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r AFFOCATTON FOR E.14 RO AC�jp& PER.'�IIT <br /> PLEASE PRINT: <br /> OFFICE USE-ONLY <br /> Date /;L- 7- 175 JOB 4 7 3 0 REF# <br /> APN -To: San Joaquin County Highway Department. EXP. DATE 7 <br /> Z DRIVEWAYS: <br /> AREA iel <br /> CONTEL OF CALIFORNIA TYPE <br /> (Applicant Nance) FORMS s_sT1�� s <br /> ATTN: BILL DETRICK CA904NTD <br /> 430 W. CENTER -OTE <br /> (Mailing Address) <br /> MANTECA, CA. 95336 <br /> (City, State Zip Code) <br /> (209)239-0343 <br /> (area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted): <br /> ---- 1552 ffFT - -}I 016 5PLICE PIT, PL/ICE 3"16" <br /> 11fDE5ThL <br /> 0 <br /> D+00 R/W <br /> --DIAf6T /3URI1;0 610LE <br /> O+OS <br /> UP <br /> 4- — UL <br /> MILGE0 AVE `�pt27 E/F <br /> vt92 - R/W <br /> cJ <br /> o + <br /> 0 <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County <br /> TS,ighway Right-of-Wav on the NORTH side of M I,L6ED ALIFAILI E approximately <br /> 1552- feet /Vie- r-_A s T of M U(t PN Y 110 A t7 ,by Performing th= <br /> folio'' work: ;description of work): D1 6 / Y'X Y ' 5 PL/G£ //T 36 ' Of-17P, /�f/tF/C CEPT r X/5T/iL6 <br /> ZLCT l301ZIEV CA-/3Lr-� PL/}Ll- PA'.rr 36 X G" T1=2Md/1/NL l'l,l�h:TirL OAi TILE IV <br /> UIZ7H <br /> 1711 _ <br /> Work will commence on or about far approximately /D days. <br /> the undersigned certify that I am the owner of the respective property, or am qualified to represent the owner an <br /> azrw to do the work described above in accordance 'with the rules,regulations of San Joaquin County and subiec <br /> to inspection and approval.:1G1TIP! 0F a P P L iCA_N'T - =E D.:TE <br />