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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: # 8612 <br />Date 3/30/2022 <br />To: San Joaquin County <br />Department of Public Works <br />Califomla Water Service Company <br />(Applicant Name) <br />1602 E Lafayette Sl <br />(Mailing Address) <br />Stockton, Ca 95205 <br />(City, State, Zip Code) <br />(209)464-8311 <br />(Area Code - Telephone Number) <br />deberhardt@calwater.com <br />(Email Address) <br />may <br />See attached <br />JOB # <br />APN <br />EXP. DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />730077 REF # <br />CR # <br />4/1/2022 To 6/15/2022 DRIVEWAYS: <br />REDWOOD AVE. ' <br />STOCKTON QUAD NS + <br />TRENCH ' <br />SSNW ,, R-29, TRENCH CUT POLICY <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on <br />the South side of Redwood Ave approximately 75 feeUmlle East <br />of E Alpine Ave , by performing the following work (description of work): <br />Main Repair STKO500 <br />Work will commence on or after <br />for approximately <br />M <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 />David Eberhardt Jr - Operations Clerk <br />Signature of Applicant - Title <br />vwaalsa rFNMtESA`CFtl.KfWEMPF.PIRAF'SKATKK16�c Psge) <br />3/30/2022 <br />Date <br />