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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 11/17/21 <br />To: San Joaquin County <br />Department of Public Works <br />PG&E <br />(Applicant Name) <br />3136 Boeing Way <br />(Mailing Address) <br />Stockton, CA 95206 <br />(City, State, Zip Code) <br />(415) 203-1616 <br />(Area Code - Telephone Number) <br />TTP4@PGE.COM <br />(Email Address) <br />may <br />See attached plans. <br />Ref permit # PS -2100557 <br />JOB # <br />APN <br />EXP.DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />730052 REF # <br />CR # <br />TO 6/15/2022 DRIVEWAYS: <br />Schulte Rd. <br />Tracy QUAD SW <br />Pole Replacements, Bore, Bore Pits <br />SSANVV, 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 side of various locations approximately @ feet/ 0mile <br />of the roads , by performing the following work (description of work): <br />Trench and/or bore approximately 1900 ft of new 6 inch conduit, install poles, new overhead conductor, switches, SCADA, etc. <br />Work will commence on or after 11/1/21 for approximately 190 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 />Tflnh Pham ��s °20211117y i32u oeoo 11/17/21 <br />Signature of Applicant - Title <br />Date <br />