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APPLICATION FOR ENCROACHMENT PERMIT # 8678 <br />PLEASE PRINT: <br />Date 02/27/2023 <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, Zip Code) <br />(209)464-8311 <br />(Area Code - Telephone Number) <br />ejose@calwater.com <br />(Email Address) <br />(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 />3/3/2023 TO DRIVEWAYS: <br />Basin St. ` <br />btockton QUAD ` <br />- e o es <br />SSIWW, R-29, Trench Cut Policy <br />Special Conditions <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on <br />the South side of Basin St approximately 285 feet/mile West <br />of Everglade Way , by performing the following work (description of work): <br />service replacement <br />commence on or after, 02/27/23 for approximately 60 <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 />Evelyn Jose - Field Service Representative <br />Signature of Applicant - Title <br />02/27/2023 <br />