Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2023_PS-2302501 thru PS-2303000_ - PS-2302664

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APPLICATION FOR ENCROACHMENT PERMIT PLEASE PRINT: Date 08/25/2023 To: San Joaquin County Department of Public Works AT&T CALIFORNIA/ VALLEY PERMITS DESK (Applicant Name) 1445 VAN NESS AVE (Mailing Address) FRESNO, CA 93721 (City, State, Zip Code) (559) 285-4894 G26977@ATT.COM (Area Code - Telephone Number) Sketch (Detailed plans may be submitted) A COPY OF THE TRAFFIC CONTROL PLAN IS SUBMITTED WITH THIS PERMIT; SEE ATTACHMENTS A02 NJ K4 The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on the NORTH side of YETTNER RD approximately 108 ee mile WEST of S LEO GIRON DR , by performing the following work (-description of work): ACCESS EXISTING MANHOLE#2517 TO SPLICE EXISTING CABLE. THE ASSOCIATED TCP IS SUBMITTED WITH THIS PERMIT FOR AT&T JOB# A02NJK4 . Work will commence on or about _09/18/2023 for approximately 1 days. 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 work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. E. �r Engineering s Administrator 08/28/2023 Signature of Applicant - Title Date MICENTP LSHNICE61CLHllCALIPUBSVWKIW STERP6IENCROACHNENT PERMIT APPLICATION 00C (0113) OFFICE USE ONLY JOB # 730079 REF # APN CR # EXP.DATE VALID TO DRIVEWAYS: STREET ee n: ett�T AREA 13tocKton QUAD WS TYPE ra i1 Devices FORMS NOTES Special Conditions A COPY OF THE TRAFFIC CONTROL PLAN IS SUBMITTED WITH THIS PERMIT; SEE ATTACHMENTS A02 NJ K4 The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on the NORTH side of YETTNER RD approximately 108 ee mile WEST of S LEO GIRON DR , by performing the following work (-description of work): ACCESS EXISTING MANHOLE#2517 TO SPLICE EXISTING CABLE. THE ASSOCIATED TCP IS SUBMITTED WITH THIS PERMIT FOR AT&T JOB# A02NJK4 . Work will commence on or about _09/18/2023 for approximately 1 days. 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 work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. E. �r Engineering s Administrator 08/28/2023 Signature of Applicant - Title Date MICENTP LSHNICE61CLHllCALIPUBSVWKIW STERP6IENCROACHNENT PERMIT APPLICATION 00C (0113)