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PLEASE PRINT: <br />Date 3/9/2021 <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 Cod <br />(209)464-8311 <br />(Area Code - Telephone <br />deberhardt@caNvater.com <br />(Email Address) <br />APPLICATION FOR ENCROACHMENT PER <br />JOB # <br />730077 <br />REF # <br />APN <br />CR # <br />EXP. DATE <br />VALID <br />3/9/2021 TQ <br />5/15/2021 <br />STREET <br />Basin St. <br />AREA <br />Stockton QUAD <br />ES <br />TYPE <br />Trench I <br />FORMS <br />renc u o'cy <br />NOTES <br />Special Conditions <br /># 8560 <br />DRIVEWAYS: <br />Sketch (Detailed plans may be submitt <br />d) <br />See attached <br />The undersigned hereby applies for <br />the North side of E <br />of Dixie Dr <br />5807 Basin St <br />2 Cuts - <br />will commence on or <br />St <br />to excavate, construct and/or otherwise <br />approximately <br />by perfor <br />I, the undersigned, certify that I am the owner of the respective property, or am qualified to <br />work described above in accordance with{ the rules and regulations of San Joaquin County <br />David Eberhardt Jr- Operations Clerk <br />Signature of Applicant - Title <br />Y -Y S&TB.1nA�QRQAGHMMTP ffA GNTIM dw(L ) <br />on County Highway Right -of -Way on <br />48 feet/mile East <br />following work (description of work): <br />days, <br />the owner and agree to do the <br />ct to inspection and approval. <br />