Laserfiche WebLink
COUNTY OF SAN JOAQUIN Date: <br />ARTMENT OF PUBLIC WORKS • Received by <br />DRIVEWAY & PAVED FRONTAGES CR# L I C <br />PERMIT APPLICATION <br />APPLICANT <br />fW, ell- XS"�o <br />city,/State -Zip Code <br />(Area Code) Telephone <br />SITE INFORMATION <br />P� cel wner's Nam <br />-� <br />,,� SityAd�ess <br />N <br />l � <br />City, State - Zip Code <br />(Area Code) Telephone <br />CONTRACTOR <br />Name <br />Address <br />City, State - Zip Code <br />(Area Code) Telephone <br />DRIVEWAY <br />TYPE QUANTITY WIDTHS <br />AGRICULTURE @ FRONTAGE <br />COMMERCIAL <br />INDUSTRIAL c@ RMI <br />RESIDENCE <br />PAVED FRONTAGE <br />LENGTH: Ft. X WIDTH: Ft. <br />The undersigned hereby applies for permission to encroach <br />on County Highway Right -o -Way on the side of <br />approximately <br />Z ee mile' 5-0u ml- of <br />by installing,''/D�/��w-�� <br />Work will commence on or about, ZIZIL Z/, for approximately S' days. <br />SKETCH (Separate sheet may be submitted) <br />r <br />Will this project be self -installed? NO YES Contractor's License <br />