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PLEASE PRINT: <br />Date 6/3/20 <br />To: San Joaquin County <br />Department of Public Works <br />CALIFORNIA WATER SERVICE COMPANY <br />(Applicant Name) <br />1602 E. LAFAYETTE ST. <br />Address) <br />STOCKTON, CA 95205 <br />APPLICATION FOR ENCROACHMENT PERMIT <br />(City, State, Zip Code) <br />(209)464-8311 <br />(Area Code - Telephone Number) <br />MRIZO@CALWATER.COM <br />(Email Address) <br />may be submitted) <br />See attached: <br />700-800 blks of Drake Avenue <br />3800 blk of Main Street <br />700-900 blks of Hinkley Avenue <br />JOB # <br />APN <br />EXP.DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />REF # <br />CR # <br />10/10/2022 TO 4/1/2023 DRIVEWAYS: <br />Main St., Hinkley Ave., Drake Ave., Anter6s Ave. <br />Stockton QUAD ES <br />Trench, Bell Hole, Bore <br />SSMNV 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 various side of sides of streets listed above approximately 3,000 (') feet/ Q mile <br />of , by performing the following work (description of work): <br />Watennain <br />51 services & 4 hydrants <br />San Joaquin County Will Be Notified 48 Hours Prior to Any Road Closure with Location, Date & Duration. All Closure Will Be Reopened During Non Working Hours. <br />Work will commence on or after 10/10/2022 for approximately 6 months 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 />Signatureol n -Title ate <br />