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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 />7/20/22 <br />Frontier Ca Inc <br />201 Flynn Road <br />Camarillo, Ca. 93013 <br />(805) 290-7709 <br />Leticia.Mattson@cyient.com; Candace.Guerrero@cyient.com <br />Please see attached. <br />FRONTIER IS REQUESTING TO PLACE APPROXIMATELY 12,725' OF FIBER CABLE INTO EXISTING DUCT BY USING EXISTING MHS AND ONTO EXISTING POLES BEGINNING ON W RIPON RD @ S HIGHLAND AVE., <br />THROUGH VARIOUS LOCATIONS AND ENDING ON S AUSTIN RD @ LYONS RD. <br />TRAFFIC CONTROL WILL BE IMPLIMENTED BY UTILIZING MUTCD STANDARDS. NO EXCAVATION REQUIRED. <br />THIS IS FOR FTTH PROJECT 5300679 FDR RTE 4, SEPT BUILD. <br />9/1/22 10 <br />7/20/22