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• A I&CAT'IC) FOR ENCROAC*ENT PERMIT <br /> ePLLASE PIUIN ': <br /> OFFICE USE ONLY <br /> Date. 12/12/95 ?OB it //00S REF/I <br /> APN - - crtvu <br /> To: Sari Joaquin county IIi�h��;iy' llep;Lrtment. EXP. DATE <br /> VALID DRIVEWAYS: <br /> Flag City L.P. STREET A�✓N�c� ST <br /> (Applicant Name) AREA Zao/ QUAD <br /> # <br /> 1820 W. Kettleman Ln. , Suite E TYPE T/ZFORMS of , ,e,2 <br /> (I' Iailing Address) NOTE ' <br /> Lodi, CA 95241 <br /> (City, SLate Zip Code) <br /> (209) 334-6613 <br /> (Area Code - Telephone Number) <br /> Sketch plass may be subraitl d) / <br /> VSs / <br /> k <br /> \/A Lye. <br /> .S7A. 56 + Z6 t N <br /> PES 5 U-0873 <br /> rl�r T� 5�A L►� <br /> The undersigned hereby applies for permission to ewivate, conswct and /or otherwise encroach on County <br /> I-highway Right-of-Way on the Northerly side of Banner Street approximately <br /> 200 feet /mile North of Capitol Avenue b rlormin l <br /> > Y Pe 8 <br /> following tivork: idesrinpdon of»'ork): to install 8" valve on existing water line. <br /> Work-v zU commence. on or about ThutsdaY:, >December' 13. ' 1995 for appro�:imately 7 days. <br /> I the undersianed certify ih,t i am the owner of the resp=ctive property, or ani qualified to represent the owner r <br /> agree to do the work Jescnbei above in accori mrc with the rules, regulations of S.Lu Joaquin Cou.uly and subj <br /> to inspection and approval. <br /> SIGs ATURE OF APP . SIT - TITLE DATE <br />