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A©!. Ll GA l 100 F0 R-u ENG 40,1kG !tlVS S._i�{ e��3]i''23 1 <br /> P!_Er IS .•RINT: V <br /> Date OFFICE USE ONLY <br /> To: San Joaquin Couniy 103 <br /> Depailtment of Public Worl s APP! CR <br /> EXE. DATE <br /> VALID _'1S_ TO _l�_IS II DRIVE�JaYS: <br /> (AL >) SIREE <br /> T <br /> AREA /� -� QUAD - <br /> `� <br /> (N�c€E[f:g t��.dt�:ae��) ( FCRP.�iS <br /> -, (7- - NOTES <br /> llfikrea Code- 'Mum Lae.,) <br /> Skeici� (D;,tailed plans;gay be suhmitfed} 1 <br /> i <br /> The Lndersigned hereby applies for permission to excavata,Construct andlor ctherL7ise encroach on Ccunty Higi;tvay Right-of-lAlay on <br /> the side o; approximately feei/mile <br /> of by perto, ing the following v ori;(description of work): <br /> kNoric will commence on or about `i- E for approximately ') days, <br /> I,tha undersigned, certify that I am the owner of the respective property, or am qualified io represent the oviner and agree to do the <br /> y,ork described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br /> err �,,' ; -Y �_.��-._ f _ - •_ _, ; - <br /> urgrP.iUre:i App =i r,le D'a"P <br />