Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 12/23/2019 <br />To: San Joaquin County <br />Department of Public Works <br />VCC PERMITS DESK, AT&T <br />(Applicant Name) <br />5555 E OLIVE AVE <br />(Mailing Address) <br />FRESNO, CA 93727 <br />(City, State, Zip Code) <br />559) 454-4900 <br />(Area Code -Telephone Number) <br />Sketch (Detailed plans may be submitted) <br />TRAFFIC CONTROL PLAN FLAGGING OPERATION ON MARIPOSA RD BETWEEN <br />CARPENTER RD AND E MUNFORD AVE, REQUIRED FOR THE PLACEMENT OF 875' <br />OF NEW AERIAL CABLE ALONG THE SOUTH SIDE OF THE ROADWAY FROM POLE <br />P.1 TO P.5. FOR SEE ATTACHED DRAWINGS FOR AT&T JOB A0I0PAT. <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on <br />the SOUTH side of MARIPOSA RD approximately 600' feet/mile FAST <br />of CARPENTER RD by performing the following work (description of work): <br />TRAFFIC CONTROL PLAN AS DESCRIBED ABOVE. <br />Work will commence on or about <br />for approximately <br />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 Appl <br />=Title <br />Engineering <br />Administrator <br />M;ICENTRALSERVICESICLERICALNUBSV.WK'MASTER.PSIENCROACRMENT PERMIT APPLICATIONAOC (09113) <br />12/23/2019 <br />Date <br />OFFICE USE ONLY <br />JOB # <br />*7$00?4� 4 REF # <br />APN <br />CR # <br />P. DATE <br />VALID <br />? /S?a <br />1 27 2G o DRIVEWAYS: <br />STREET <br />APM RIS• <br />AREA <br />STaGkmtV QUAD 1W <br />TYPEQE¢✓AG <br />&4ek ` <br />FORMS <br />9ivr✓ <br />NOTES <br />A57 u094 e0AjVr7V40A5' <br />TRAFFIC CONTROL PLAN FLAGGING OPERATION ON MARIPOSA RD BETWEEN <br />CARPENTER RD AND E MUNFORD AVE, REQUIRED FOR THE PLACEMENT OF 875' <br />OF NEW AERIAL CABLE ALONG THE SOUTH SIDE OF THE ROADWAY FROM POLE <br />P.1 TO P.5. FOR SEE ATTACHED DRAWINGS FOR AT&T JOB A0I0PAT. <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on <br />the SOUTH side of MARIPOSA RD approximately 600' feet/mile FAST <br />of CARPENTER RD by performing the following work (description of work): <br />TRAFFIC CONTROL PLAN AS DESCRIBED ABOVE. <br />Work will commence on or about <br />for approximately <br />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 Appl <br />=Title <br />Engineering <br />Administrator <br />M;ICENTRALSERVICESICLERICALNUBSV.WK'MASTER.PSIENCROACRMENT PERMIT APPLICATIONAOC (09113) <br />12/23/2019 <br />Date <br />