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COUNTY OF SAN JOAQUIN 1 Date: 311123 <br />DEPARTMENT OF PULIC WORKS <br />DRIVEWAYS AND PAVED FRONTAGES <br />PERMIT APPLICATION <br />APPLICANT <br />Name: Robert <br />JOB M <br />Smith <br />APN <br />Address: Po Box 22748 <br />City, State, Zip Code:Sacramento <br />Ca 95822 <br />Area Code - Telephone Number: 91&22 424 <br />EmaiI:CC S.rIS <br />mail.com <br />QUAD <br />SITE INFORMATION: <br />Parcel Owner's Name: <br />Panella Enterprises, LP <br />Site Address: 11030 Copperopolis Rd <br />City, State, Zip Code: Stockton Ca 95215 <br />Area Code -Telephone Number: 209-482-0101 <br />CONTRACTOR <br />Nam , caner Builder <br />Add *s, <br />WIDTHS <br />, State, Zi Code: <br />AreaCit <br />Code - Telephone <br />Number: <br />Received By: <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on itie <br />south Side of COPPEROPOLIS RD approximately feetlmiie <br />of , by installing <br />commence on or about <br />days. <br />Work will <br />SKETCH <br />WIII this project beself-Installed? V <br />OFFICE USE ONLY <br />JOB M <br />11005 ISSUE DATE: <br />APN <br />FEE DUE: <br />EXP. DATE: <br />DRIVEWAYS: <br />STREET: <br />AREA: <br />QUAD <br />TYPE: <br />FORMS: <br />NOTES: <br />�Y4DT� 56-11 <br />DRIVEWAY <br />TYPE: <br />QUANTITY <br />WIDTHS <br />AGRICULTURE: <br />I @FRONTAGE <br />COMMERCIAL: <br />� <br />INDUSTRIAL: <br />@RM <br />RESIDENCE: <br />PAVED FRONTAGE <br />LENGTH: <br />Ft. X WIDTH: <br />Ft. <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on itie <br />south Side of COPPEROPOLIS RD approximately feetlmiie <br />of , by installing <br />commence on or about <br />days. <br />Work will <br />SKETCH <br />WIII this project beself-Installed? V <br />(Separate sheet may be <br />submitted) <br />�Y4DT� 56-11 <br />I1rVC - <br />- CX / �7`-✓.�/ G <br />� <br />zv' <br />A rp1co1?457,7i <br />0 <br />I <br />J <br />� <br />Yes NO Goniractor's License <br />klfjlCROACNAIENI51Wgn Fmm.iomNdev�FNCROgtNAiENi PERNn gRIVEY(AY.Ew�O&98f <br />