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PLEASE PRINT: <br />Date 8/12/22 <br />To: San Joaquin County <br />Department of Public Works <br />Duran and Venables <br />(Applicant Name) <br />748 S. Hillview Dr <br />(Mailing Address) <br />Milpitas CA 95035 <br />(408) 9347300 <br />APPLICATION FOR ENCROACHMENT PERMIT <br />(City, State, Zip Code) <br />(Area Code - Telephone Number) <br />(Email Address) <br />may <br />Please see attached. <br />JOB # <br />APN <br />EXP. DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />760036 REF # <br />CR # <br />2128/23 <br />8/24/22 TO 2/28/23 <br />Manthey Road <br />Stockton QUAD SE <br />Road Widening, Driveways, Turn Lanes <br />SSMM/, R-29, Trench Cut Policy <br />Special Conditions <br />PS -2102021 <br />DRIVEWAYS: <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 MantheyRd approximately 2000 @ feet/ 0mile <br />of _ , by performing the following work (description of work): <br />Work will includes demo and excavation of existing road, widening and adding in a turn pocket. <br />Work will commence on or after 8115122 for approximately 128 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 />8/12/22 <br />Signature of Applicant - Title <br />Date <br />