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APPLICATION FOR ENCROACHMENT PERMIT <br /> i <br /> PLEASE PRINT: <br /> Date y- .2 9-1 y OFFICE USE ONLY <br /> To: San Joaquin County JOB# 7300 5' REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE: <br /> VALID TO DRIVEWAYS: <br /> Pacific Gas and Electric Co. STREET <br /> P.O. BOX 930 AREA ; QUAD <br /> TYPE /� i f hd1 <br /> Stockton, CA 9520'! FORMS 5;IW] 1 2_2-g <br /> NOTES <br /> (209) 9W - /4/96 <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> Traffic Control Plan <br /> See attached sketch. Shall be as per <br /> PM 31071151 current M.U.T.C.D. j <br /> Notif. /o 7'730Y.2 y i California supplement. <br /> I <br /> The undersigned hereby applies for permission to excavate,construct andfor otherwise encroach on County Highway Right-of-Way on <br /> the /.AC- <7' side of EX TEa/S10A/ Rb, approximately 282. feetlmile .SOU>1 <br /> of /,(R &r C1 4 A ,_ -L0t61 J by performing the following work(description of work): <br /> 13 qYZ LEX rE 1,51081 RD . - B aIL L IAI& 7Z_R,!9- j o i <br /> E1CC10rJ/9TC //DLL` D!/F2 Lf9S /YI/9/.t! /?il/L� GG�r DFF SE.2lJ/CE' <br /> Ae'2&?11AA6A/TAs�.s�i9 L.7' REl�y4c�� 1�' ro .Go�cocJ. <br /> Work will commence on or about S-/2 -/I/ _for approximately �Sa days. <br /> i <br /> I,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 /> I <br /> /Z/ i <br /> Signature of Applicant-Title Date <br /> EAPUBSV.WKWAS'rERPMENCROACHMENi PERMITAPPIICURIN.DOC(07108) <br />