Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date OFFICE USE ONLY <br /> To: San Joaquin County JOB# REF# <br /> Department of Public Works APN CR# <br /> EXP. DATE <br /> VALID TO DRIVEWAYS: <br /> DRIVEWAYS: <br /> Pacific Gas & Electric STREET 6 54 <br /> P.O. BOX 93O AREA ���r�� QUAD <br /> TYPE ha 102 <br /> STOCKTON, CA 95201 FORMS 3SUIV <br /> 209-942-1627 NOTES <br /> Sketch(Detailed plans may be submitted) <br /> Traffic Control Plan <br /> shall be as per <br /> See attached sketch. current M.U.T.C.D. <br /> PM <br /> California supplement <br /> X233 �I�� <br /> Notif. <br /> The undersi ped hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the�l1csideof Webb ' -. approximately JDA ' feet/wiL- _ <br /> of Von PVL. jg cY by performing the following work(description of work): <br /> o A2 b <br /> Work will commence on or about 1 —for approximately 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 Applicant-Title Date <br /> E:N KIMASTERPBIENCROACNMENTPERMITAPPUCATION.DOC (01108) <br /> Return Permits to: <br /> CCD <br /> P.O. Box 930 <br /> Stockton, CA 952.01-0930 <br />