Laserfiche WebLink
-APPLICATION FOR LN CROACITMENT I'IJI011T ' <br /> PLEASE MUM': <br /> OFFICE USE ONLY <br /> Date December 7 , 1995 JOB # REF# <br /> APN - - CRV# <br /> To: San Joaquin County Highway Department. EXP. DATE <br /> VALID /2-, / R. to 4 DRIVEWAYS: <br /> Philip Martin STREET c_ <br /> (Applicant Name) AREA `1-i�G QUAD <br /> TYPE=T <br /> 12067 W. Lammers Road FORMS — <br /> (hlailing Address) NOTE <br /> Tracy, CA 95376 <br /> (City, State Zip Coe w) <br /> (209) 835-5258 <br /> (Arca lc==Tcicphone Number) <br /> S4etch(Deiaile�plans:nay�subrai"et.'� <br /> i, <br /> SEE ATTACHED PLAN <br /> The undersigned hereby applies for permission to excavate, construct and/,or othenvise encroach on County <br /> N,ghNvayRiaht-of-W,-iy on+.he East side of Chrisman Road approximately <br /> 14 . 0 feet i mile North of Schulte Road , by performing <br /> follotiving-yvork: idescripuonofworK j: to install 55 LF. of 30" dia. rubber gasket <br /> aW-RCP with a minimum cover of 36" <br /> Work urill coaunence on or about December 18 , 1995 for approximately 30 days. <br /> I L:e undersigned certify t..hat ram the owner of the respective property, or am qualified to represent the owner <br /> agree to do the Work cicscnbed above in accordaace tivith the rules, regutahous of Smi Joaquin Couuty and subs; <br /> to inspection and approval. <br /> �4� r 2-/-7/?-S- <br /> SIGNATURE OF APPLICANT - TITLE DATE <br />