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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRW: <br />Deb RIZ-6 /2 <br />Tm San Joaquin Couey <br />aw" Of Pd* Waft <br />(Apprcst►m) <br />3110 l�i)Gti< Y <br />(Mdlln doral <br />(Cl0'. State, ZIP Cods) <br />2 dei Z -4Z S -S <br />(Ans Cods Trsphons NwW <br />srn, rPcrP �A-,c. <br />1� Aaar.a) <br />JOB 8 <br />APN <br />EXP. DATE <br />VALK) <br />STREET <br />AREA <br />TYPEo�TeReplacement <br />FORMS <br />NOTES <br />OFFICE USE WY - <br />NLY•OB8 730052 REF <br />CRi <br />To DRIVEWAYS: <br />- fv o =ey ' <br />Stockton QUAD SE' <br />' <br />SWAN <br />pecial Conditions <br />Sketln (Oetalkl plass may be submitted) n <br />-tc Tfieu"c \k1 <br />4 ff � me lei I� <br />T <br />ft <br />of - <br />Work will Commence on or aW - ' z for appronmately days <br />1 to undersgned, cenify that I am mspectiro prop", or am quM'AW to represent Use owner and agree b do Ue <br />wwk dascnlaed above in with aro regulations of San Joaquin County and subool to irspaeton and approval - <br />1 Za/1 3 <br />puturs of A • Two . Dip <br />:. <br />