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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 22/23 <br />To: San Joaquin County <br />Department of Public Works <br />Buzz Oates Construction <br />(Applicant Name) <br />555 Capitol Mall Suite 900 <br />(Mailing Address) <br />Sacramento, CA, 95814 <br />(City, State, Zip Code) <br />(916)3]9-3838 <br />(Area Code - Telephone Number) <br />miguelgalvan@buzzoates. com <br />(Email Address) <br />may <br />See plans attached. <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 />5/1/2023 TO 6/1/2023 DRIVEWAYS: <br />Longe St. <br />Stockton QUAD SS <br />Frontage Improvements <br />Conditions <br />_SMial <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the East side of forge &rest%Northrop Street approximately 6 @ feet/Qmile <br />of the South East corner offorge &rest&Northrop St ,by performing the following work (description of work): <br />Frontage improvements along Longe Street & Northrop Street. <br />Work will commence on or after 5//23 for approximately 30 calendar 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 />Miguel Calash La'v •^^^ _^ �� <br />Signature of Applicant - Title tl em <br />22/23 <br />Date <br />