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COUNTY OF SAN JOAQUIN <br />DEPARTMENT OF PULIC WORKS <br />DRIVEWAYa AND PAVED FRON I AUES <br />PERMIT APPLICATION <br />APPLICANT <br />o <br />aft"6C,LS <br />JOB #: <br />Name: <br />APN %Gjl� <br />S <br />EXP. DATE: <br />Address: b� <br />STREET: <br />12d 0 <br />City, State, Zi Code: �y <br />4 7 <br />7 <br />Area Code - Telephone Number: <br />—$S <br />7 <br />SITE INFORMATION: <br />DRIVEWAY <br />Parcel Owner's Name: <br />C vxC 1 <br />34 <br />Site Address: J;p `S G j " eA <br />AGRICULTURE: <br />City, State, Zip Code: 2.a 60rvp <br />COMMERCIAL: <br />INDUSTRIAL: <br />Area Code Telephone Number: PS - <br />t21 <br />RESIDENCE: <br />CONTRACTOR <br />PAVED FRONTAGE <br />Name: <br />coteS <br />Address: b <br />i ctU <br />Ft, X WIDTH: <br />City, State, Zip Code: C <br />S 3 ? ' <br />Area Code <br />Telephone <br />Number <br />7— Z <br />The ndersigned hereby appl <br />DMAM side of <br />commence on or about <br />Date: <br />Received By: <br />for permiss'on to excavate, construct andlor otherwise encroach on County Hi way Right -of -Way on the <br />/ approximately He <br />�ip , by installing <br />SKETCH (Separate sheet may be subm <br />Will this project be self -installed? ,YES <br />P:IENCROACHMENTSIMeslet Farms-TemplaleslENCRCACHMENT PERMIT CRIVEWAY.doc (08108) <br />for approximately <br />NO Contractor's License <br />days, <br />Work will <br />OFFICE USE ONLY <br />JOB #: <br />11005 ISSUE DATE: <br />APN %Gjl� <br />(Z� FEE DUE: <br />EXP. DATE: <br />DRIVEWAYS: <br />STREET: <br />12d 0 <br />AREA: <br />c,4Vj jr *,o QUAD <br />TYPE: <br />FORMS: <br />NOTES: <br />DRIVEWAY <br />TYPE: <br />QUANTITY <br />WIDTHS <br />AGRICULTURE: <br />@FRONTAGE <br />COMMERCIAL: <br />INDUSTRIAL: <br />@ RMI <br />RESIDENCE: <br />PAVED FRONTAGE <br />LENGTH: <br />Ft, X WIDTH: <br />Ftq <br />for permiss'on to excavate, construct andlor otherwise encroach on County Hi way Right -of -Way on the <br />/ approximately He <br />�ip , by installing <br />SKETCH (Separate sheet may be subm <br />Will this project be self -installed? ,YES <br />P:IENCROACHMENTSIMeslet Farms-TemplaleslENCRCACHMENT PERMIT CRIVEWAY.doc (08108) <br />for approximately <br />NO Contractor's License <br />days, <br />Work will <br />