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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 6/5/2020 <br />To: San Joaquin County <br />Department of Public Works <br />PG&E PM 35144549 <br />6121 Bollinger Canyon Rd <br />San Ramon, CA 94583 <br />(City, State, Zip Code) <br />(925)270.6009 <br />(Area Code - Telephone Number) <br />d6d3@pge.com <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />OFFICE USE ONLY <br />JOB # REF # <br />APN CR # <br />EXP.DATE <br />VALID TO DRIVEWAYS: <br />STREET <br />AREA QUAD <br />TYPE <br />FORMS <br />NOTES <br />Crew to call SJ County Inspector at (209) 953-7421 48 to 72 hours before work starts. <br />When calling, crew shall request "rain clearance" for any work during winter months <br />November through March <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way <br />on E CLARKSDALE RD at N HWY 99 FRONTAGE RD <br />The new poles will be installed in line with the existing poles since we will be transferring the existing conductor to them as well as <br />installing the new. Holes approx. e ge of payment. PG&E will be installing all. e UG electric service is on private property. <br />Work will commence on or after 7/6/2020 for approximately 120 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 <br />V]FORMS&TENPIATEIENCROACHMEN T PERMIT APPLICATION dov(W&OP <br />6/5/2020 <br />Date <br />