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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 12/4/23 <br />To: San Joaquin County <br />Department of Public Works <br />Soracco, Inc. <br />(Applicant Name) <br />903 E. Lodi Ave <br />(Mailing Address) <br />Lodi, CA 95240 <br />(City, State, Zip Code) <br />(209) 267-4030 <br />(Area Code - Telephone Number) <br />Richard@soraccoinc.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 />110005 REF # <br />CR # <br />1/19/24 TO 3/19/24 DRIVEWAYS: <br />Augusta St. <br />Woodbridge QUAD <br />Trench <br />SSANW, R-29 <br />Special Conditions <br />New 1" domestic water service to newly built residential house. See Attached. <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 E. Augusta St approximately 127' @ feet/Qmile west <br />of olive St. _ Woodbridge , by performing the following work (description of work): <br />New 1" Domestic water service. Existing road does not have a sidewalk. The existing water main is located on the south side of the road in the shoulder. <br />Work will commence on or after 12/11/23 for approximately 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 />12/4/23 <br />Signature of Applicant - Title <br />Date <br />