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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 1/13/22 <br />To: San Joaquin County <br />Department of Public Works <br />Sunny Thipsidakhom for Comcast <br />(Applicant Name) <br />3011 Triad PI. <br />(Mailing Address) <br />Livermore, CA 94551 <br />(City, State, Zip Code) <br />858-761 5426 <br />(Area Code - Telephone Number) <br />CHC-Permitting-6@chcconsulting.com <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <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 />110005 REF # <br />CR # <br />2t22t2022 511 "'1-POPP <br />TO DRIVEWAYS: <br />Tracy QUAD <br />Bore Pits, Bores, Trench, Aerial Work <br />SS/WW, 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 east side of Hansen Rd approximately 22' feet/mile south <br />of Von Sosten Rd , by performing the following work (description of work): <br />Overlash approximately 336' from existing pole#1 to pole#6 via 4 existing poles. Riser down at pole#6. Hand trench & bore approximately 14' <br />& 431' to place 2-2" conduit from existing pole#6 to existing pole#8. Riser up at pole#8. Overlash approximately 174' from existing pole#8 to <br />existing pole#9. Access pedestal #1 for splicing on Redondo Dr. <br />Work will commence on or after 02/22/2022 <br />for approximately <br />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 />�m Permitting for Comcast <br />Signature of Applicant - Title <br />1/13/22 <br />Date <br />