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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 11/30/2022 <br />To: San Joaquin County <br />Department of Public Works <br />California Water Service Company <br />(Applicant Name) <br />1602 E Lafayette St <br />(Mailing Address) <br />Stockton, Ca 95205 <br />(City, State, Zip Code) <br />(209)464-8311 <br />(Area Code - Telephone Number) <br />mrizo@calwater.com <br />(Email Address) <br />Sketch (Detailed plans may <br />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 />730077 REF # <br />CR # <br />12/5/2022 TO DRIVEWAYS: <br />Michigan Ave. & Monterey Ave. <br />Stockton QUAD CC <br />Trenching <br />SSAMy, R_29, Trench Cut Policy <br />Special Conditions <br />1400-1800 Blocks of Michigan Ave & Monterey Ave <br />From Pershing Ave to Mission Rd <br />Additional emergency contacts: <br />Sean Soulsby 209-639-6721 <br />Rosemarie Guzman 209-479-9464 <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 2,677 feet/mile <br />of Ductile Iron pipe I , by performing the following work (description of work): <br />Watermain Replacement Project 131 services and 7 hydrants <br />Work will commence on or after December 5, 2022 for approximately 4 mon s 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 />Melissa Rizo MRP Field Operations Clerk 11/30/2022 <br />Signature of Applicant - Title Date <br />Y:YO S& TEMPUTESENCRWAC NT PEPMMA LWMA. WS) <br />