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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: P S — / S(� 78 7 S Z 3 S <br /> Date June 30, 2015 OFFICE USE ONLY <br /> To: San Joaquin County JOB# ( I oo V � REF# <br /> Department of Public Works APN c/ 7 ADO OZ CR# <br /> EXP.DATE -7 Zq t6 <br /> Clark & Sullivan Construction VALID - S' TO -7-2!9-1' DRIVEWAYS: <br /> (Applicant Name) STREET <br /> AREA QUAD L <br /> 2024 Opportunity Drive Suite 150 TYPE <br /> (Mailing Address) FORMS <br /> Roseville, CA 95602 NOTES <br /> (City, State,Zip Code) <br /> 916-677-7622 or 916-338-7707 <br /> (Area Code-Telephone Number) <br /> Sketch (Detailed plans may be submitted) <br /> Please see the attached DRL group drawings of Village Oaks School Parking Lot at 1900 <br /> Swain Road, Stockton, CA. <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the South side of 1900 Swain Road, Stockton, CA approximately 60/feet feet/mile <br /> of two new driveway approaches by performing the following work(description of work): <br /> Please review attached DLR Group drawings C2.1, C6.1 & C6.2 of 1900 Swain Road, Stockton, <br /> CA. The work consists of demolition of existing curb/sidewalk to install two new driveway <br /> approaches along Swain Road at the east side of Village Oaks School <br /> Work will commence on or about July 15. 2015 for approximately 2 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 /> Signature of p licant-Title Date <br /> E:IPU&SV.WKIMASTER.PSIENCROACHMENTPE ITAPPLICATION.DOC (01108) <br />