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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 />2/16/22 <br />PG&E PM 45079992 <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) 953-7 421 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 />EAST POCK LANE 600 SOUTH <br />CARPENTER RD, SAN JOAQUIN COUNTY CA <br />PG&E PROPOSES TO REPLACE AN ELECTRIC TRANSMISSION JUMPER ON AN EXISTING POLE . NO GROUND DISTURBANCE . DURATION : ONE DAY <br />ELECTRIC TRANSMISSION JUMPER WIRE (004/129) replacement in the County of San Joaquin scheduled for 3/25/2022. <br />3/25/22 1 DAY <br />Beau Heffron Digitally signed by Beau Heffron <br />Date: 2022.02.15 21:15:22 -08'00'2/16/22