Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 3/30/2021 <br /># 8571 <br />J08 # <br />APN <br />EXP.DATE <br />VALID <br />STREET <br />OFFICE USE ONLY <br />730077 REF # <br />CR # <br />TO DRIVEWAYS: <br />Drake Ave. <br />To: San Joaquin County <br />Department of Public Works <br />Califomia Water Service Company <br />(Applicant Name) <br />1602 E Lafayette St <br />AREA <br />TYPE <br />Stockton QUAD <br />Bell Hole <br />(Mailing Address) <br />Stockton, Ca 95205 <br />FORMS <br />NOTES <br />SSAAM/, R-29, Trench Cut Policy <br />Special Conditions <br />(City, State, Zip Code) <br />(209)464-8311 <br />(Area Code - Telephone Number) <br />deberhardt@calwater.com <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />See attached <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right-of-WaV on <br />the East side of Drake Ave approximately 0 feet/mile Nortf, <br />of E Guernsey Ave by performing the following work (description of work): <br />Main <br />Work will commence on or after 3/30/2021 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 />T WPM&&T PIAIESfNCFCPCIM@R FBCARPF}LICAT LN.Orc paw <br />3/30/2021 <br />Date <br />