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PS- 241)lb/ (p <br />COUNTY OF SAN JOAQUIN <br />DEPARTMENT OF PULIC WORKS <br />DRIVEWAYS AND PAVED FRONTAGES <br />PERMIT APPLICATION <br />APPLICANT <br />OFFICE USE ONLY <br />JOB #: <br />Name: S r 5v rZ <br />APN <br />Address: ISS EAw cT <br />EXP. DATE: <br />City, State, Zip Code: 71 <br />CIS <br />STREET: <br />Area Code - Tele hone Number: L 6o - <br />5 %t <br />SITE INFORMATION: <br />TYPE: <br />Parcel Owner's <br />Name: "jNpca. <br />or <br />Site Address: <br />7jry v3c s— wav�wA <br />DRIVEWAY <br />City, State, Zip Code' Ft? erAc14 QArAT <br />Area Cade - Tele hone Number: <br />sro) �jGo - <br />a <br />CONTRACTOR <br />Name:c= <br />,�,\kwcx>SAN-.{SEN �c�.S <br />Address:kSS EDS cT <br />City, State, Zip Code: ^r Cpx 0l <br />3 <br />Area Code - Tele hone Number: 0 3 -o <br />COMMERCIAL: <br />Received By: <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Hi way Right -of -Way on the <br />45w.:�N side of approximately 00 mile r <br />Of ,iVln rf iae. _ e by installing <br />commence on or about <br />may <br />far approximately <br />Will this project be self -installed? ✓- YES NO Contractor's License � � 2 � 11� <br />PIENCAOACHMEMCINesler FamsTemplaWIENCRMCHFFNf PERMIlgWEWAVEoo(0&9B� <br />days. <br />Work will <br />OFFICE USE ONLY <br />JOB #: <br />11005 ISSUE DATE: <br />APN <br />143.2400-19 FEE DUE: <br />EXP. DATE: <br />vDRIVEWAYS: <br />STREET: <br />110.om&n led, <br />AREA: <br />QUADf5A) <br />TYPE: <br />i /bac <br />FORMS: <br />NOTES: <br />DRIVEWAY <br />TYPE: <br />QUANTITY <br />WIDTHS <br />AGRICULTURE: <br />@FRONTAGE <br />COMMERCIAL: <br />INDUSTRIAL: <br />@ RNV <br />RESIDENCE: <br />PAVED FRONTAGE <br />LENGTH: <br />Ft, X WIDTH: Ft. <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Hi way Right -of -Way on the <br />45w.:�N side of approximately 00 mile r <br />Of ,iVln rf iae. _ e by installing <br />commence on or about <br />may <br />far approximately <br />Will this project be self -installed? ✓- YES NO Contractor's License � � 2 � 11� <br />PIENCAOACHMEMCINesler FamsTemplaWIENCRMCHFFNf PERMIlgWEWAVEoo(0&9B� <br />days. <br />Work will <br />