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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date OFFICE USE ONLY <br />To: San Joaquin County <br />JOB #REF # <br />Department of Public Works APN CR # <br />EXP. DATE <br />VALID TO DRIVEWAYS: <br />(Applicant Name)STREET * <br />AREA QUAD * <br />TYPE * <br />(Mailing Address)FORMS <br />NOTES <br />(City, State, Zip Code) <br />(Area Code - Telephone Number) <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on &ounty Kighway ULght-of-Zay on <br />the ______________ side of ___________________________________ approximately ____________ feet/mile _________ <br />of _______________________________________, ____________________, by performing the following work (description of work): <br />Work will commence on or after _____________________________________ for approximately ________________________ 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 />Signature of Applicant - Title Date <br />4/27/22 <br />PG&E PM 31596403 <br />3580 EAST CALIFORNIA AVE <br />FRESNO ,CA. , 93725 <br />(559) 203-4619 <br />BPH7@PGE.COM & ETPGEPERMITS@PGE.COM <br />Crew to call SJ County Inspector at (209) 953-7421 48 to 72 hours before work starts. <br />When calling, crew shall request "rain clearance" for any work during winter months <br />November through March <br />SOUTH E MORADA LANE 25 SOUTH <br />HICKORY AVE , SAN JOAQUIN COUNTY CA <br />PG&E PROPOSES TO REPLACE EXISTING ELECTRIC TRANSMISSION POLE. DURATION ONE DAY <br />ONLY ONE DAY OF TRAFFIC CONRTOL NEEDED. CONTACT JASON BARRETT 925-459-2177 <br />NEW POLE TO BE SET HARD WEST OF EXISTING POLE. <br />APPROX 3 FT FROM ROW, APPROX 1 FT FROM EOP, APPROX 15 FT FROM CL OF E MORADA LN. POLE IS APPROX 25 FT SOUTH OF HICKORY AVE. ON THE SOUTH SIDE OF E MORADA LANE . <br />6/16/22 6 MONTHS <br />Beau Heffron Digitally signed by Beau Heffron <br />Date: 2022.04.27 13:36:37 -07'00'4/27/22