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_ APPLICAIWN FOR ENCROACHMENT <br />PLEASE PRINT: <br />Date April 19, 1995 <br />To: San Joaquin County fiis�hway Department. <br />Pacific Bell <br />(Applicant Name) <br />44 W. Yokuts Avenue <br />(Mailing Address) <br />Stockton, CA. 95207 <br />(City, State Zip Code) <br />209/474-4723 or 474-4285 <br />(Area Code -Telephone Number) <br />Sketch (Detailed plans may be submitted <br />OFFICE USE ONLY <br />JOB 7 3 cr7 y REF# <br />APN _ _ CRV# <br />EXP. DATE__7/ a S_ <br />VALID T6 DRIVEWAYS: <br />STREET/0,#1�i/o.s;+ ,ear <br />AREA QUAD # <br />TYPE <br />_ <br />FORMS ;�s 'A �,Z S <br />T <br />NOTE <br />SEE ATTTACHM SKETCH <br />t^then billing please refer to Pacific Bell Job "#UE1744R. <br />C -D <br />(P504 #1) <br />-` n Z. <br />Report code 45C <br />o r _ <br />STKMNc= <br />�`- <br />i r1 <br />a vZE <br />• • W4{_� <br />r <br />x <br />7r <br />Cnn W <br />v� <br />cn <br />�A <br />The undersigned hereby applies for permission to excavate, construct and ! or otherwise encroach on County <br />to wa Right -of -Way on the south side of mariposa Road approximately <br />Kms. y - y , by performing the <br />350 feet./ West of Duck Slough <br />following work: (description of work': Trench approximately 5 feet, all in dirt as shown on <br />attached sketch. Place buried Telco cable -min cover - restore area all in dirt <br />- to original or better condition. <br />Work will commence on or about May for approximately 180 Sys, <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 work described above in accordance with the Jules, regulations of San Joaquin County and subject <br />to inspection and a val. <br />SI i 'ATURE OF PLICA�ti'T - TITLE <br />Ll - go <br />DATE <br />