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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date OFFICE USE ONLY <br />To:San Joaquin County JOB #REF # <br />Department of Public Works APN CR # <br />EXP. DATE <br />VALID TO DRIVEWAYS: <br />(Applicant Name)STREET * <br />AREA QUAD * <br />TYPE * <br />(Mailing Address)FORMS <br />NOTES <br />(City, State, Zip Code) <br />(Area Code - Telephone Number) <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right-of-Way on <br />the ______________ side of ___________________________________ approximately ___________________ feet/mile _________ <br />of _______________________________________, ____________________, by performing the following work (description of work): <br />Work will commence on or after _____________________________________ for approximately ________________________ 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 />Signature of Applicant - Title Date <br />Y:\FORMS & TEMPLATES\ENCROACHMENT PERMIT APPLICATION.doc (08/08) <br />Garrett L. Arnaudo <br />110005 PS-2002045 <br />08/10/2020 <br />07/20/2020 08/10/2020 <br />Brandt Road <br />Lockeford NW <br />Road Closure, Pavement Repair <br />SS/WW, R-29, Trenchcut Policy <br />Special Conditions <br />July 4, 2020 <br />(209) 207-4501 <br />garrett@arnaudoinc.com <br />(See attached Traffic Control Plan) <br />shoulder Brandt Road n/a <br />Tretheway Rd <br />closing the westbound lane of Brandt Rd in between Locke Rd and Tretheway Rd in order to demo existing North San Joaquin Water Junction Box and install new <br />Junction Box. <br />PO Box 174 <br />Tracy, CA 95378 <br />Arnaudo Construction, Inc. <br />7/9/20