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PG&E - 35401940 - C-2050- DWA INSTALL <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 />JN23@PGE.COM / STDIVPERMITS@PGE.COM <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />OFFICE USE ONLY <br />JOB # REF # <br />APN CR # <br />EXP. DATE <br />VALID TO DRIVEWAYS: <br />STREET <br />AREA QUAD <br />TYPE <br />FORMS <br />NOTES <br />*SEE ATTACHED DRAWINGS AND TRAFFIC PLANS FOR WORK DETAILS <br />*We would need the road closed for 6 days <br />from 3/11- 3/15 , 3/18 For Restoration <br />Work hours would be 7am to 5pm. <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 STADIUM DR approximately 50 @ feet/ © mile WEST <br />Of WEST LN by performing the following work (description of work): <br />DEEP WELL ANODE INSTALLATION <br />Work will commence on or after 3/11/24 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 />Ty Caulk °�=MW JJM21_.� 1/17/24 <br />Signature of Applicant - Title <br />Date <br />