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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT; .......It.7 <br /> PSI. ice[USE ON <br /> fif,L i <br /> i <br /> r;i. ':•'J!i .Il?r3Clltl'"1 P�,i�'1�Ire� j �!_�if�R _'.I_LLV.V._� _ �1t_I' �i <br /> De «rtmi-rtt ci Public W•ark_ I A_,t <br /> 1 . 15 5� <br /> .;'�: i'z:`:r1 L i•�.�1;'Lir tet.I'.l,r i,*'4t { ;' S -sr F:l,l y _ _ Tsr ..���f'i'� I <br /> APPlicanf Nairne) L , <br /> AFiEA <br /> i�.fli_, _4s'.f&_,.', ".AtiN• ` ,.oily"�. 'r`L' ri�Gt� I lC �Q�/ `"� I <br /> Wailing Address) FORMS 1/b/ <br /> NOTES <br /> (City,State,Zip bode) <br /> (Arqa Cada-Telephone Nijmbe� <br /> tt <br /> ►'1 .�.«�0�Y► <br /> 9-:sten 'etailed Mans matt' be F-: e' <br /> I <br /> l I <br /> , I <br /> I h h�Pff Ly app!2s for Dr-mission is eym ati,co stpict znd,ar ukrlerwis=encmach on Giiun'hi High'iav Rgh1-n`,o,+'a f cry, <br /> "he �:,'7T rtt cif r,�_;��r i':r. _ _s._..._ O tprDx1rn3t l/ <br /> c'1 arc '�_ a by perflrminq�,101,o��ng�,��_�rk.6r�scriptic�i ct�sor}..;i: <br /> {'L''y' {• (.- -J„� <br /> V%iort will vjrYt;lr''tG`v on or an4Uk ��._�•._ __ fair ppltroxirrma Cly <br /> °I'!� t!rnranu ,crit rht I ami�. nruf the rsgective pra.mj, ,jr gim gLaliFi=d to nY !esent iP: 4Pars✓ r:,ir to r:i:i Itt <br /> ,,os-( descrlbec a rai; r r ;rjrr:�,7r W1.1 li^:4)-cies-.and regulatons of Sat.cia�a•_tn�'ounty and subjer',�to inmpe Ln rind aP�,."Ival. <br /> K �•__... :�,.Y-r.';. ;i�=;r� .W_._tom:..._ <br /> tignature of Applicant-Titt2 Date <br /> i�'.}.:A9Ms'-f`:."v:��C•Al_iiiTtL7:f.-=.^J':.r.Sii •. . <br />