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APPLICATION FOR ENCROACHMENT PERMIT X' <br />PLEASE PRINT: B528 <br />Date 7/2/2020 <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, Tip 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 REF # <br />CR # <br />9/15/2020 - <br />7!7/2020 TO 9/15/2020 DRIVEWAYS: <br />Bradford St. <br />Stockton QUAD NS <br />Bell Hole <br />SSMNV, R-29, Trench Cut Policy <br />Special Conditions <br />M <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 Bradford St approximately 143 feet%mile West <br />of Sanguinetti Ln , by performing the following work (description of work): <br />2140 Bradford St <br />1" Service Replacement "Emergency Repair' STK0600 <br />1 Cut - 6'x8' <br />Work will commence on or after <br />for approximately <br />days. <br />I, 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 />Y:WORMs& mNPIAIESENCRWCHNEM PMT MRICAiWdV (WN) <br />7/2/2020 <br />Date <br />