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PLEASE PRINT: <br />APPLICATION FOR ENCROACHMENT PERMIT <br />Date 10/24/22 <br />To: San Joaquin County <br />Department of Public Works <br /> Mountain F. Enterprises Inc/Contractor for PG&E <br />(Applicant Name) <br /> 950 Iron Pont Rd Suite 210 <br />(Mailing Address) <br /> Folsom, Ca 95630 <br />(City, State, Zip Code) <br /> 530-957-1756 <br />(Area Code - Telephone Number) <br /> M.Burks@Mtfent.com <br />(Email Address) <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the side of approximately feet/ mile <br />of , , by performing the following work (description of work): <br /> MFE will be performing Vegetation Management around PG&E Facilities with in County ROW including Traffic Control <br /> between 5325 – 5253 E. Harney Ln- Aprrox 4 units. All wood and debris will be removed day of. <br />. Work will take place from 8:30 am to 4:00 pm daily, Monday through Friday. Work may only take 2 -3 days. <br />Work will commence on or after 11/7/22 – 11/11/22 for approximately 2 - 3 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 />10/24/22 <br />Signature of Applicant - Title Date <br />Sketch (Detailed plans may be submitted) <br />See Attachment for TCP and Site-Specific Locations <br />JOB # <br />APN <br />EXP. DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br /> REF # <br /> CR # <br /> TO DRIVEWAYS: <br />* <br /> QUAD * <br />*