Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2023_PS-2302501 thru PS-2303000_ - PS-2302934

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APPLICATION FOR ENCROACHMENT PERMIT PLEASE PRINT: Date 09/26/2023 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 The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on the EAST; WEST side of N -SHAW RD approximately 1 335 & 1 295 ee mile N/W of E FREMONT ST , by performing the following work (3rscription of work): ACCESS SPLICEBOXES#1163 & #1164 TO SPLICE EXISTING CABLE. THE ASSOCIATED TCP IS SUBMITTED WITH PERMIT FOR AT&T JOB# A02P45R. ESTIMATED START: 10/10/23 ESTIMATED COMPLETE: 01/10/24 DURATION: 1 DAYS Work will commence on or about 10/10/2023 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. Engineering 3rtia411£ Sclw k Administrator Signature of Applicant - Title MICENTP LSHNICE61CLHllCALIPUBSVWKIW STERP6IENCROACHNENT PERMIT APPLICATION 00C (0113) 09/26/2023 Date OFFICE USE ONLY JOB # 730079 REF # APN CR # EXP.DATE VALID 10/10/2023 TO 01/10/2024 DRIVEWAYS: STREET Shaw Rd. AREA Stockton QUAD NS TYPE Traffic Control Devices FORMS SSAA/VV NOTES Special Conditions A COPY OF THE TRAFFIC CONTROL PLAN IS SUBMITTED WITH THIS PERMIT; SEE ATTACHMENTS The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on the EAST; WEST side of N -SHAW RD approximately 1 335 & 1 295 ee mile N/W of E FREMONT ST , by performing the following work (3rscription of work): ACCESS SPLICEBOXES#1163 & #1164 TO SPLICE EXISTING CABLE. THE ASSOCIATED TCP IS SUBMITTED WITH PERMIT FOR AT&T JOB# A02P45R. ESTIMATED START: 10/10/23 ESTIMATED COMPLETE: 01/10/24 DURATION: 1 DAYS Work will commence on or about 10/10/2023 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. Engineering 3rtia411£ Sclw k Administrator Signature of Applicant - Title MICENTP LSHNICE61CLHllCALIPUBSVWKIW STERP6IENCROACHNENT PERMIT APPLICATION 00C (0113) 09/26/2023 Date