Laserfiche WebLink
COUNTY OF SAN JOAQUIN Date: 12,20-2-0( <br /> DEPARTMENT OF PULIC WORKS <br /> DRIVEWAYS AND PAVED FRONTAGES Received By: <br /> PERMIT APPLICATION CR#: <br /> APPLICANT OFFICE USE ONLY <br /> Name: T1AGD T MA12-i )A V(ALLNCI <br /> Address: 0 JOB#: 005 ISSUE DATE: <br /> City,State,Zip Code: �� E C� C q 53 APN FEE DUE: <br /> Area Code -Telephone Number: 20 q - U / EXP.DATE: DRIVEWAYS: <br /> STREET: t... „1_ <br /> SITE INFORMATION: AREA: �nae�, Q AD t <br /> Parcel Owner's Name: 5AN-1IA Cs0 VA LEU/� TYPE: <br /> Site Address: 2 g Q 7 A U TII J F2_0 FORMS: <br /> City,State,Zip Code: I�N t' Cf1v q5 �SL NOTES: <br /> Area Code -Telephone Number: <br /> DRIVEWAY <br /> ---CONTRACTOR-- _- ._ ____ -_ -TYPE-.-",-------- - -- _QUANTITY - -- WIDTHS-- <br /> Name: AGRICULTURE: FRONTAGE <br /> C Address: COMMERCIAL: <br /> City,State,Zip Code: INDUSTRIAL: @ R/W <br /> Area Code -Telephone Number: RESIDENCE: <br /> PAVED FRONTAGE <br /> LENGTH: Ft. X WIDTH: Ft. <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County ay Rig�- I-Way on the <br /> side f approximately e e <br /> of ' rsk'i L /Y] by installing <br /> Work will <br /> commence on or about for approximately days. <br /> SKETCH(Separate sheet may be submitted) <br /> x Will this project be self-installed? YES NO Contractor's License <br /> M:ICENTRALSERVICESICLERICALIPUB-SV.WKIMASTER.PSIENCROACHMENT PERMIT ORIVEWAYAOC (09113) Page 1 of 2 <br />