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ArrLlt•A I lUiN k*ux EIN t;ROACB MENT PERi'�IIT <br /> PLEASE PRINT: i ��5�• <br /> OFFICE USE ONLY <br /> Date 9-20-95 JOB 4 73: 9 REF# <br /> 1APN - - CRV4 <br /> To: San Joaquin County Highway Department. gyp. DATE i/ 3a S-" <br /> VALIDo O DRIVEWAYS: <br /> Pacific Bell STREET <br /> (Applicant Name) AREA Srk.�.� QUAD s� <br /> TYPE 6o�a <br /> 44 W. Yokuts Avenue FORMS u-1, -7 `7 <br /> (Mailing Address) NOTE <br /> Stockton, CA. 95207 <br /> (City, State Zip Code) <br /> 209/474-4723 <br /> (Area Code-Telephone Number) <br /> Sketch(L--tailed plans may be subnit+.e;I) <br /> SEE ATTACHED SKETCH .,a <br /> C- L <br /> Refer to form P3077 #K8051 <br /> Report code 45C r- <br /> r' <br /> STKIAN '= rn <br /> W C <br /> CQ <br /> C/) v <br /> The undersigned hereby applies for permission to exca'mte, construct and!or otherwise encroach on County <br /> I ighway Right-of-Way on the X-ina side of Amerigo Road approxnnately <br /> 300 feet !mile south of end• , ,by performing the <br /> following work: (description of work): Bore and place 50' 2 Plastic duct for service wire. <br /> . 2 . <br /> _ Work will commence on or about 9-30-95 for approximately 3o days. <br /> I the undersismed 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 rules,regulations of San Joaquin County and subject <br /> toinspection and approval. <br /> l <br /> SIG' ATL O PLICAti'T - TITLE DATE <br />