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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 08/12/2022 <br />To: San Joaquin County <br />Department of Public Works <br />AT&T CALIFORNIA - VALLEY 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 g26977@att.com <br />(Area Code - Telephone Number) <br />Sketch (Detailed plans may be submitted) <br />A COPY OF THE TRAFFIC CONTROL PLAN IS SUBMITTED WITH THIS PERMIT; <br />SEE ATTACHMENTS <br />A02ES68 <br />The and igST hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on <br />the E side of ELMWOOD AVE approximately 91 ee mile WEST <br />of N PERSHING AVE Ibyperforming the following work( scriptionofwork): <br />ACCESS MANHOLE#2558 TO PLACE & SPLICE EXISTING CABLE. <br />THE ASSOCIATED TCP IS SUBMITTED WITH THIS PERMIT FOR AT&T JOB# A02ES68. <br />Work will commence on or aboutSTART DATE 8/26/2022 END DATE 11/26/22 for approximately 4 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 />Engineering <br />54z ,L �'� � Administrator <br />Signature of App ant - Title <br />MICENTP LSHNICE61CLHllCALIPUBSVWKIW STERP6IENCROACHNENT PERMIT APPLICATION 00C (0113) <br />08/15/2022 <br />Date <br />OFFICE USE ONLY <br />JOB # <br />730079 REF # <br />APN <br />CR # <br />EXP.DATE <br />VALID <br />8/26/2022 TO 12/1/2022 DRIVEWAYS: <br />STREET <br />Elmwood Ave. <br />AREA <br />Stockton QUAD CC <br />TYPE <br />Traffic Control Devices <br />FORMS <br />SS/ww <br />NOTES <br />Special Conditions <br />A COPY OF THE TRAFFIC CONTROL PLAN IS SUBMITTED WITH THIS PERMIT; <br />SEE ATTACHMENTS <br />A02ES68 <br />The and igST hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on <br />the E side of ELMWOOD AVE approximately 91 ee mile WEST <br />of N PERSHING AVE Ibyperforming the following work( scriptionofwork): <br />ACCESS MANHOLE#2558 TO PLACE & SPLICE EXISTING CABLE. <br />THE ASSOCIATED TCP IS SUBMITTED WITH THIS PERMIT FOR AT&T JOB# A02ES68. <br />Work will commence on or aboutSTART DATE 8/26/2022 END DATE 11/26/22 for approximately 4 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 />Engineering <br />54z ,L �'� � Administrator <br />Signature of App ant - Title <br />MICENTP LSHNICE61CLHllCALIPUBSVWKIW STERP6IENCROACHNENT PERMIT APPLICATION 00C (0113) <br />08/15/2022 <br />Date <br />