Laserfiche WebLink
Nov.• 13. 2013 4: 01PM Pacific Gas and Electric No. 1150 P. 2 <br /> APPLICATION FOR ENCROACHMENT PERMIT <br /> PM#3085 4534(Please include this#on all Invoices and correspondence) <br /> PLEASE PRINT: <br /> Date November 13,2013 <br /> OFFICE USE ONLY <br /> To: San Joaquin County-Highway Department JOB# 7352-4 REF# <br /> APN# - - CRV# <br /> PG&E—Katie Lee <br /> (Applicant Name) EXP. DATE / /s j¢ <br /> VALID �2 r 3 T 1115114 DRIVEWAYS: <br /> 3185 'M'Street—2"d Floor STREET ,,�,a <br /> (Mailing Address) <br /> AREA,(M QUAD z <br /> Merced,CA,95348 TYPE ka FORMS <br /> (City,State,Zip Code) NOTES: <br /> 209-726-6342/Fax:209-726-6437 <br /> (Area Code—Telephone Number) <br /> Sketch (Detailed lans may be submitted) <br /> `aid Job 4o mades4o A* PePc.$E (P%r-cew 0z1;:n) 1,//413@ <br /> The undersigned hereby applies for permission to excavate,construct, and/or otherwise encroach on County <br /> Highway Right-of-Way on the East side of Santa Fe Road approximately 961 fee Ile <br /> North of Santa Fe Road/Henry Road intersection by performing the following work. <br /> (Description of work): Provide(1)4'x4' bellhole(s)at 23023 Santa Fe Road in Escalon,to cutoff and plug <br /> existing 3/"STL gas service stub. <br /> Work will commence on or about December 1,2013 for approximately 30 days. <br /> I the undersigned certify that I am the owner of the respective property,or am qualified to represent the owner <br /> agree to do the work described above in accordance with the rules, regulations of San Joaquin County and . <br /> subject to inspection and approval. <br /> -Gas Engineer Estimator November 13,2013 <br /> GNATURE OF APPLICANT-TITLE DATE <br />