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Q5-Zm 3431 <br />COUNTY OF SAN JOAQUIN <br />DEPARTMENT OF PULIC WORKS <br />DRIVEWAYS AND PAVED FRONTAGES <br />PERMIT APPLICATION <br />APPLICANT <br />Name: Ramon Montanez Fernandez <br />Address: 10979 N. Micke Grove Rd <br />City, State, Zip Code: Lodi, CA 95240 <br />Area Code -Telephone Number: 209-366-4156 <br />SITE INFORMATION: <br />Parcel Owner's Name: Ramon Montanez Fernandez <br />Site Address: 10979 N. Micke Grove Rd <br />City, State, Zip Code: Lodi, CA 95240 <br />Area Code -Telephone Number: 209-366-4156 <br />CONTRACTOR <br />Name: <br />Address: <br />City, State, Zip Code: <br />Area Code -Telephone Number: <br />Date: <br />Recei�vred By: L rV <br />The undersigned hereby applies for ermission to excavate, construct andlor otherwise engro� c n County H' ay Rig�f-Way on the <br />side of �r approximately ��oo e ile Lys/ <br />of +hEti ✓u+oLC- ZD./ by installing, ?cl'.✓ f wGmu <br />commence on or about <br />may <br />for approximately <br />Will this project beself-installed? � YES NO Contractor's License <br />P,I[NCItOACHMENibVkslx Fans-imiplales�fNCROACNMENi PERMIT ONNEWAY.tloc�ofl00) <br />days. <br />Work will <br />OFFICE USE ONLY <br />JOB #: <br />11005 ISSUE DATE: <br />APN X597 FEE DUE: <br />EXP. DATE: <br />DRIVEWAYS: <br />STREET: <br />kr. &/e✓c. <br />AREA: <br />+' QUAD <br />TYPE: <br />♦ 0 <br />FORMS: <br />NOTES: <br />DRIVEWAY <br />TYPE: <br />QUANTITY <br />WIDTHS <br />AGRICULTURE: <br />_ <br />@FRONTAGE <br />COMMERCIAL: <br />INDUSTRIAL: <br />@ RIW <br />RESIDENCE: <br />PAVED FRONTAGE <br />LENGTH: <br />Ft, X WIDTH: <br />Ft. <br />The undersigned hereby applies for ermission to excavate, construct andlor otherwise engro� c n County H' ay Rig�f-Way on the <br />side of �r approximately ��oo e ile Lys/ <br />of +hEti ✓u+oLC- ZD./ by installing, ?cl'.✓ f wGmu <br />commence on or about <br />may <br />for approximately <br />Will this project beself-installed? � YES NO Contractor's License <br />P,I[NCItOACHMENibVkslx Fans-imiplales�fNCROACNMENi PERMIT ONNEWAY.tloc�ofl00) <br />days. <br />Work will <br />