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PLEASE PRINT: <br />Date 11/21/2022 <br />To: San Joaquin County <br />Department of Public Works <br />California Water Service Company <br />(Applicant Name) <br />1602 E Lafayette St <br />Address) <br />APPLICATION FOR ENCROACHMENT T PERMIT <br />Stockton, Ca 95205 <br />(City, State, Zip Code) <br />(209)464-8311 <br />(Area Code - Telephone Number) <br />deberhard t@calwater.00m <br />(Email Address) <br />plans may <br />See attached <br />#8662 <br />JOB If <br />APN <br />EXP. DATE <br />VAUD <br />STREET <br />OFFICE USE ONLY <br />730077 REF# <br />CR # <br />11/28/2022 TO 2/1/2023 DRIVEWAYS: <br />Howe Ave. <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />Stockton QUAD WS <br />Bell Hole <br />SSANVV R-29 Trench Cut Policv <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 Howe Ave approximately 210 feel/mile South <br />of Lowell Ave by performing the following work (description of work): <br />New 1' Service Install STK0600 <br />4 I`,d - d'vd' <br />Work will commence on or after 11/21/zozz 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 11/21/2022 <br />Signature of Applicant - Title Dale <br />vvaa s s rsururtse�rautHs waxr uarcaasrox az Foal <br />