Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 3/13/23 <br />To: San Joaquin County <br />Department of Public Works <br />City of Stockton - Municipal Utllltles -All Gharegozloo <br />(Applicant Name) <br />2800 Navy Drivo <br />— _— (Mailing Address) <br />- <br />Stockton, CA 98208 <br />(City, State, Zip Code) <br />(209) 937-8428 <br />(Area Code - Telephone Number) <br />all.garegozloo@stocktonca.gov, asael.gutlerrez@stocktonca.gov <br />(Email Address) <br />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 />//door REF# <br />CR # <br />3 rs z; TO s z3 DRIVEWAYS: <br />QUAD s6 ` <br />ISH V46&.A'r ' <br />e <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the West side of Kingsley Read approximately 1.0 OfeeUQmile south <br />Of Arch Road Stockton CA , by performing the following work (description of work): <br />Existing manhole has deteriorated and has a sinkhole around it, so it will need to be abandoned and the soil around It will need to be backfilled/compacted. <br />Work Includes abandoning of existing sanitary sewer manhole at the shoulder west of Kingsley Road, and installation of a new sanitary sewer manhole In <br />the southbound cane of Kingsley Road. <br />Work will commence on or after 3116/23 for approximately 3d 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 �des/scribed above in accordance with the rules and regulations of San Joaquin County and subject to Inspection and approval. <br />&134 4b <br />S a (616f Appllca t- Title d Difte <br />