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pS- 2,0008`i <br />COUNTY OF SAN JOAQUIN <br />DEPARTMENT OF PULIC WORKS <br />DRIVEWAYS AND PAVED FRONTAGES <br />PERMIT APPLICATION <br />APPLICANT <br />Name: <br />�t.GN ISVEi <br />JOB #: <br />Address:E. <br />j <br />00r 00!03 FEE DUE: <br />city, State, Zi Code: Pr cH rx O I CwA 5 0 <br />Area Code - Tele hone Number: 366 O <br />SITE INFORMATION: <br />Parcel <br />Owner's Name:CSV c J 4 oizl To <br />Site Address: <br />T pn-1 1�4 <br />14 <br />51 a+'S <br />QUAD A(& <br />City, State, Zip Code: G/!•M O D <br />Area Code -Telephone Number: b <br />CONTRACTOR <br />yc) pOR"AC.P <br />A <br />ort <br />rmA-� <br />Drtte <br />6.3D 'TOlN2I <br />FAreaCode <br />City,i Code: ON <br />Tele hone Number 3 7— 02 <br />Date: I Z -ZL4 -Zn21�' <br />Received By: LN/ CP>`I mals) <br />CR#: �7d2J3 <br />The undersigned hereby applies for permission to excavate, construct andlor otherwise encroach on County Hi hway Right -of -Way on the <br />tk side of SPrHRruT a approximately /0 d ile wes <br />of �-o t%oSTtAr� L � by installing FTcA N A C <br />Wark will <br />commence on or about r approximately 7 days. <br />sheet maybe <br />y0✓D0� IU <br />Will this project be self -installed? YES NO Contractor's License <br />P?fNCR0A0NMENISIMa,kr FamsTenplalea�ENCROACHMENTPERMITDRIVEWAYIoc(dPPoO) <br />OFFICE USE ONLY <br />JOB #: <br />11005 ISSUE DATE: <br />APN <br />00r 00!03 FEE DUE: <br />EXP. DATE: ' <br />DRIVEWAYS: <br />STREET: <br />T pn-1 1�4 <br />_ A <br />AREA: <br />QUAD A(& <br />TYPE: <br />yc) pOR"AC.P <br />FORMS: <br />ww l <br />NOTES: <br />DRIVEWAY <br />TYPE: <br />QUANTITY <br />WIDTHS <br />AGRICULTURE: <br />_ <br />RFRONTAGE <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 permission to excavate, construct andlor otherwise encroach on County Hi hway Right -of -Way on the <br />tk side of SPrHRruT a approximately /0 d ile wes <br />of �-o t%oSTtAr� L � by installing FTcA N A C <br />Wark will <br />commence on or about r approximately 7 days. <br />sheet maybe <br />y0✓D0� IU <br />Will this project be self -installed? YES NO Contractor's License <br />P?fNCR0A0NMENISIMa,kr FamsTenplalea�ENCROACHMENTPERMITDRIVEWAYIoc(dPPoO) <br />