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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 2116124 <br />To: San Joaquin County <br />Department of Public Works <br />Pacific Gas & Electric <br />(Applicant Name) <br />4155 E Childs Ave <br />(Mailing Address) <br />Merced, CA, 95340 <br />(City, State, Zip Code) <br />(408)605-6657 <br />(Area Code - Telephone Number) <br />DDHN a@PGE.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 />730052 REF # <br />CR # <br />4/1/2024 TO 10/1/2024 DRIVEWAYS: <br />Multiple Locations - Tracy Area <br />QUAD <br />Traffic Control Devices <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 side of Various approximately Q feet/ Q mile <br />of Tracy , by performing the following work (description of work): <br />Vegetation Management: trimming tree's, possible mowing of grass. <br />Traffic Control for multiple location. <br />Order #2010347 <br />Work will commence on or after 3/8/24 for approximately 2-3 Months 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 />2/16/24 <br />Signature of Applicant - Title Date <br />