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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 4/26/23 <br />To: San Joaquin County <br />Department of Public Works <br />PACIFIC BELL TELEPHONE COMPANY DBA AT&T CALIFORN IANCC PERMIT DESK <br />(Applicant Name) <br />1445 VAN NESS AVE <br />(Mailing Address) <br />Fresno, CA 93721 <br />(City, State, Zip Code) <br />(559) 552-4608 <br />(Area Code - Telephone Number) <br />g26977@att.com <br />(Email Address) <br />may <br />OFFICE USE ONLY <br />JOB # REF # <br />APN CR # <br />EXP.DATE <br />VALID TO DRIVEWAYS: <br />STREET <br />AREA QUAD <br />TYPE <br />FORMS <br />NOTES <br />SEE ATTACHED LAYOUT & TCP DRAWINGS FOR AT&T JOB# A02F7BN. <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 SORO AVE approximately 120 @ feet/ Qmile NORTH <br />of E MAIN ST _ , by performing the following work (description of work): <br />DIG 4X4PIT &RAISE EXIST MH #259 TO THE PROPOSED SIDEWALK GRADE. DIG 3'X4' PIT & RAISE EXIST. SAI TO THE PROPOSED SIDEWALK GRADE. <br />DIG 6X7' PIT & RAISE EXIST SAI & CONCRETE PAD TO THE PROPOSED SIDEWALK GRADE. DIG ]XB' PIT & RAISE EXIST ARAD &CONCRETE PAD TO THE PROPOSED SIDEWALK GRADE. <br />DIG4x6 PIT & RAISE EXIST 3'X5' SB #2556 To THE PROPOSED SIDEWALK GRADE. <br />Work will commence on or after 6/1/23 for approximately 5 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 />5/19/23 <br />Signature of Aplicant-Title Engineering <br />Administrator <br />Date <br />