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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 8/18/23 <br />To: San Joaquin County <br />Department of Public Works <br />Jenna Ortega / SEFNCO Communications <br />(Applicant Name) <br />12687 S Manthey Rd <br />(Mailing Address) <br />Lathrop, CA 95330 <br />(City, State, Zip Code) <br />(209) 817-4566 <br />(Area Code - Telephone Number) <br />JenOrtega@SEFNCO.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 />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the side of W LINNE RD approximately Q feet/ Qmile <br />of _ by performing the following work (description of work): <br />AMEND PERMIT # PS -2302096 <br />ADDING: COMCAST TO BORE APPROX.780' ±Between 4 failed poles <br />Comcast To Overpull Approx. 680'± Between 2 Existing Vaults & 1 Existing Node Ped Then Overlash Approx 1192'± To Place Cable Thru <br />9 ExistingPoles Riser Up/Down 100'±,Splice On (8) Existing Locations <br />Work will commence on or after 10/30/23 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 />Ctmm <br />Signature pplicant - Title <br />8/18/23 <br />Date <br />