Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 08/30/2023 <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)547-7934 <br />(Area Code - Telephone Number) <br />ahenson@calwater.com <br />(Email Address) <br />Sketch (Detailed plans may <br />See attached <br />#8706 <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 />TO1 112012023DRIVEWAYS: <br />' <br />StocktonQUAD ' <br />-B-erRore— ' <br />-SSMVVTrench Cuto icy <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 South side of Sutro Ave approximately 150 feet/mile North <br />Of John St , by performing the following work (description of work): <br />1630 Sutro Ave <br />1 Cut - 2'X3' <br />STK0600 <br />Work will commence on or after 08/30/2023 for approximately 60 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 />Antoinette Henson - Field Service Representative <br />Signature of Applicant - Title <br />Y MWS& MPlAM9 CRO WMT PEWff AM=NA (a ) <br />08/30/2023 <br />Date <br />