Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2019_PS-1901501 thru PS-1902000_ - PS-1901964

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APPLICATION FOR ENCROACHMENT PERMIT LEASE PRINT: Date 5/20/2019 To: San Joaquin County Department of Public Works AT&T / VCC PERMITS DESK (Applicant Name) 5555 E. Olive Ave (Mailing Address) Fresno, CA 93727 (City, State, Zip Code) (559) 454-4900 g26977@att.com (Area Code -Telephone Number) Sketch (Detailed plans may be submitted) FROM AT&T SB.1 TRENCH 16' IN DIRT TO PLACE 16' (1)-4" CPC TO N CHRISMAN RD RIGHT OF WAY BOUNDARY, UTILIZING THE SAME TRENCH AS THE CONDUIT PLACEMENT, PLACE A GROUND BED CONSISTING OF (3)-8' GROUND RODS AND #6 GROUND WIRE AT SB.1, FROM THE RIGHT OF WAY BOUNDARY, CONDUIT PLACEMENT CONTINUES ALONG CARMELO AVE (A PRIVATE ROAD) TO A CUSTOMER PEDESTAL AT 7553 CARMELO AVE. SEE ASSOCIATED 46L CONDUIT DRAWINGS FOR COMPLETE CONDUIT PATH, AT AT&T PA, TRENCH 18' IN DIRT TO PLACE A GROUND BED CONSISTING OF (3)-8' GROUND RODS AND #6 GROUND WIRE, SEE ATTACHED DRAWINGS FOR AT&T JOB A01 L3HC, NUMBER OF WORK DAYS -5 The u�ErSsigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on the TT side of N CHRISMAN RD approximately 35' fee mile S of C/L OF CARMELO AVE by performing the following work ( escription of work): TRENCH IN DIRT SURFACE TO INSTALL 16' (1)4' CPC AND GROUND BED FROM AT&T SB 1 TO RIGHT OF WAY BOUNDARY. PLACE A GROUND BED AT PA Work will commence on or about 6/28/2019 for approximately 5 days. 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 work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. r Signature of ant -Title Engineering Administrator hl:1CEMRALSER.VICESICLERICALIPUB-SV.WY;WIAS7ER.PSIENCRDACHMENT PERIrIIT APFLICATIDN.DOC X03/13) 5/20/2019 Date OFFICE USE ONLY JOB # 7 REF # APN CR # EXP. DATE VALID TO DRIVEWAYS: STREET AREA QUAD TYPE FORMS NOTES FROM AT&T SB.1 TRENCH 16' IN DIRT TO PLACE 16' (1)-4" CPC TO N CHRISMAN RD RIGHT OF WAY BOUNDARY, UTILIZING THE SAME TRENCH AS THE CONDUIT PLACEMENT, PLACE A GROUND BED CONSISTING OF (3)-8' GROUND RODS AND #6 GROUND WIRE AT SB.1, FROM THE RIGHT OF WAY BOUNDARY, CONDUIT PLACEMENT CONTINUES ALONG CARMELO AVE (A PRIVATE ROAD) TO A CUSTOMER PEDESTAL AT 7553 CARMELO AVE. SEE ASSOCIATED 46L CONDUIT DRAWINGS FOR COMPLETE CONDUIT PATH, AT AT&T PA, TRENCH 18' IN DIRT TO PLACE A GROUND BED CONSISTING OF (3)-8' GROUND RODS AND #6 GROUND WIRE, SEE ATTACHED DRAWINGS FOR AT&T JOB A01 L3HC, NUMBER OF WORK DAYS -5 The u�ErSsigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right -of -Way on the TT side of N CHRISMAN RD approximately 35' fee mile S of C/L OF CARMELO AVE by performing the following work ( escription of work): TRENCH IN DIRT SURFACE TO INSTALL 16' (1)4' CPC AND GROUND BED FROM AT&T SB 1 TO RIGHT OF WAY BOUNDARY. PLACE A GROUND BED AT PA Work will commence on or about 6/28/2019 for approximately 5 days. 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 work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. r Signature of ant -Title Engineering Administrator hl:1CEMRALSER.VICESICLERICALIPUB-SV.WY;WIAS7ER.PSIENCRDACHMENT PERIrIIT APFLICATIDN.DOC X03/13) 5/20/2019 Date