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A.rrLl�.g.11v��i r OK .trllyCROAt;IINIENI: PER UT <br /> PLEASE PRINT: <br /> OMrE USE ONLY <br /> Date nc-tober 20. "1995 JOB # �� �/ REF# <br /> AFN —�- - CRV# <br /> To: San Joaquin County Highway Department. =.DATE 3 <br /> VALID D A6 T DRIVEWAYS: <br /> Pacific Bell STRUT etir,.4 <br /> (Applicant Name) AREA tt,, QUAD 15�� <br /> ME IWIC41 <br /> 44 W. Yokuts Avern11- FORMS <br /> (Mailing Address) NOTE <br /> Stockton, . CA. 95207 <br /> (City, State Zip Code) <br /> (209)474-4742 <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> SEE ATTACHED SKETCH <br /> When billing please refer to P3028 M74838 <br /> Report code - 45C <br /> Tracy <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County <br /> Flia way Right-of-Way on the south side of Lehman Road approximately <br /> 1200 feet / easT of Bird Road Tracg, ,by perfOmung the <br /> following work: (description of work): Trench approximately 1160' in dirt along the south <br /> side of Lehman Road to a utilitv joint pole to place a buried service wire. <br /> a+ <br /> Work will commence on or about 10-26-95 for approximately 2 days, <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 rules,regulations of San Joaquin County and subject <br /> to inspection and approval. <br /> - r <br /> S IiATliRE OF APPLICAN-r - DATE <br />