Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date 45 OFFICE USE ONLY <br /> To: San Joaquin County JOB# 7 3 00 SZ REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE 8-(-/S <br /> Pacific Gas and Electric Co. VALID¢-Z7-.[ TO -� - s DRIVEWAYS: <br /> ET <br /> P.O. BOX 930 AREAr QUAD <br /> Stockton, CA 95201 TYPE t3P I h6l PFORMS <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 3//yyy39 current M.U.T.C.D. j <br /> Notif. / 0/37990 California supplement. <br /> I <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the EAST' side of LoLj6e 2D. approximately 2G S feet444e Svurh/ <br /> Of L�Doy 13,e♦y I E 2A, !.>oo��BtZi� by performing the following work(description of work): <br /> /9y/0 LtJ2 ssoc 27�. <br /> EXGi4vR7'E /-1oc.E ouE.12 C.4S /Y!/9/A/ /AI& G[�f oF� SEf2tJ/GE. <br /> AZ-4 LJv21< ?D /3E P�•2.�o2rHE1� .zit/ i].iILT /,►ILEA. <br /> Work will commence on or about 'y-a 7-/5 for approximately !D. 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 /> L/1S A hE. Is, <br /> Signature of Applicant-Title Date <br /> E:1PUB-SV.WKWASTER.PSIENCROACHMENT PERMIT APPLICATION.DOC(07108) <br />