Laserfiche WebLink
COUNTY OF SAN JOAQUIN <br />DEPARTMENT OF PULIC WORKS <br />DRIVEWAYS AND PAVED FRONTAGES <br />y PERMIT APPLICATION <br />Dale: f'lo- <br />Received By: /14/ <br />cR#1 atw49 <br />APPLICANT <br />Name: <br />JOB #: <br />Address: <br />City, State, Zip Code: <br />�� 'f5 <br />5 <br />Area Code -Telephone <br />Number: G <br />SITE INFORMATION: <br />Parcel Owner's Name: <br />4!r"i fid• <br />6 IfLGI <br />AREA: <br />Site Address: <br />U <br />City, State, Zip Code: <br />2W 040Pi2dAGM <br />Area Code -Telephone <br />Number: 20317 r7 I"I <br />3S ✓t/ 17 <br />NOTES: <br />CONTRACTOR <br />Name: a <br />- <br />Address: <br />n16 <br />City, State, 1p Code: <br />L-KTJN Syy <br />Area Code -Telephone <br />Number: <br />Dale: f'lo- <br />Received By: /14/ <br />cR#1 atw49 <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on the <br />side of approximately feeunme <br />l of by installing <br />J' <br />Work will <br />commence on or about for approximately days. <br />Will this project be self -installed? YES NO <br />P:OHGtOALHMENi5lMasm, Fnms-iempUiesUNLROALHMEIRPERIARORNEWAY.Jx PNB7 <br />Contractor's License <br />OFFICE USE ONLY <br />JOB #: <br />11005 ISSUE DATE: <br />APN <br />tJs'/-020-2L FEE DUE: <br />EXP. DATE: <br />DRIVEWAYS: <br />STREET: <br />4!r"i fid• <br />AREA: <br />Goui QUAD <br />TYPE: <br />2W 040Pi2dAGM <br />FORMS: <br />3S ✓t/ 17 <br />NOTES: <br />DRIVEWAY <br />TYPE: <br />QUANTITY <br />WIDTHS <br />AGRICULTURE: <br />@FRONTAGE <br />COMMERCIAL: <br />NDUSTRIAL: <br />RAW <br />RESIDENCE: <br />PAVED FRONTAGE <br />LENGTH: <br />Ft. X WIDTH: <br />Ft. <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on the <br />side of approximately feeunme <br />l of by installing <br />J' <br />Work will <br />commence on or about for approximately days. <br />Will this project be self -installed? YES NO <br />P:OHGtOALHMENi5lMasm, Fnms-iempUiesUNLROALHMEIRPERIARORNEWAY.Jx PNB7 <br />Contractor's License <br />