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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 12/15/2023 <br />To: San Joaquin County <br />Department of Public Works <br />Pacific Gas and Electric - PM 35495334 <br />3136 Boeing Way <br />Stockton, CA 95206 <br />(City, State, Zip Code) <br />(209)470-2300 <br />(Area Code - Telephone Number) <br />STDivPGEpermits@pge.com <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />JOB # <br />APN <br />EXP.DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />730052 REF # <br />CR # <br />1/2/2024 TO 7/2/2024 DRIVEWAYS: <br />Drennan Ave. <br />Fccalon QUAD SE " <br />Trarrr confirm De.I <br />SgAVW <br />Special Conditions <br />— <br />Crew to call SJ County Inspector at (209) 953-7421 48 to 72 hours before work starts. <br />When calling, crew shall request "rain clearance' for any work during winter months <br />November through March <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on <br />the WEST — _side of ----S Bren nan Ave — — _approximately_ 721 — — ee mile NORT <br />of Lone Tree Rd _ _ _ , -- Escalon , by performing the following work (description of work): <br />Traffic control only for pole replacement beyond county ROW. <br />Work will commence on or after_ — _1/2024— — — for approximately— _180— — — 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 />SigAature r ff I card - Title <br />urovus areurovESENCROACHMENT PERM T APPLICATION P.A(POPE) <br />12/15/2023 <br />Date <br />