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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE <br />I1af 1Q <br />i o: San Joaquin County <br />Department of Public Works <br />(Ap�li�an� �a�®} • <br />• (l�ailing,Adde��j <br />(C) y, States zip! Code) <br />�ketcl�(17etalledplansmaybesubmitfed) •• • . , <br />Ciro undersigned hereby applies for enriissionto pxcauato, construct aitdlar ofiheivuise encroach,on County III -gill Right of Way do . <br />tho. .No .____, [do or rd, V.l a applmtmately ; Z9 life rAt <br />ox <br />,DeAawace, m8iiee, by Poff0filfig tha olfowing work (esceipfion of. work). <br />UuonCwnl CpninlOnC� onorabaut_ IU y f �� 17. .forapproximatefy_ �-b ,day$. <br />i, L U undersigned, wilily LIM 1 am the owner ofihe respective property, or am qualified to represent the owner and agreeto do•the- <br />work described above in accordance with the rufes and requiations •of San doaqufn Couniy and subject to inspection and approval, <br />n&m+i.s IT/ <br />SlEgnatum ofApplailt, life <br />UcettitUlsERv�cEslcLadeN_1Fi1�sV.VJh�,NslgxFslgtettoAEH,;lslnp�tYYAFpticnllo�tooc fouls) <br />OFFiur. use U114T , <br />JOB# <br />'Voo7? REFS <br />WN <br />CR tr <br />iWaDATE <br />2 <br />1IA11D <br />%/ i 2 q T . 0 , • � DRIVEWAYS, <br />rlRUt T <br />OX AIAV <br />AREA <br />yrdeA nA) QUAD GG <br />TYp>r, <br />F�Eu Nd <br />�ORfuls <br />As 0 de9 <br />NOTES <br />S . ee n ' i1put •, <br />�ketcl�(17etalledplansmaybesubmitfed) •• • . , <br />Ciro undersigned hereby applies for enriissionto pxcauato, construct aitdlar ofiheivuise encroach,on County III -gill Right of Way do . <br />tho. .No .____, [do or rd, V.l a applmtmately ; Z9 life rAt <br />ox <br />,DeAawace, m8iiee, by Poff0filfig tha olfowing work (esceipfion of. work). <br />UuonCwnl CpninlOnC� onorabaut_ IU y f �� 17. .forapproximatefy_ �-b ,day$. <br />i, L U undersigned, wilily LIM 1 am the owner ofihe respective property, or am qualified to represent the owner and agreeto do•the- <br />work described above in accordance with the rufes and requiations •of San doaqufn Couniy and subject to inspection and approval, <br />n&m+i.s IT/ <br />SlEgnatum ofApplailt, life <br />UcettitUlsERv�cEslcLadeN_1Fi1�sV.VJh�,NslgxFslgtettoAEH,;lslnp�tYYAFpticnllo�tooc fouls) <br />