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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date ;7- 3 /4/ OFFICE USE ONLY <br /> To: San Joaquin County JOB# &C-1:30052..-(. REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE - t^ o t" <br /> VALID 7_1S_-?.014T0 DRIVEWAYS: <br /> Pacific Gas and Electric Co. STREET <br /> P.O. BOX 930 AREA QUAD -Fes <br /> TYPE ---- <br /> Stockton, CA 95201 FORMS a5&r� fz?fi <br /> NOTES <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 current M.U.T.C.D. j <br /> Notif. California supplement. <br /> I <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the tAF Sside of 4A17'N,onJ,1 approximately 131 feetlffte nlo2rl-1 <br /> of lg..J/VS1.11 7_DA,( S7: S72 -94 _,by performing the following work(description of work): <br /> 1113 s, �ArriYo vy 140e. <br /> Lfxcf4y'e9TC /1044 oLhfi' c�s /YlKIAI Ak)AL) 4.U7- DFS _�qE.evl =z5_ <br /> ALL LJQP_K TU 86 126eAbzLiE[) zX-1 L127— IgE&c-A. <br /> Work will commence on or about 7-21- 11/ _for approximately 90. days. <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 /> 00 Alm` 7-2 <br /> Signature of Applicant-Title Date <br /> E1PUB-SV.WKWASTER.PSIENCROACNMENTPERNTAPPLICATION.DOC(01)08) <br />