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APPLICATION FOR ENCROACI IMEN T PERMIT <br />PLEASE PRINT: <br />Dale 11/18/2022 <br />To: San Joaquin County <br />Department of Public Works <br />Califomia 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@caKvater.com <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />See attached <br /># 8660 <br />JOB # <br />APN <br />EXP. DATE <br />VALID112 <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />730077 REF # <br />CR # <br />TO DRIVEWAYS: <br />ucIv <br />btocKton QUAD CC ' <br />Bell Hole ' <br />rench 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 South side of WEuclid Ave approximately 365 feeUmile West <br />of N Wallace Ave by performing the following work (description of work): <br />3250 & 3260 W Eudid Ave <br />2 - 1" Service RBDlarements STKO600 <br />Work will commence on or after 11118/2022 for approximately 60 days. <br />I, the undersigned, certify that I am the owner of the respective properly, 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 <br />Signature of Applicant - Title <br />VV s TFYMIE9FN(fl0.'LMJ8rt a< "a) <br />11/18/2022 <br />Date <br />