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- i • <br /> .�PpLic?�'Tlu v rc�r�El <br /> rCROACHME�T PMUT <br /> PLEASE, PRINT: <br /> O < BICE USE ONLY <br /> Date iO c JOB H REF# <br /> A-AIN _ CRVa /o Z <br /> To: San Joaquin County IJighw y Depar=cnt EXP.DATE_ <br /> VALID TO I0 DRIVEWAYS: <br /> (Appkcant dame) AREA STAN QUAD S� ` <br /> TYPE �iiv6 .c- so/4 ,ts <br /> (ASailin.g Address) NOTE <br /> c� '( <br /> (City, State Zip Code) <br /> 1� )5 — 6)zco <br /> (Arca Code-Tcicphonc Fumbcr) <br /> Sketch(D.•.tail:: p'l=mw bc subrm".c l <br /> The u:adersigned heraby applies for r permission to excavate, construct pd/or otherwise encroach on County <br /> Ixa wayRi�ht-cf Way Qmine _ ��' side of � >� �.�� approximately <br /> fee r-�c s� of eG,��, Q t;r �,� , -� 720 A. ,by Pwfor' l <br /> following work: (description of:v om . <br /> Wort will comracncc on or about 11 Ca 53 /h - Z �'�l for approximatek - y <br /> i <br /> I the undersi n cer• r'h�t T azm,�c ewrcr of the:esr dive groper'.y, or su qualified to irpresent the ownar <br /> agree to 0o tila work descnbed m�*ve in-towrdanw with the rule,rcgvlatians of San Joaquin t;oumly and subj <br /> to jupcotion approve vel. <br /> k l•'° <br /> SiGi�. r E GF A'PLiC.�uYI' • Tr17,E —� DATE <br /> TOTAL P.01 <br />