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V�A 2 0,9 9; 2A V k','O IL UN16TA I!LCr TR Tr 4 3C' I'Q6r' <br /> N0. o.F 2;'a <br /> APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date March 27, 2009 OFFICE USE ONLY <br /> To: San Joaquin County JOB# REF# <br /> Department of Public Works APN CR# <br /> EXP.DATE ja - <br /> Emilia Sanchez VALID? 3 TO S l v DRIVEWAYS: <br /> (Applicant Nana') STREET / w <br /> AREA MAD r <br /> 1980 Davis St TYPE "} C-C&-ira <br /> 0mlmg Address) FORMS <br /> �r.? .c.. 31C�,1,,�Q <br /> NOTES <br /> San Leandro, CA 94577 <br /> (City,stia2e,4 Code) <br /> (510)430-9505 <br /> (Area Cade-Teleptane Number} <br /> Sketch(Detailed plans may be submitted) <br /> See attached <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-0f-Way on <br /> the sideof Alpine Road approximately 250 ` feay ile <br /> of Route 88 by performing the follgwing work(description of work): <br /> Installation of traffic signal and flashing beacons. Boring,esca-rating ) <br /> will occur in the ar a <br /> Work will commence on or about March 3 for approximately 40 days. <br /> 1,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 /> F'roject Manager March 27, 2009 <br /> gnaWre a Applicant-True <br /> Date <br /> E''AUMV.WKWK5Y4UWMRQ%GNefP9BWAPPUtATUIDW ft") <br />