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APPLICATION FOR ENCR©ACI IMENT PERMIT <br />PLEASE PRINT: # 8666 <br />Date 11/29/2022 <br />To; San Joaquin County <br />Department of Public Works <br />California Water Service Company <br />(Applicant Name) <br />1602 E Lafayette St <br />(Mailing Address) <br />Stockton, Ca 95205 <br />(City, State, Zip Code) <br />(209)464-6311 <br />(Area Code - Telephone Number) <br />deberhardt@calwater.com <br />(Email Address) <br />may <br />See attached <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 />12/5/2022 TO 2/15/2023 DRIVEWAYS: <br />McComb Ave. <br />Stockton QUAD <br />Bell Hole <br />SSAVWV, R-29, Trench 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 west side of McComb Ave approximately 115 feet/mile North <br />of Cherokee Rd , by performing the following work (description of work): <br />2217 McComb Ave <br />1" Service Replacement STK0600 <br />1 Cut -4'x4' <br />Work will commence on or after 11/29/2022 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 <br />Signature of Applicant - Title <br />YVIXYS 6 TFIIMiE9FNAgVCINFIR PrR/IT MRKAMXIbs rAPoj <br />11/29/2022 <br />Date <br />