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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 3/27/24 <br />To: San Joaquin County <br />Department of Public Works <br />AT&T California -Valley 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 />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 />730079 REF # <br />CR # <br />4/16/24 TO 7/16/24 DRIVEWAYS: <br />Arch -Airport Rd <br />Stockton QUAD <br />Traffic Control Devices <br />SS/VVVV <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 NORTH side of ARCH AIRPORT RD. approximately 120 @ feet/ Qmile N/E <br />of S B ST. _ , by performing the following work (description of work): <br />TCP NEEDED FOR RIGHT LANE CLOSURE TO ACCESS SB #2297 ON ARCH AIRPORT RD. AND SHOULDER CLOSURE TO ACCESS SB #2379 ON S B ST. <br />AT&T JOB#A02SYYK <br />2001 ARCH AIRPORT RD. & 2120 BOEING WAY <br />Work will commence on or after 4/16/20 for approximately 4 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 />3/27/24 <br />Signature of Applicant - Title <br />Date <br />