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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Dale 10/12/2022 <br />To: San Joaquin County <br />Department of Public Works <br />California Water Service Company <br />(Applicant Name) <br />1602 E Lafayette St <br />(Mailing Address) <br />Stockton, Ca 95205 <br />(City, State, Zip Code) <br />(209)464-8311 <br />(Area Code • Telephone Number) <br />deberhardt@calwater.com <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />See attached <br /># 8649 <br />JOB # <br />APN <br />EXP. DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />730077 REF # <br />CR# <br />11/10/2022 TO 1/15/2023 DRIVEWAYS: <br />Oro Ave. ` <br />Stockton QUAD ES ` <br />(2) -Bell Holes ` <br />SSMNV, 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 West side of N Oro Aveapproximately 285 feet/mlle South <br />of E Fremont St , by performing the following work (description of work): <br />716 N Oro Ave <br />New 1" Service Install STK0600 <br />2 Cuts - 4'x4' +2'x2' <br />Work will commence on or after 10/12/2022 for approximately 60 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 />David Eberhardt Jr - Operations Clerk 10/12/2022 <br />Signature of Applicant - Title Date <br />v�raase iwcuresarna�c�rvwrwaRuxicAnateaN� <br />