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APPLICATION FOR ENCROACHMENT PENIT <br />PLEAS <br />Date <br />To: San doquin County <br />bepar#m�lnt of Pabllc Wants <br />(CRY5 stak dip Code) <br />7LD� <br />�1{etch (➢etailed plans maybesubrnitfied� ' • ' ; • ,• . <br />Id <br />Tire u derslgned herebyapplies far penr(issian #a exaavaf�, cgrtstruct andCor othaivufs� encroach,a`� bounty Iligl • �igh#�oi �1ay an <br />tha v side�f � 1�r�%����-• ��� approximafaly; `�, Ile <br />mila._.�•�zS�- <br />by performing Cher""allowing work captfort of �rorfc�: <br />uuonfw((� cernmenc� qn oraboux �y - � -�(} } �Y . forapproximately(-�� days. <br />I, the undersigned, comfy that I aurthe owner of the respectiva properfy, or om qualifad to represen#the owner and agree to Qmne• <br />wont described abova In accordanco with tha rules and regufauons of S'an �Iaagain County and sul5jeot to inspection and approval. <br />[(6wls CITk 1. 110 ;L0 91 <br />81gim tyre ofAppifGar�' "Ttk10 <br />islCEiiliUJf+E}ZUICES1CIf�CNJ.°{1�SU WKVUSZE7iPS1FRCADA(�i41EtI1'pEF6YfAPPUChi1U11000 (W(13J <br />�EFf CE tISE �i�I.� - <br />JOB <br />?3�Q77 <br />RrT9 <br />At'N <br />Cly <br />EXP. DATE <br />1lALID <br />z a' 2 <br />za DRtVE4NAS: <br />TREf~I <br />SBA ✓�C; <br />- <br />AREA <br />�..r• rat�'ad QUAD <br />E <br />FORMS <br />�1OTES <br />�1{etch (➢etailed plans maybesubrnitfied� ' • ' ; • ,• . <br />Id <br />Tire u derslgned herebyapplies far penr(issian #a exaavaf�, cgrtstruct andCor othaivufs� encroach,a`� bounty Iligl • �igh#�oi �1ay an <br />tha v side�f � 1�r�%����-• ��� approximafaly; `�, Ile <br />mila._.�•�zS�- <br />by performing Cher""allowing work captfort of �rorfc�: <br />uuonfw((� cernmenc� qn oraboux �y - � -�(} } �Y . forapproximately(-�� days. <br />I, the undersigned, comfy that I aurthe owner of the respectiva properfy, or om qualifad to represen#the owner and agree to Qmne• <br />wont described abova In accordanco with tha rules and regufauons of S'an �Iaagain County and sul5jeot to inspection and approval. <br />[(6wls CITk 1. 110 ;L0 91 <br />81gim tyre ofAppifGar�' "Ttk10 <br />islCEiiliUJf+E}ZUICES1CIf�CNJ.°{1�SU WKVUSZE7iPS1FRCADA(�i41EtI1'pEF6YfAPPUChi1U11000 (W(13J <br />