Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 4/22/2021 <br />To: San Joaquin County <br />Department of Public Works <br />PGE PM 35220245 <br />(Applicant Name) <br />3136 Boeing Way <br />(Mailing Address) <br />Stockton, CA 95206 <br />(City, State, Zip Code) <br />209-279-3846 <br />(Area Code - Telephone Number) <br />S9P3@PGE.com <br />(Email Address) <br />may <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 />6/9/2021 TO DRIVEWAYS: <br />Olive Ave. <br />Stockton QUAD ES <br />Aerial Work <br />SSANVV <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 Both side of S Olive Ave approximately 720ft feet/mile South <br />of Washington St Stockton by performing the following work (description of work): <br />PGE to replace transformer. install service and meter. <br />Work will commence on or after for approximately 3 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 />� y Tone <br />Signature of Applicant - Title <br />V]FORMS&TENPIATEIENCROACHMEN T PERMIT APPLICATION dov(W&OP <br />4/22/2021 <br />Date <br />