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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 2/29/24 <br />To: San Joaquin County <br />Department of Public Works <br />PACIFIC BELL TELEPHONE COMPANY DBA AT&T CALIFORNIANCC PERMIT DESK <br />(Applicant Name) <br />1445 VAN NESS AVE <br />(Mailing Address) <br />Fresno, CA 93721 <br />(City, State, Zip Code) <br />(559) 285-4894 <br />(Area Code - Telephone Number) <br />g26977@att.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 />730079 REF # <br />CR # <br />4/1/24 TO 7/1/24 DRIVEWAYS: <br />Airport Way <br />Stockton QUAD <br />Bore Pits, Bores (in Dirt Shoulder) <br />SS/WW, R-29 <br />Special Conditions <br />SEE ATTACHED LAYOUT & TCP DRAWINGS FOR AT&T JOB# A02MA7E. <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 AIRPORT WAY approximately 63 (j)feet/ Q mile NORTH <br />of FRENCH CAMP ROAD 9103 S AIRPORT WAY , by performing the following work (description of work): <br />DIG (1) 4'X4' PIT; PL. 848'4-4" DUCTS VIA BORE; DIG 7'X11' RECEIVE PIT LOCATE & INTERCEPT EXIST. TELCO & PL. NEW PTS -65 MH; <br />DIG (2) 2'X2' PITS & REMOVE EXIST. POLES; DIG 7'X11' RECEIVE PIT & PL. NEW PTS -65 MH; WORK EXTENDS BEYOND COUNTY R/W. <br />SIGNAGE PLACED IN COUNTY OF SAN JOAQUIN R.O.W. TO PLACE NEW MH AND CONDUIT IN CITY OF STOCKTON R.O.W. <br />Work will commence on or after 4/1/24 for approximately 15 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 />2/29/24 <br />Signature of Applicant - Title Engineering Date <br />Administrator <br />