Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 2/1/22 <br />To: San Joaquin County <br />Department of Public Works <br />West Coast Backhoe, Inc. <br />(Applicant Name) <br />33 Maxwell St <br />(Mailing Address) <br />Lodi, CA 95240 <br />(City, State, Zip Code) <br />(209) 339-7394 <br />(Area Code - Telephone Number) <br />timj@westcoastbackhoe.net (cc: h.mendoza@haggertybuilds.com) <br />(Email Address) <br />may <br />JOB # <br />APN <br />EXP.DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />110005 REF # <br />CR # <br />2/14/2022 TO 3/15/2022 DRIVEWAYS: <br />Piccoli Rd. <br />Stockton QUAD NS <br />Trenching <br />SSMNV, R-29, Trench Cut Policy <br />Special Conditions <br />Scope: <br />Reroute 6" fire service line, Install 12" storm drain service line, install 4" sanitary sewer service line. <br />Includes saw cutting and patch back of trenches. <br />Refer to attached updated plans by Michael Smith Engineering, Inc. <br />Removal of exisitng fire hydrant, waterline and bollards. <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the East side of Picolli Road, Stockton, CA approximately 32 feet feet/mile East <br />of Picolli Road, Stockton, CA Picolli Road, Stockton, CA , by performing the following work (description of work) <br />Work will commence on or after 02/14/2022 for approximately 15 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 />olglhlly sgned by Hugo mendura <br />oa�e 20220201 12 16 05-0000 2/1/22 <br />Signature of Applicant - Title <br />Date <br />