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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 6/15/2018 <br />To: San Joaquin County <br />Department of Public Works <br />PG&E PM O luoza15 <br />(Applicant Name) <br />4040 West Lane <br />(Mailing Address) <br />Stockton, CA 95204 <br />(City, State, Zip Code) <br />(209) 470 - 2300 <br />(Area Code - Telephone Number) <br />s6pz aRpge.com <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />See attached sketch, <br />JOB # <br />APN <br />EXP. DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS�a <br />NOTES <br />OFFICE USE ONLY <br />0056 -67 REF # <br />CR # <br />J lWlcf <br />(o 11g TO q 7 DRIVEWAYS: <br />�,AGl QUAD <,o V <br />S y1466j; , �ewrj.5, <br />-rrusf�l���� aF <br />rye au!-�s <br />Crew to call SJ County Inspector at (209) 953-7421 48 to 72 hours before work starts. <br />When calling, crew shall request "rain clearance" for any work during winter- months <br />November through March <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way <br />on the WEST side of Lammer Road, approximately 2800' SOUTH of Valpico &Lammers Road <br />by performing the following work (description of work): <br />Relocation of regulator station - Installation of RTU cabinet, 3 underaround vaults with traffic rated lids - flush with arade. "no oarkina <br />signs -removal of existing posts <br />Work will commence on or after 6/20/2018 for approximately 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 />Y:IFCRMS & TEMPLATESIENCROACHMENT PERMIT APPLICATICN.doc (08N8) <br />6/20/2018 <br />