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Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2023_PS-2301001 thru PS-2301500_ - PS-2301135
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Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2023_PS-2301001 thru PS-2301500_ - PS-2301135
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Entry Properties
Last modified
4/27/2023 9:27:48 AM
Creation date
4/27/2023 9:26:35 AM
Metadata
Fields
Template:
Permits_Development
DocName
PS-2301135
Category07
Encroachment(EP)/Driveway(DW) Permits
Year2
2023
Notes2
2132 Polk Way
Address
PO Box 3031, Modesto,CA 95353
Application
Pacific Gas & Electric-Modesto
Type
Traffic Control Devices
Supplemental fields
Cross Ref
PWP730052
Type (2)
Encroachment Permit (EP)
Text box
ID:
1
Creator:
Created:
4/27/2023 9:26 AM
Modified:
4/27/2023 9:26 AM
Text:
730052
ID:
2
Creator:
Created:
4/27/2023 9:26 AM
Modified:
4/27/2023 9:26 AM
Text:
4/15/2023
ID:
3
Creator:
Created:
4/27/2023 9:26 AM
Modified:
4/27/2023 9:26 AM
Text:
10/15/2023
ID:
4
Creator:
Created:
4/27/2023 9:26 AM
Modified:
4/27/2023 9:26 AM
Text:
Polk Way
ID:
5
Creator:
Created:
4/27/2023 9:26 AM
Modified:
4/27/2023 9:26 AM
Text:
Stockton
ID:
6
Creator:
Created:
4/27/2023 9:26 AM
Modified:
4/27/2023 9:26 AM
Text:
LV
ID:
7
Creator:
Created:
4/27/2023 9:26 AM
Modified:
4/27/2023 9:26 AM
Text:
TCP for Pole Replacement (backyard)
ID:
8
Creator:
Created:
4/27/2023 9:26 AM
Modified:
4/27/2023 9:26 AM
Text:
SS/WW
ID:
9
Creator:
Created:
4/27/2023 9:26 AM
Modified:
4/27/2023 9:26 AM
Text:
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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 />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right-of-Way 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 />Y:\FORMS & TEMPLATES\ENCROACHMENT PERMIT APPLICATION.doc (08/08) <br /> <br />3* ( <br />:HVW/DQH <br />6WRFNWRQ&$ <br /> <br />VS]#SJHFRP <br />Sketch (Detailed plans may be submitted) <br />&UHZWRFDOO6-&RXQW\,QVSHFWRUDW WRKRXUVEEHIRUHZRUNVWDUWV <br />:KHQFDOOLQJFUHZVKDOOUHTXHVWUDLQFOHDUDQFHIRUDQ\ZRUNGXULQJZLQWHUPRQWKV <br />1RYHPEHUUWKURXJKK0DUFK <br />Signature of Applicant -Title <br />:HVW/DQH1524NCarpenter:HVW /DQH:HVW /DQH <br />Rd <br />6WRFNWRQ&$Modesto, 6WRFNWRQ6WRFNWRQ CA&$&$95351 <br /> <br />209 857 0181 <br />p <br />VS]#SJHFRP <br />p <br />VS #SJH FR <br />WAT8@PGE.COMVS]#SJHFRPVS]#SJHFRP <br />PM 35391188 <br />3/28/23 <br />3/28/23 <br />6 h//23__________________0/ /23____________________ <br />O 2132 O <br />Stockton <br />Backyardy pole p replacement,p,set in same hole. crane set on W Polk Way.y
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