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:�rrLl�.gl tvl�r vx �NCKOAC:fti 1I1N'1' FE10111' ' G� <br /> .. PIiEASE PRINT: • Ak <br /> OFFICT USE ONLY <br /> Date 12-11-95 JOB 7 3 G 79' 3 REFS <br /> APN - - CRV4 <br /> To: San Joaquin County Highway Department. Ems. DATE Z/ZZ <br /> VALID i2 TO DRIVEWAYS: <br /> Pacific Bell STREET CAI, <br /> (Applicant Name) AREA ,e c� QUAD SW <br /> _ <br /> TYPE_T C/,2 <br /> 44 W. Yokuts Avenue FORMS !zs W — 2 <br /> (Mailing Address) NOTE <br /> Stockton, CA. . 95207 <br /> (City, State Zip Code) <br /> 209/474-4285 or 474-4742 <br /> (Area Code -Telephone Number) <br /> Sketch(Detailed pians may be submitted) <br /> cfl <br /> I En <br /> SEE ATTACHED SKETCH <br /> when billing please refer to Pacific Bell Job #UE4268Q. _? <br /> Report code - 451d <br /> Tracyrn <br /> . . <br /> C <br /> c-n <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County <br /> Highway Right-of-Way on the west side of Chrisman Road approximately <br /> 2800 feet /Mik north of Durham Ferry Road ,byperforming the <br /> following work: (description of work): Excavate approximately 4'x4'x4' splice pit to access <br /> existing buried Telco cable. Restore area to original or better condition. <br /> i• <br /> Work will commence on or about 12-18-95 for approximately 90 days. <br /> I the undersized 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 accordsnce with the rules,regulations of San Joaguin County and subject <br /> to inspection andap oval. <br /> SI A 'RE APPLICANT - =E DATE <br />