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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 12/22/23 <br />To: San Joaquin County <br />Department of Public Works <br />Traffic Management Inc. C/O Industrial Railways <br />(Applicant Name) <br />4900 Airport Plaza Dr. Ste 300 <br />(Mailing Address) <br />Long Beach, CA 90815 <br />(City, State, Zip Code) <br />562]241-1997 <br />(Area Code - Telephone Number) <br />permits@trafficmanagement.com <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <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 />2/3/24 TO 2/5/24 DRIVEWAYS: <br />Broadway Ave. " <br />Stockton QUAD <br />Temp Road Closure <br />Ss/WW <br />Special Conditions <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the Both side of Broadway approximately 2,900 (Q feet/ 0mile South <br />of Waterloo Road in Stoc<ton , by performing the following work (description of work): <br />Industrial Railways to replace train tracks on D Street, requesting a full road closure per plan provided during normal business hours. <br />Plan includes detour route to assist local tragic get around the closure. <br />Work will commence on or after <br />213)24 <br />for approximately <br />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 />(A;, 12/22/23 <br />Signature of Appl�t - Witle Date <br />