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t-',- 22 o <br />COUNTY OF SAN JOAQUIN <br />DEPARTMENT OF PULIC WORKS <br />DRIVEWAYS AND PAVED FRONTAGES <br />PERMIT APPLICATION <br />E4J2391, <br />PLICANT <br />Name: a d oar <br />Address: 333 Clay St,28000 <br />Cit State, Zi Code: n, Tx 77002 <br />Area Code -Telephoneer: <br />Email: <br />NFORMATION: <br />Parcel Owner's Name:ade Ener Store a <br />Site Address: 9 a <br />City, State, Zi Code: Stockton. 95205 <br />Area Code -Telephone ber: aNTRACTORName: Sargent FlectdpanyAddress: 2740 SmOnreetCi , State, ZI Code: ur h, PA 95222Area Code -Tele honber: <br />Date: <br />Received By: <br />CR#: 271521 <br />The under I ned hereby app )es for permis ion to excavate, construct and/or otherwise encroach n County H' ay Right -of -Way on the <br />- _ approximately fe mile <br />T ,side of ✓ by installing _%�i <br />commence on <br />sheet may <br />for approximately <br />Will this project be self -Installed? YES NO Contractor's License <br />%IENCRORGWENT&N Wrm,,w0aez,ENCR0ACHM@a POUT 0RNEWFYdo Pea) <br />oa7�, <br />Will <br />OFFICE USE ONLY <br />11005 ISSUE DATE: <br />rAPN/7-/A� <br />/ FEE DUE: <br />DRIVEWAYS: <br />w es <br />" <br />; QUAD ,m <br />TYPE: <br />FORMS: 0!,; &P C-17 <br />NOTES: <br />DRIVEWAY <br />TYPE: <br />QUANTITY WIDTHS <br />AGRICULTURE: <br />FRONTAGE <br />COMMERCIAL: <br />INDUSTRIAL: <br />RM <br />RESIDENCE: <br />PAVED FRONTAGE <br />LENGTH: <br />Ft. X WIDTH: Ft. <br />The under I ned hereby app )es for permis ion to excavate, construct and/or otherwise encroach n County H' ay Right -of -Way on the <br />- _ approximately fe mile <br />T ,side of ✓ by installing _%�i <br />commence on <br />sheet may <br />for approximately <br />Will this project be self -Installed? YES NO Contractor's License <br />%IENCRORGWENT&N Wrm,,w0aez,ENCR0ACHM@a POUT 0RNEWFYdo Pea) <br />oa7�, <br />Will <br />