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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 />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 about _____________________________________ 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 />E:\PUB-SV.WK\MASTER.PS\ENCROACHMENT PERMIT APPLICATION.DOC (01/08) <br />02/24/2023 <br />AT&T/VCC Permit Desk <br />1445 Van Ness Ave <br /> Fresno, CA 93721 <br />(559) 552-4608 G26977@ATT.COM <br />Please see attached TCP for location of work. AT&T project number A01WT1M. <br />Traffic Control only in San Joaquin County. <br />North W. Schulte Rd 3095'EastBud Lyons Way <br />03/20/2023 2 Days <br />Engineering <br />Administrator 02/24/2023 <br />One way traffic control on W. Schulte Rd in San Joaquin Co