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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date 04/22/15 OFFICE USE ONLY <br /> To: San Joaquin County F�PN <br /> t/0OLQ5" REF# <br /> Department of Public Works CR# <br /> XP.DATE <br /> Zayo Group c/o Monica Pino VALID <br /> (Applicant Name) STREET 2— -%QUAD <br /> TO �h_! I DRIVEWAYS: <br /> AREA <br /> 2700 Merced St TYPE <br /> (Mailing Address) FORMS <br /> San Leandro, CA 94577 NOTES <br /> (City,State,Zip Code) <br /> _916-804-0573, monica.pino@zayo.com <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) <br /> Please see drawings and traffic control plans. <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the side of Byron Rd <br /> of approximately feet/mile <br /> Zayo fiber optic cable placement(aerial) build,'pole attachments to existing AT&T/PG&E <br /> phe oles, traffic aff cwork(cont control, all scription of work): <br /> Work will commence on or about 05/01/15 for approximately 180 <br /> 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 /> 4/22/15 <br /> Signature of Applicant-Title Date <br /> E.VPUB-SV.WKAIASTER.PSVENCROACHMENT PERMIT APPLICATION.0013 Iowa) <br />