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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 11/02/2023 <br />To: San Joaquin County <br />Department of Public Works <br />California Water Service Company <br />(Applicant Name) <br />1602 E Lafayette St <br />(Mailing Address) <br />Stockton, Ca 95205 <br />(City, State, Zip <br />(209)547-7934 <br />(Area Code - Telephone Number) <br />ahenson@calwater.com <br />(Email Address) <br />may be <br />See attached <br />#8718 <br />JOB # <br />APN <br />EXP.DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />730077 REF # <br />CR # <br />11/6/2023 TO 01/6/2024 DRIVEWAYS: <br />Sanguinetti L.. ' <br />Stockton QUAD NS ' <br />Bell Hole ` <br />SS R_?0 Trench Cut Policy <br />Special Conditions <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on <br />the South side of Sanguinetti Lane approximately 15 feet/mile North <br />of Cherokee Rd by performing the following work (description of work): <br />1717 Sanguinetti Ln <br />Abandon (1) 2" Service <br />1 -Cut - 3'X4' <br />STK0600 <br />Work will commence on or after 11/02/2023 for approximately 60 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 />Antoinette Hanson - Field Service Representative 11/02/2023 <br />Signature of Applicant - Title Date <br />Y.f WS M 1EMIMUMOMHMEM PER 9N WON ft (MO) <br />