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r <br /> APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> -�� 5 - 130 3 z 5-0 <br /> Date November 21,2013 OFFICE USE ONLY <br /> To: San Joaquin County JOB# _i10005 REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE <br /> ~ <br /> Mozingo Construction,Inc. VALID fl_:/161=1 TO DRIVEWAYS: <br /> (Applicant Name) STREET n 1,11ky er A4 Peas k Av, <br /> AREA /�,ty�t((A QUAD <br /> 751 Wakefield Court TYPE �C <br /> �a�t c Cons t <br /> (Mailing Address) FORMS ss�yJlt/ <br /> NOTES <br /> Oakdale,CA 95361 <br /> (City,State,Zip Code) <br /> 209-848-0160 (Contact:Nicole Davis) <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> PERMIT APPLICATION IS FOR TRAFFIC CONTROL ONLY <br /> See attached traffic control plan. We are installing underground utilities in the City of Manteca ROW on Oleander Avenue, <br /> but traffic control will encroach in the County ROW. No digging will be done in the County ROW. <br /> Traffic control will be in effect for approximately two months,and remain in place 24/7. <br /> Traffic control will be removed once the road is re-paved. <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the o- - 144810- approximately feet/mile <br /> Of SEE ABOVE , , by performing the following work(description of work): <br /> Work will commence on or about December 9,2013 for approximately two months --days- <br /> 1,the undersigned,certify that I am the owner of the respective property,or am qualified to represent the owner and agree to do the <br /> work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br /> Nicole Davis,Project Coordinator November 21,2013 <br /> Signature of Applicant-Title Date <br /> M:ICENTRALSERVICES%CLERICALIPUB-SV.WKIMASTER.PSIENCROACHMENT PERMIT APPLICATION.DOC (09/13) <br />