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APPLICATION FOR'ENCROACHMENT PERMIT <br /> PLEASE PRINT: p L/ <br /> Date l„2 _ �/ "- �7 OFFICE USE ONLY <br /> To: San Joaquin County JOB# 10-0 0 S REF# <br /> Department of Public Works APN CR# <br /> pk/� ` EXP.DATE j-I -(f <br /> 1 ' /G'll&eld �.c///lAGi/dam 111d VALID '5-1-15' TO ,�-I '(s DRIVEWAYS: <br /> (Applicant Name) STREET 06dd got <br /> AREA <C u In Y% QUAD s <br /> / q�LtZi� TYPE <br /> (Mail in Address) FORMS <br /> I/ <br /> NOTES <br /> (City,State,Zip Code) <br /> 707- X103 - 11;?37 <br /> (Area Code-Telephone Number) <br /> Sketch (Detailed plans may be submitted) <br /> Our job calls to raise 8 PG&E towers and set 1 steel pole all on the South side of Dodds Road. <br /> Starting at the east end of the project, the first tower is 0.5 mile east of Henry Road and goes <br /> west 3.3 miles to 800 feet east of Escalon-Bellota Road. The job calls to install a new 10 foot <br /> vertical extension at the base of the tower; the drawing are included.This requires the use of a <br /> crane to lift the tower so the base can be installed.The crane needs to be setup in the road and <br /> will block 1 lane of traffic on Dodds Road. The total time to complete one tower is about 4 hrs. <br /> Our Traffic Plan is included with the encroachment permit application requesting 1 lane closure <br /> and using 2 flaggers. <br /> The undersi n d hereby applies for per is ion to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the -5,2!yla side of approximately x'00 feet/ 4-7 <br /> of ew e A by performing the following work(description of work): <br /> e Rau e U o A. <br /> S'T«L d cc�ers <br /> Work will commence on or about /1,44eh / / for approximately O 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 /> Si re of Applicant-Title Date - - <br /> M:ICENTRALSERVICESICLERICALIPUB-SV.WKUAASTER.PSIENCROACHMENT PERMIT APPLICAT1014.DOC (09113) <br />