Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date OFFICE USE ONLY <br />To: San Joaquin County JOB # REF # <br />Department of Public Works APN CR # <br />EXP. DATE <br />VALID TO DRIVEWAYS: <br />STREET * <br />AREA QUAD * <br />TYPE * <br />FORMS <br />NOTES <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 County Highway Right-of-Way 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 />Y:\FORMS & TEMPLATES\ENCROACHMENT PERMIT APPLICATION.doc (08/08) <br />PGE <br />(Applicant Name) <br />560 West 15th Street <br />(Mailing Address) <br />Merced CA, 95340 <br />(City, State, Zip Code) <br />209.355.5087 <br />(Area Code - Telephone Number) <br />CYSO@PGE.com <br />PM 35238574 <br />See attached for pole(s) location and details <br />North Bethany Road See attached for each pole EastNaglee Rd <br />PGE to; {LOC1} remoce 341' downguy wire and anchor and install insulator with 341' Downguy wire and anchor. {LOC2} remove <br />brackets and install 8' Composite crossarm and insulators. {LOC3} TOP Pole- Remove Brackets and Aluminum Conductor Install <br />new 50' pole, 8' composite crossarms and insulator with 320' Aluminum Conductor. {LOC4} Remove steel corssarms, insulators, <br />OH transformer and 5/16" downguy and anchor. Install new 50' pole, 8' composite crossarm, insulator, new OH transformer and <br />OH service wire and downguy's with anchors. <br />09/17/2021 <br />10/15/2021-04/15/2022 3 <br />09/17/2021