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PLEASE PRINT: <br />Date 7/24/25 <br />To: San Joaquin County <br />Department of Public Works <br />AT&T California — Valley Permit Desk <br />(Applicant Name) <br />1445 Van Ness Ave <br />(Mailing Address) <br />APPLICATION FOR ENCROACHMENT PERMIT <br />Fresno, CA 93721 <br />(City, State, Zip Code) <br />(559)285-4894 <br />(Area Code - Telephone Number) <br />g26977@att.com <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />Please see the attached drawings. <br />JOB # A057QAF <br />APN <br />EXP. DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />REF # <br />CR # <br />TO DRIVEWAYS: <br />QUAD <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the West side of Thornton Rd approximately 0.3 Q feet/ O mile SOUTH <br />of W WALNUT GROVE RD , by performing the following work (description of work): <br />AT&T NEEDS TO PERFORM 2-4'x4' DIG UPS TO REPAIR DAMAGED CONDUIT ALONG THORTON RD. <br />SEE ATTACHED DRAWINGS FOR DETAILS. <br />Work will commence on or after 8/7/25 for approximately 10 days. <br />I, the undersigned, certify that I am the owner of the respective property, or am qualified to represent the owner 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 />7/24/25 <br />Signature of Applicant - Title Date <br />