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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 9-21-2021 <br />To'. San Joaquin County <br />Department of Public Works <br />PG&E, PM -70040802 <br />(Applicant Name) <br />6121 Bollinger Canyon Road <br />(Mailing Address) <br />San Ramon, CA 94583 <br />(City, State, Zip Code) <br />(650)379-9294 <br />(Area Code � Telephone Number) <br />ET PG E P E R M I T S@ P G E. C O M <br />(Email Address) <br />may <br />JOgg <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 A <br />10/18/2021 TO 4/1/2022 DRIVEWAYS <br />B St. ` <br />Stockton QUAD SS ` <br />Aerial Work ' <br />SSAAAV <br />Special Conditions <br />Crew to call SJ County Inspector at (209) 953-7421 48 to 72 hours before work starts. <br />When calling, crew shall request "rain clearance" for any work during winter months <br />Novemberthrough March <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 See Attachment l a approximatelyee mile <br />of San Joaym County CA, , by performing the following work (description of work), <br />Overhead Stockton A to Weber Sub Fiber Install Project <br />PG&E to do overhead aerial work to install fiber wire on poles and do other Dole maintenance work. Seelap ns for more <br />detail Pnlpc a ragp -R-A it from Pdgp of navpri and -1A-95 ft frnm epntpr of RC)VV TCP are TC -1 and TC -2. <br />To be worked in conjunction with underground work Permit PS -2103028. <br />Workwill commence on or after 10/18/2021 for approximately 90 days. <br />I, the undersigned, codify 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 />Permit Facilitator 9/21/2021 <br />Signature of App ca - Title <br />Dale <br />