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AYYL1k :A 11U1N k'UK ENCROACHMENT PERNUT <br /> v­w�F.kSE PRINT: • <br /> OFFICE USE ONLY <br /> Data 9-21-95 JOB # 73o REF# <br /> AFN - - CRV9 <br /> To: San Joaquin County Highway Department. Exp. DATE a <br /> VALID O DRIVEWAYS: <br /> Pacific Bell STREET S X10, <br /> (Applicant Name) AREA y�r�po�gaP.�o QUAD 15/w <br /> �. TYPE iXe:w� <br /> 44 W. Yokuts Avenue FORMS <br /> (Mailing Address) T ' <br /> NOTE <br /> Stockton, CA. •95207 <br /> (City, State Zip Code) <br /> 2.09/474-4285 or 4726 <br /> (Area Code'-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> SEE ATTACHED SKETCH <br /> when billing please refer to Pacific Bell Job* #UE7126W. C-) <br /> _ v <br /> Report code - 45C C C7 <br /> P w t'►'t <br /> Lodi n C <br /> 77 <br /> C <br /> The undersigned here applies for <br /> -. by pp permission to excavate, construct and/or otherwise encroach on County <br /> Noway Right-Of--Way On the east side Of Deyries Read appro�amately <br /> 120 feet !-Aft south of Peltier Road to Approx ` 50V Porth. " byperfonming the, <br /> F .. following work: (description of work j: Excavate and place new buried Telco cable to replace <br /> existing facilities which are failing and no longer sericeable <br /> all „ <br /> Work will commence on or about 10-2-95 for'approximately; 18o 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 /> to on and proval. <br /> - LiL-w <br /> Y SIGtiATliRE OF APPLICANT <br /> .> TTTL DATE <br />