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PLEA E PRINT: <br />Date 4-10-95 <br />APPLICA*ON FOR ENCROACMIEN <br />To: San Joaquin County Highway Department. <br />Pacific Bell <br />(Applicant Name) <br />44 11. Yokuts Avenue <br />(Mailing Address) <br />Stockton, CA_ 95207 <br />(City, State Zip Code) <br />209/474-4739 <br />_ (Area Code - Telephone Number) <br />Sketch (Detailed plans may be submitted) <br />See attached sketch <br />OFFICE USE ONLY <br />JOB # REF# <br />APN _ - CRV# <br />EXP. DATE I <br />VALID ? S O !/ 1 DRIVEWAYS: <br />STREET_ Ci <br />0 <br />AREA 0'r b^ , d eQUAD S * - <br />TYPE_ <br />FORMS -- <br />NOTE <br />When billing please refer to Paci:Eic Bell Job #UE'78(1V <br />P, 1c, q!S C- <br />Uof <br />The undersigned hereby applies for permission to excavate, construct and / or otherwise encroach on County <br />N-iza way Right -of -Way on the S / E side of Cindy w a y, <br />approximately <br />following work: (description, at front of 19000 Cindv ,��av _,byperf(description,of worx ): Remove 4' section o f s i d ewalk , t r e n 5 0' n n L o t <br />B and bore sidewalk and drivewa at the front n_f ;�nnn �;to in except <br />existing 2" conduit. <br />Work will commence on or about A , ; , 4 , i for approximately 7 <br />days. <br />I the undersigned certify that I am the owner of the respective property, or am qualified to represent the owner and <br />agree to do the worm described above in accordance with the rules, regulations of San Joaquin County and subject <br />to inspection and approval. <br />SIGti RE OF APPLICANT - TITLE <br />DATE <br />