Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date OFFICE USE ONLY <br /> To: San Joaquin County JOB# -] d-Q2 . REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE <br /> VALID h ¢ l S TO 4;t S-l 5 DRIVEWAYS: <br /> Pacific Gas and Electric Co. STREET <br /> P.O. p-aB®x 930 AREA Lalli e QUADa N i%��O <br /> Stockton, Cf/� 95201 TYPE ee/lit(e. <br /> �i FORMS 5S/ 14Z h/ � <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 311.21010. current M.U.T.C.D. j <br /> Notif. California supplement. <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the LyEST side of HCl. /0:Acle Rbapproximately 31/1z feetlpwAe n./o,eT/f <br /> Of �RIYlSTi2�.tlL �tA. , by performing the following work(description of work): <br /> 12 /2 S Al. Z_L..7 . s.*w. /226 <br /> 45CCOI'MrZE //04S nVZJe ZAS MW.'A! AV41 C1e7- DFF rb <br /> DCCU,P� i3�TG��Eic/ rv0 L/.s./� i9k1�1 ��E aF ��L/.Eniu�!% <br /> Work will commence on or about /—/9—/.5 for approximately 4719 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 /> GAS /9.L.'-. /1?-15-15/ <br /> Signature of Applicant-Title Date <br /> E1PUB-SV.WKWASTER.PSIENCROACNMEM PERMIT APPLICATION.DDC (01108) <br />