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APPLICATION FOR ENCROACHMENT PERMIT # 8546 <br />PLEASE PRINT: <br />Date 1/15/2021 <br />To: San Joaquin County <br />Department of Public Works <br />California Water Service Company <br />(Applicant <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 />Sketch (Detailed plans may be submitted) <br />See attached <br />JOB # <br />APN <br />EXP. DATE <br />VALID <br />STREETaim <br />AREA <br />TYPE <br />FORMS88 <br />NOTES <br />OFFICE USE ONLY <br />730077 REF # <br />CR # <br />TO DRIVEWAYS: <br />StocktonOUAD <br />-Bermuis <br />u o icy <br />pecia on i ions <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 E Main St approximately 45 feetlmile West <br />of S Oro Ave , by performing the following work (description of work): <br />4075 E Main St <br />Main Repair 761000 <br />1 Cad ss><1a, <br />Work will commence on or after 1/15/2021 for approximately 60 days. <br />1, 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 1/15/2021 <br />Signature of Applicant - Title Date <br />V WOWS&TWI TE�T PE KO IO4iIMft(M) <br />