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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 3/22/2023 <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 />deberhardt@ratwater.com <br />(Email Address) <br />Sketch (Detailed plans may <br />See attached <br /># 9657 <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 />3/27/2023 TO 6/1/2023 DRIVEWAYS: <br />Pock Ln. ` <br />Stockton QUAD SS ' <br />(2) -Bell Holes ' <br />SSANVV, 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 East side of Pock Ln approximately 275 feet/mile South <br />of Mariposa Rd , by performing the following work (description of work): <br />1735 Mariposa Rd (On Pock Ln) <br />Install New 2" Service STK0600 <br />2 Cuts - 3'x3' <br />Work will commence on or after 3/22/2023 for approximately 60 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 />David Eberhardt Jr - Operations Clerk <br />of Applicant - Title <br />YVOMdS6TFHP.ATESA'CHNIANElfI PFfdIIi IPR1UTKK1bz�03) <br />3/22/2023 <br />Date <br />