Laserfiche WebLink
A P P LI C ATI O N F O R E N C R O A C H M E NT P E R MI T <br />PL E A S E P RI NT: <br />Date O F FI C E U S E O NL Y <br />To: San Joaquin County J O B # R EF # <br />Depart ment of Public Works A P N C R # <br />E X P. D AT E <br />V ALI D T O D RI V E W A Y S: <br />( Applicant Na me) ST R E ET * <br />A R E A Q U AD * <br />T Y P E * <br />( Mailing Address) F O R M S <br />N OT E S <br />( City, State, Zip Code) <br />( Area Code - Telephone Nu mber) <br />(E mail Address) <br />Sketch ( Detailed plans may be sub mitted) <br />The undersigned hereby applies for per mission to excavate, construct and/or other wise encroach on County high way right-of-way on <br />the ______________ side of ___________________________________ approxi mately ____________ feet/ mile _________ <br />of _______________________________________, ____________________, by perfor ming the follo wing work (description of work): <br />Work will co m mence on or after _____________________________________ for approxi mately ________________________ days. <br />I, the undersigned, certify that I a m the o wner of the respective property, or a m qualified to represent the o wner and agree to do the <br />work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br />Signature of Applicant - Title Date <br />8/ 1 9/ 2 4 <br />Cr a wf or d & Ass oci at es, I nc. <br />4 7 0 1 Fr e e p ort Blv d <br />S acr a m e nt o, C A 9 5 8 2 2 <br />( 5 5 9) 3 9 3- 1 0 6 8 <br />c hris.z av al a @cr a wf or d-i nc.c o m <br />s e e att ac h e d p a g es. <br />i nt ers ecti o nsE M ari p os a R d a n d S J ack T o n e R d 5 0 0 <br />wi d e ni n g r o a d <br />Cr a wf or d a n d Ass oci at es, I nc. ( Cr a wf or d) will p erf or m s u bs urf ac e ex pl or ati o ns o nsit e by c o n d ucti n gs s oil s a m pli n g b ori n gs t o a d e pt h of 5 t o 8 f e et b el o w s urf ac <br />8/ 2 7/ 2 4 1 <br />8/ 1 9/ 2 4