Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 7/21/23 <br />To: San Joaquin County <br />Department of Public Works <br />PACIFIC BELL TELEPHONE COMPANY DBA AT&T CALIFORN IANCC 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 <br />(Area Code - Telephone Number) <br />g26977@att.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 />SEE ATTACHED TCP DRAWINGS FOR AT&T JOB# A021­2AE. <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the MULTIPLE LOCATIONS ALONG WATERLOO RD (CA -88) approximately 3,000 @feet/Qmile <br />of CONDUIT TO BE PLACED UNDERGROUND AT BACK OF Row IN RUE t by performing the following work (description of work): <br />SIGNAGE PLACED IN COUNTY OF SAN HCAOUIN RC w. To PLACE DUCT AND SB IN THE CALTRANS CA 88) R o w <br />Work will commence on or after 7/31/23 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 />Dion Gaga p23ofzwvlisis-ie203n0700 7/21/23 <br />Signature of Applicant - Title Engineering Date <br />Administrator <br />