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Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2019_Driveway Permits_PS-1903001 thru PS-1903500_ - PS-1903320
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PS-1903001 thru PS-1903500
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Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2019_Driveway Permits_PS-1903001 thru PS-1903500_ - PS-1903320
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Last modified
6/26/2024 3:36:53 PM
Creation date
6/26/2024 3:36:37 PM
Metadata
Fields
Template:
Permits_Development
DocName
PS-1903320
Category07
Encroachment(EP)/Driveway(DW) Permits
Year2
2019
Notes2
3070 W. Kingdon Rd., Lodi
Address
PO Box 696, Ceres, CA 95307
Application
Keri Costner
Supplemental fields
APN
05525007
Cross Ref
PWP110005
Type (2)
Encroachment Permit (EP)
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r <br />COUNTY OF SAN JOAQUIN <br />DEPARTMENT OF PULIC WORKS <br />DRIVEWAYS AND PAVED FRONTAGES <br />PERMIT APPLICATION <br />APPLICANT <br />Name: ,r <br />Address: Po /Soy q' <br />City, State, Zip Code: 6�creS CA ''s367 <br />Area Code Telephone Number: ' OSI -0'OLI-(v <br />SITE INFORMATION: <br />Parcel Owner's Name: Chc� Lc� S r p Kc)viti <br />Site Address: 6 70 kf r oke <br />City, State, Zip Code: lLo c(l c' G.A- f!�7a.Ll a - <br />Area Code - Tele hone Number: <br />CONTRACTOR <br />Name::' <br />Address: <br />City, State, Zip Code: <br />Area Code - Telephone <br />Number: <br />DRIVEWAY <br />Date: <br />Received By: <br />The undersigned hereby applies for permission to excavate, construct andlor otherwise encroach on County Highway Right -of -Way on the <br />side of approximately feetlmHe <br />of _ by installing <br />commence on or about <br />SKETCH (Separate sheet may be submitted) <br />Will this project be self -installed? _YES <br />P:IEfJCRCACHNENTSIMasler FarmsTemplaleslEIJCRDACHtdENT PERN.R DRIVEVJAI'.doc (03108) <br />for approximately <br />days. <br />M�fa I gaffe <br />Work will <br />NO Contractor's License <br />OFFICE USE ONLY <br />JOB #: <br />11005 ISSUE DATE; <br />APN :03 S ZSd U FEE DUE: <br />EXP. DATE: <br />DRIVEWAYS: <br />STREET: <br />AREA: <br />QUAD <br />TYPE: <br />FORMS; <br />NOTES: <br />DRIVEWAY <br />TYPE; <br />QUANTITY <br />WIDTHS <br />AGRICULTURE: <br />FRONTAGE <br />COMMERCIAL: <br />INDUSTRIAL; <br />@ R/W <br />RESIDENCE: <br />PAVED FRONTAGE <br />LENGTH; <br />Ft, X WIDTH: Ft. <br />The undersigned hereby applies for permission to excavate, construct andlor otherwise encroach on County Highway Right -of -Way on the <br />side of approximately feetlmHe <br />of _ by installing <br />commence on or about <br />SKETCH (Separate sheet may be submitted) <br />Will this project be self -installed? _YES <br />P:IEfJCRCACHNENTSIMasler FarmsTemplaleslEIJCRDACHtdENT PERN.R DRIVEVJAI'.doc (03108) <br />for approximately <br />days. <br />M�fa I gaffe <br />Work will <br />NO Contractor's License <br />
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