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PG&E- 35434350- C-2110 - INSTALL DEEP WELL ANODE <br />PLEASE PRINT: <br />Date 1/17/24 <br />To: San Joaquin County <br />Department of Public Works <br />PG&E - TY CAULK PERMIT FACILITATOR <br />3136 BOEING WAY <br />(Applicant Name) <br />(Mailing Address) <br />APPLICATION FOR ENCROACHMENT PERMIT <br />STOCKTON , CA 95126 <br />(City, State, Zip Code) <br />(408) 313-0963 <br />(Area Code - Telephone Number) <br />JN23QPGE.COM / STDIVPERMITSQPGE.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 />730052 REF # <br />CR # <br />3/11/2024 TO 7/11/2024 DRIVEWAYS: <br />Chrisman Rd. <br />Tracy QUAD <br />Trenching, Bore <br />SSMNV, R-29, Trench Cut Policy <br />Special Conditions <br />*SEE ATTACHED DRAWINGS AND TRAFFIC PLANS FOR WORK DETAILS <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 CHRISMAN RD approximately 350 (') feet/ O mile NORTH <br />of RENA DR by performing the following work (description of work): <br />DEEP WELL ANODE INSTALLATION <br />Work will commence on or after 3111/24 for approximately 14 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 />Caulk@* MIIYfi-,Mm• <br />Signature of Applicant - Title <br />1/17124 <br />Date <br />