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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 11/29/2022 <br />�f0:-.S2T1-70�-�OU�y ---- <br />Department of Public Works <br />California Water Service Company <br />(Applicant Nai <br />1602 E Lafayette St <br />(Mailing <br />Stockton, Ca 95205 <br />(City, State, Zip Code) <br />(209)464-8311 <br />(Area Code - Telephone Number) <br />deberhardt@catwater.com <br />(Email Address) <br />may <br />See attached <br /># 8669 <br />3013 <br />APN <br />EXP. DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />- 73n"' -- 'REF# - <br />CR # <br />12/5/2022 TO 2/15/2023 DRIVEWAYS: <br />Euclid Ave. <br />Stockton QUAD CC <br />Bell Hole <br />SSIWVV 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 North side of W Euclid Ave approximately 137 feetlmile West <br />of Delano Ave , by performing the following work (description of work): <br />Main R <br />1 Cut - <br />Work will commence on or after <br />for approximately 60 <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 />11/29/2022 <br />Signature of Applicant - Title Date <br />r VIXAIS a TfLRAIESfHCPA1Ge/EitFFRFtAHUC1MHkc rAOe� <br />