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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 3/10/2023 <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@calwater.com <br />(Email Address) <br />may <br />See attached <br /># 8681 <br />JOB# <br />APN <br />EXP. DATE <br />VALID <br />STREETo <br />OFFICE USE ONLY <br />730077 REF# <br />CR # <br />TO 5/15/2023 DRIVEWAYS: <br />egeve. « <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />Stockton QUAD NW <br />(2)--Eell Hales « <br />zsS/vvvv,m-29, IrenchCutpolicy <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 North side of College Ave approximately 60 feet/mile West <br />of West Ln by performing the following work (description of work): <br />1227 College Ave R 1801 West Ln (On College Ave) <br />Service Repair 763000 <br />2 Cuts - 3'x5' + 3'x3' - <br />Work will commence on or after 2/28/2023 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 />Signature of Applicant - Title <br />YAFOM$« TENPlA1ESENCROACHMEM PEWff AP =MN dw(DNS) <br />2/28/2023 <br />