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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 11/15/2023 <br />To: San Joaquin County <br />Department of Public Works <br />Pacific Gas and Electric - PM 31321706 <br />3136 Boeine W <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 />OFFICE USE ONLY <br />JOB # 730052 REF # <br />APN CR # <br />EXP. DATE <br />VALID 1/18/2024 TO 7/18/2024 DRIVEWAYS: <br />STREET Mariposa Rd <br />AREA Stockton QUAD <br />TYPEre—T n� <br />FORMS SS/WW, R-29, Trench cut Policy <br />NOTES Special Conditions <br />Gas Main Replacement <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 />Mariposa Ave, Learned Ave, Hall Ave, Section Ave, Pock Ln, Juliet Rd, Silva St. <br />PG&E to install: 4891' of 2" HP PL main, 3817' of 4" HP PL main, (2x) 634' of #6 stranded wire <br />Abandon: 267' fo 1-1/4" STL HP main, 8007' of 2" STL HP main, 520' of 2" HP PL main, 16' of 4" HP PL main <br />Replace: (62) STL of ALDYL-A services, transfer (7) PL services, abandon (2) services <br />Pre/Post construction CCTV inspections may take place. Method of install HDD <br />Work will commence on or after 1/2/2024 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 />_ ! 11/15/2023 <br />Sig ure # Applicant - Title Date <br />Y.+FORMS d TEMPLATES'FHCROACHMENT PERMfT APPLICAPON-dw 0081 <br />