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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 3/29/2022 <br />To: San Joaquin County <br />Department of Public Works <br />California 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@GaKvater.com <br />(Email Address) <br />may be <br />See attached <br /># 8609 <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 6/1 DRIVEWAYS: <br />Horner Ave. ' <br />Stockton QUAD ES <br />Trench t <br />SSMNV, R-29, Trench Cut Policy <br />Special Conditions <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 Horner Ave approximately 50 feel/mile East <br />of S Oro Ave by performing the following work (descdplion of work): <br />Main Repair & 1" Service Replacement STK0600 <br />1 Cut - 6'x12' <br />Work will commence on or after 4/112022 for approximately 60 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 />David Eberhardt Jr - Operations Clerk 3/29/2022 <br />Signature of Applicant - Title Date <br />YYgwsnn+rnnresrxcttnMwr&rrprnurtuttiuncxarc esa� <br />