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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 />(Applicant Name) <br />3136 BOEING WAY <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 />JN23QPGE.COM / STDIVPERMITSQPGE.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 />NEED ROAD CLOSURE 3/20 - 3/21 <br />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/ O mile FEST <br />of WEST LN , by performing the following work (description of work): <br />DEEP WELL ANODE INSTALLATION <br />INSTALLATION COMPLETE, NEED ROAD CLOSED FOR RESTORATION <br />Work will commence on or after 3/20/24 for approximately 2 days. <br />I, the undersigned, certify that I am the owner of the respective property, or am qualified to represent the owner ar <br />work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br />Ty Caulk°o.�°�..'�,"pwOA,.oi,I'�,'".a,m• 1/17/24 <br />Signature of Applicant - Title <br />Date <br />