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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date OFFICE USE ONLY <br />To: San Joaquin County <br />JOB #REF # <br />Department of Public Works APN CR # <br />EXP. DATE <br />VALID TO DRIVEWAYS: <br />(Applicant Name)STREET * <br />AREA QUAD * <br />TYPE * <br />(Mailing Address)FORMS <br />NOTES <br />(City, State, Zip Code) <br />(Area Code - Telephone Number) <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on &ounty Kighway ULght-of-Zay on <br />the ______________ side of ___________________________________ approximately ____________ feet/mile _________ <br />of _______________________________________, ____________________, by performing the following work (description of work): <br />Work will commence on or after _____________________________________ for approximately ________________________ 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 />Signature of Applicant - Title Date <br />Superintendent <br />3/29/23 <br />California Water Service Company <br />1602 E. Lafayette St <br />Stockton, CA 95205 <br />(209) 479-9464 <br />rguzman@calwater.com <br />1119, 1139, 1133, 1223 E. Harding Way - No construction work will be performed in San Joaquin <br />County jurisdiction. <br />ONLY TRAFFIC CONTROL WILL BE IN PLACE. <br />Closures/detours shown in TCP are to take place intermittently and not for the full extent of project. <br />County will be notified 48 hours before any closures take place, as noted in TCP. <br />various address listed above 225'8" <br />Ductile Iron Pipe <br />water main replacement project - 4 services <br />4/3/20 6 MONTHS <br />3/29/23