /> FORMS <br /> - NOTES <br /> -A10 roO9G'uTf7�t! <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 30'791/34, current M.U.T.C.D. <br /> Notif. !B log 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 L�7L S`f side of TiyvR/./rZ)AI e.6 approximately _ y!S feet/mile Syarll <br /> of i3/�Ri3ER ��. 7'11-o /AbAl ,by performing the following work(description of work): <br /> �x��vii+rE' /�'oL.� Div�lz GAS m.�ict �1�c.l� .�CdST",►gLL. �.qs SE-ievi��. <br /> Work will commence on or about 3-.25- /3 for approximately 20 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 <br /> Signature of Applicant-Title Date <br /> E:1PUB-SV.WKIMASTER.PSIENCROACHMENTPERMIT APPLICATION.DOC (01/01) <br />