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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date 5/27/2014 OFFICE USE ONLY <br /> To: San Joaquin County JOB# t 2_() '�, REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE <br /> Johnathan Wright VALID 7-((,-14. TO 8-(,C- 14 DRIVEWAYS: <br /> (Applicant Name) STREET s, • ) <br /> AREA L (IG F' .�,,;( QUAD <br /> 4030 S Land Park Drive,Suite.C TYPE <br /> (Mailing Address) FORMS <br /> NOTES <br /> Sacramento,Ca,95822 <br /> (City,State,Zip Code) <br /> (916)455-0225 <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> Please see attached documents <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the North side of Messick Road approximately 2500 to 2700 feet/mile East <br /> Of Intersection N Duncan Road&E Messick Road _,by performing the following work(description of work): <br /> Performing a geotechnical investigation near the bridge on E Messick Road located-2600'East of the above intersection. This investigation will <br /> involve drilling two borings on either side of the bridge. Both borings will be drilled in the shoulder,and will only require partial lane/shoulder closure.A <br /> map with the boring locations,as well as traffc control Fagg ams,are attached to this document. <br /> Work will commence on or about May 29 to June 13 —for approximately Two 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 /> Signatur f Applicant-Title Date <br /> MICEMM&WRVICESCLetIULPJBSV.WMWSrEFLPS JCROACINENTPEPMRAPPl1GT)ON000[09'13) <br />