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PLEASE PRINT: APPLICATION FOR ENCROACHMENT PERMIT # 8548 <br />Date 1/15/2021 <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 />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 />JOB # <br />APN <br />EXP. DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />730077 <br />REF # <br />CR # <br />1191202TO 4111202DRIVEWAYS: <br />-fit <br />8tockton QUAD <br />-Be7FFFoe— <br />rencn UutPolicy <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 Basin St approximately 233 feet/mile West <br />of Everglade way by performing the following work (description of work): <br />1" Service Replacement STK0600 <br />2 Cuts - 5'x10' Asphalt (Street) + 5'x5' Concrete (Sidewalk) <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 <br />Signature of Applicant - Title <br />Y1F W&TFMnA SaiCF0ACM1eJT ffA CATIGKd (MR <br />1/15/2021 <br />Date <br />