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35426191- C- 2088 - DEACTIVATE DEEP WELL - STOCKTON <br />APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 1/30/24 <br />To: San Joaquin County <br />Department of Public Works <br />PG&E - TY CAULK PERMIT FACILITATOR <br />(Applicant Name) <br />3136 BOEING WAY <br />(Mailing Address) <br />STOCKTON , CA 95126 <br />(City, State, Zip Code) <br />(408)313-0963 <br />(Area Code - Telephone Number) <br />JN23@PGE.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 />4/15/2024 TO 8/15/2024 DRIVEWAYS: <br />Harding Way <br />Stockton QUAD <br />Traffic Control Devices ' <br />SSNVW, R-29, Trench Cut Policy <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 SOUTH side of E HARDING WAY approximately 40 @ feet/ © mile EAST <br />Of N RHODE ISLAND AVE , by performing the following work (description of work): <br />DEEP WELL ANODE DEACTIVATION <br />Work will commence on or after 4/15/24 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 DtNiyb MMTrcmk <br />Dar=MW nsasi-Drvn <br />Signature of Applicant - Title <br />1/30/24 <br />Date <br />