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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 7/28/25 <br />To: San Joaquin County <br />Department of Public Works <br />AIMS COMPANIES - DIANA GOMEZ <br />(Applicant Name) <br />1616 DOOLITTLE DR <br />(Mailing Address) <br />SAN LEANDRO, CA 94577 <br />(City, State, Zip Code) <br />(510)421-9582 <br />(Area Code - Telephone Number) <br />DGOMEZ@AIMSCOMPANIES.COM <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />OFFICE USE ONLY <br />JOB # REF # <br />APN CR # <br />EXP. DATE <br />VALID TO DRIVEWAYS: <br />STREET <br />AREA QUAD <br />TYPE <br />FORMS <br />NOTES <br />SEE ATTACHED: <br />PGE REQUEST FORM (POST CCTV INSPECTION IN SEWER/STORM MAIN/LATERAL). <br />TC PLAN <br />SITE PLAN <br />COI <br />BUS. LIC. <br />CONTRACTOR LIC. <br />FOR PM # 35145395 <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the MULTIPLE side of approximately Q feet/ O mile <br />of N LOCKEWOOD LANE, LOCKEFORD by performing the following work (description of work): <br />CCTV POST INSPECTION IN SEWER/STORM MAINMTERAL LINES SEARCHING FOR ANY POTENTIAL CROSS BORES. AFTER PGE PERFORMED THEIR WORK. <br />Work will commence on or after <br />814/25 for approximately ONE-TWO DAYS 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 i accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br />1 7/28/25 <br />Signa a of A III nt - Title Date <br />