Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date 7/6/2015 OFFICE USE ONLY <br /> To: San Joaquin County JOB# -7 <br /> Department of Public Works APN CR# <br /> (Applicant Name) STREET le�>. <br /> AREA FAWA40)/QUAD JW Alt <br /> 850 STILLWATER RD. TYPE <br /> (Mailing Address) <br /> NOTES <br /> WEST SACRAMENTO, CA, 95605 <br /> (City,State,Zip Code) <br /> 925-327-0990 <br /> (Area Code-Telephone Number) <br /> Sketch (Detailed plans may be submitted) <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br /> the- WEST side of— EAST SONORA ROAD approximately 3/4 MILE feet/mile SOUTHEAST <br /> Of— STATE HIGHWAY 4 by performing the following work(description of work): <br /> REPLACE DETERIORATED POLE <br /> Work will commence on or about �rapp�roximately days. <br /> 1,the undersigned,oortify that|30the owner Ofthe respective property,{K80qU3|ifi8db]represent the owner and agree b>dnthe <br /> work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br /> DAVID SAV/TZ 7/0/2015 <br />