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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 611212020 <br />To: San Joaquin County <br />Department of Public Works <br />K.W. Emerson, Inc <br />(AppllcantName) <br />P,0 Box 649 <br />(MaflingAddresa) <br />San Andreas, CA 95249 <br />(Chl State, 21p Code) <br />(209)7543839 <br />(Area Code• Telephone Number) <br />loloiahwemersonmm <br />(EmallAddrees) <br />See allached <br />Jos# <br />APN <br />EKP.DATE <br />VAUD <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />110005 REF# <br />CRN <br />09M020 <br />sasao20 TO osrot= DRIVEWAY& <br />Ketlleman Lane ' <br />Lodi QUAD NE <br />Traffic Control Devices <br />SSW <br />Special Conditions <br />Theunderalgned hereby apples for permisslonto excavate, construct andloralherwHeerwroachon County Highway Rght•of•Wayon <br />the both sided E.KattlemanLane approximately 525 Ieetlmile East <br />of Highwaoll by pehi the hllowingwork (description ofwork): <br />Temporarily removing appmximatei1471guardrail on the east side of the levee toad entrancewidening the levee mad entrance <br />from approximately 2D 10 48' using Class II Aggregate Base. Re-mstallation of removed guardrail At happen at theoomphill of <br />theproieol. Temporary construction alone will be placed an eambound KeIlleman Lana prior to the levee road entrance as well as <br />the West bound lane prior tothe levee mad entrance. Construction signs will be posted through thedureiaa of the project am <br />will be removed 0 the conclusion of $a oroled <br />Work wlllcommerce onorafter 02320 forappraxlmately 42 days. <br />I, the undersgned,certitythat lam the ownerof the respective properly, oram quakied la represerdlheowner and agree todoite <br />work described above in accordance with the rules and regulations of San Joaquin Coi and subject toinspedionand approval, <br />l� wi' � ) 61111"[020 <br />Signatarool Icart •11K Date <br />r�msh�m .r* miawaul <br />