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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 DateSignature of Applicant -Title <br />escribed above in accordance w <br />110005 <br />2/3/22 <br />Morada Land Company <br />3108 N Cherryland Ave. <br />Stockton, CA 95215 <br />(209) 915-0009 <br />george@vanguardofcalifornia.com <br />PLEASE SEE ATTACHED <br />West Report Ave 380 <br />Ditch/Dirt <br />Installing 12" Galvanized Corrugated Steel Pipe and covering with sod <br />Also on the North side of Francis Street approximately 100 feet <br />5/1/22 Depending when parts arrive, one week <br />2/3/22