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� idAMMU UP <br />911MUL111 1111 1111 11,1111 Ilk! 1]111111111, 111 <br />PLEASE PRINT: <br />Date 08/28/2019 <br />I o: San Joaquin County <br />Department of Public Works <br />AT&T / VCC PERMITS DESK <br />(Applicant Name) <br />5555 E. Olive Ave <br />(Mailing Address) <br />Fresno, CA 93727 <br />(City, State, Zip Code) <br />(559) 454-4900 g26977@att.con <br />(Area Code -Telephone Number) <br />Sketch (Detailed plans may be submitted) <br />OFFICE USE ONLY <br />JOB # 7Y00 7q REF # <br />APN CR # <br />EXP. DATE <br />VALID TO DRIVEWAYS: <br />STREET <br />AREA QUAD <br />TYPE <br />FORMS <br />NOTES <br />A COPY OF THE TRAFFIC CONTROL PLAN IS SUBMITTED WITf-I THIS PERMIT; <br />SEE ATTACHMENTS A01 N6EA <br />The undersianed hereby applies for ppermission to excavate,. construct and/ <br />the EAST side of HUBBARD RD a <br />of CHEROKEE RD <br />TCP IN PLACE TO DIG PITS, PLACE DUCT, PLACE G <br />Aaron Moore <br />(559)454-3826 <br />or otherwise encroach on County Highway Right-of-Wa on <br />pproximately 1,667 ee mile NOR�H <br />by performing the following work ( scription of work): <br />ROUND BEDS & ANCHORS. SEE THE <br />&JOB DESCRIPTION. <br />ATTACHED DOCUMENT FOR SPECIFIC JOB LOCATION <br />Work will commence on or about 0 9 / 2 6 / 2 019 to 12 / 2 3 / 2 019 for approximately 5 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 />Engineering <br />Administrator <br />Signature of Applicant -Title <br />M:ICENTRALSERVICE5ICLERICALIPUB-SV.N°RIMASTER.PSIENCRDACNMENT PERMIT APPLICATIDN.DDC �09/13j <br />08/28/2019 <br />Date <br />