Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 04/03/2024 <br />To: San Joaquin County <br />Department of Public Works <br />California Water Service Company <br />(Applicant Name) <br />1602 E Lafayette St <br />(Mailing Address) <br />Stockton, Ca 95205 <br />(City, State, Zip Code) <br />209-226-3022 <br />(Area Code - Telephone Number) <br />mmarquez@calwater.com <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />See attached <br />#8747 <br />JOB # <br />APN <br />EXP. DATE <br />VALID <br />STREET <br />OFFICE USE ONLY <br />730077 REF # <br />CR # <br />4/6/2024 TO 6/6/2024 DRIVEWAYS: <br />Marine Ave. <br />AREA <br />TYPE <br />QUAD <br />Bell Hole <br />FORMS <br />NOTES <br />SS/WW, R-29 Trench Cut Policy <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 West side of Marine Ave approximately 40 feet/mile N <br />of Bristol Ave by performing the following work (description of work): <br />2701 Marine Ave <br />Main Repair <br />1 Cut -3'x3' <br />761000 <br />Work will commence on or after 04/03/2024 for approximately 60 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 />Marcos Marquez 04/03/2024 <br />Signature of Applicant - Title <br />YAFORMS 8, TEMPLATES\ENCROACHMENT PERMIT APPLICATION.d. (08/08) <br />Date <br />