Laserfiche WebLink
PLEASE PRINT: <br />Date 1/11/24 <br />To: San Joaquin County <br />Department of Public Works <br />VALLEY PERMIT DESK <br />(Applicant Name) <br />1445 VAN NESS AVE <br />(Mailing Address) <br />FRESNO, CA 93721 <br />APPLICATION FOR ENCROACHMENT PERMIT <br />(City, State, Zip Code) <br />(559) 285-4894 <br />(Area Code - Telephone Number) <br />g26977@att.com <br />(Email Address) <br />may <br />JOB # <br />APN <br />EXP.DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />730079 REF # <br />CR # <br />1/24/24 TO 4/24/24 DRIVEWAYS: <br />Multiple Location - See Below <br />Tracy QUAD <br />Traffic Control Devices <br />SS/VVVV <br />Special Conditions <br />A COPY OF THE TRAFFIC CONTROL PLAN IS SUBMITTED WITH THIS PERMIT; <br />SEE ATTACHMENTS <br />A02RBVL <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 CANAL BLVD. approximately 330 @ feet/ Qmile WEST <br />of BERRY AVE. _ , by performing the following work (description of work): <br />TCP NEEDED FOR ONE LANE F AGGER FOR BV #1049 ACCESS ON CANAL BLVD SHOULDER CLOSURE FOR MH M3757 ACCESS ON ELEVENTH ST. & SB #2385 ACCESS ON CANAL BLVD AT&T PROJECT JOB #A02RBVF <br />ADDRESS 3771 wELEVENTH ST., APN 21328011& 21328008 <br />Work will commence on or after 1/24/24 for approximately 2 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 />1/11/24 <br />Signature of Applicant - Title <br />Date <br />