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APP LICATI ON FOR ENCROAC HME NT PE f~MIT <br />PLE ASE PR IN T: <br />Date 1/1 4/2020 OFFICE USE ONL Υ <br />Το: San Joaquin Co unty <br />Department of Public Works <br />-~W~A~Y E;-6.ROA DBANl:).J.1.Q___ <br />(Ap pli cant Name) <br />215 MASON CIRCL E <br />(Mailin g Address ) <br />GONCORD, CA 94520 <br />(City, State , Zip Code ) <br />925-49 9-54 33 <br />(Ar ea Code • Te lephone Number) <br />RWINSTON@WAVEBROADBAND.COM <br />(Email Addres s) <br />Sketch (Detailed pla11s may be submitted) <br />JOB# <br />ΑΡΝ <br />ΕΧΡ. DATE <br />VAL ID <br />STREET <br />AREA <br />ΤΥΡΕ <br />FORMS <br />NOTES <br />P LEASIΞ SEE ATTACHED CONSTRUCTION PERM!T DRAWINGS. <br />4 6062-G reat Wolf Resorts-2500 Dan ie ls St-Manteca <br />REF# <br />CR# <br />το <br />QUAD <br />DRIVEWAYS: <br />• <br />• <br />• <br />The undersigned hereby app lies for permission to exca vate, constr uct and/or otherwise encroach on Couπty Highway R i ght -of-ΙNay on <br />the _____ side of W YOSEMITE AVE approximately 5 900 feet/mile __ _ <br />of _w_yos EMIIE AV E , MCKINL EY AV E , by performing the following worl< (description of work): <br />VVAVE ΤΟ ΡιΑCΕ 5,900 FEEI..Q!= AERIAL FIB ER ΟΝ EXISTl.NG POLES ALONG W YOSEMITE AVE <br />& Μ CΚ ΙΝ! Ε Υ HA VE. \NA'iE..AL.'ill_ill..E.l ACE (4) 36"χ48" STORAGE..\ίAL!LI ... .I.!::ff..NELAC.ELAJ.IACH <br />...ΙΩ ANCHOBS ΑΤ VABIO\ IS I Ο<:ΑΙΙΟΝ ..... ...__ __________________ _ <br />Work will cornιnence 011 or after ---~A=S~A~P _______ for· approximately _------"-30-=---_____ days. <br />1, the uπcl ersigned, certi fy that I aπ1 the owner of tt1e respective property, 01· am φalifιed to reρresent the owner and agree to do the <br />work d scribed above ίπ accordance with the rules and regulations of ~,an Joaquin County and subje ct to inspection and approva l. <br />/ <br />.---/-~-;=:::i.. __ ... -:~~~Ί~~-------- <br />$ίg 11 a tu re of App licant • Title <br />V:\F~i J, TΘ,ΙP1..ATfSΘJCROλCHf/.εf{f PERMΠ ι..PPUCλllO!l.dvc (Οtι ϋ8) <br />1/14/2020 <br />Date