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APPLATION FOR ENOROACIDIE0 PE&NIIT <br /> PLEASE PRINT: <br /> OFFICE USE ONLY <br /> Date /D- 7-9s JOB 0 7 3 ©s/ REFH <br /> APN -To: San Joaquin County Highway Department. EXP. DATE6_C. -3/ / S—DRIVEWAYS: <br /> T— s <br /> 4REA <br /> CONTEL OF CALIFORNIA TYPE z?a2E <br /> (Applicant dame) FOR\LS <br /> 1430 W. CE11Trr`? .sr. <br /> NOTE <br /> (Mailing Address) <br /> MANTECA, CA. 95336 <br /> (City, State Zip Code) <br /> CZDII Z39102G5 <br /> (area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted): LO/U T FL... L) , O 7 P 0 // K V <br /> �IIDZ(o L AVAJ <br /> iz <br /> o � - <br /> iz <br /> w <br /> FfVCC_ <br /> IQ <br /> EIPI I <br /> a� <br /> j FLOW TELE PHO UE CA[SLE <br /> � I D b' :SDI' D E`PTH <br /> LOOP OF d SET PEDESTALS RC.AIuST <br /> — - FFk)CE Fvk .4,0iZ`JICL" h <br /> NTS <br /> M I LTD N f•Z D'Pt D 1 <br /> The undersigned hereby applies for permission to excavate, constrict and i or otherwise encroach on County <br /> HTirhway Right-of-Way on the lVneTfl side of In/,G 7-all 160/¢-D approximately <br /> 3o/S feet ale CtgsT of r//V4 ,�'Di9D , by performing the <br /> rollowins work: (description of work):�3D�PE Jr9L,�/ �'' Py[ Dv�Ty,va�ryz lejqAp <br /> r1,143,6E .Gam7V �� r�•v '� <br /> Work will commence on or about 0,--7– 03 for approximately days. <br /> I the undcrsi�zned certify that I am the owner of the respective property, or am qualified to represent the owner an. <br /> agree to do the work described above in accordance 'With the rules, regulations of San Joaquin County and subiec, <br /> to inspection and approval. <br /> :Ir,N a F OF IPLICAN7 - TITLE DATE <br />