Laserfiche WebLink
COUNTY OF SAN JOAQUIN Date: 1 5 <br /> DEPARTMENT OF PULIC WORKS <br /> Received By:n- Jlrv� <br /> DRIVEWAYS AND PAVED FRONTAGES <br /> PERMIT APPLICATION CR#:O L,36 j <br /> APPLICANT OFFICE USE ONLY <br /> Name: Z-o <br /> Address: 'L7-1 cow I-e�, JOB#: 11005 ISSUE DATE: <br /> City,State,Zip Code: L-z,c-, APN (>t' , ©Sj�>3FEE DUE: <br /> Area Code -Telephone Number: EXP.DATE: DRIVEWAYS: <br /> STREET: <br /> j SITE INFORMATION: AREA: Y QQUAD <br /> Parcel Owner's Name: TYPE: <br /> Site Address: '3Z1(00 Doc`JL.s rza. FORMS: <br /> City,State,Zip Code: L-ooli , CA NOTES: <br /> Area Code -Telephone Number: <br /> DRIVEWAY. <br /> CONTRACTOR TYPE: QUANTITY WIDTHS <br /> Name: C�ra.� a rel �+^5.h ea r�r,' AGRICULTURE: @FRONTAGE <br /> Address: Po COMMERCIAL: <br /> City,State,Zip Code: L-- o( INDUSTRIAL: @ R/W <br /> Area Code -Telephone Number. RESIDENCE: <br /> PAVED FRONTAGE <br /> LENGTH: Ft. X WIDTH: Ft. <br /> The undersigned hereby ap lies for permi sioo((��to excavate,construct and/or otherwise encroach on County Highway Ri ht-of-Way on the <br /> side of "(:y tS c approximately /S � fe�t/mile �e. <br /> of r1 P\r by installing <br /> Work will <br /> commence on or about for approximately days. <br /> SKETCH(Separate sheet may be submitted) <br /> Will this project be self-installed? YES X NO Contractor s License <br /> M.\CENTRALSERVICEMLERICALIPU&SV.WKNASTER.PSIENCROACHMENT PERMfi DRIVEWAY.DOC (09113} Page 1 of 2 <br />