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aY. Paoifio Gas and Ele,,tric Co. <br /> No. 3539 P. 2 <br /> ApPI..ICATION FOR EN�CROACHMNT PERMIT <br /> PLEASE PR1NT: I <br /> Date 5-1909 <br /> To: San Joaquin County-highway Department <br /> OFFICE USE ONLY <br /> PG&E JOB# 30712143 REF# <br /> (Applicant Name) ` PN —247_- _-_17 CRV# <br /> EXP.DATE •a <br /> 1524 N. CARPENTER RD. 'V'ALID TO <br /> (Mailing Address •09 (.6•f'al DRIVEWAYS:STREET Sr. ON <br /> MODESTO CA. 95351 AREA cAt,00j QUAD 5� <br /> (City,State,Zip Code) TYPE SSU- k'01-4 FORMS 1� <br /> NOTE •Z <br /> 209-576-6603 <br /> (Area Code w Telephone Number) <br /> Sketch (Detailed plans may be submitted) <br /> 5$0' <br /> O <br /> '1 <br /> AJV <br /> The undersigned hereby applies for e <br /> County highway Right-of-Way p rmisston to excavate, construct and/or otherwise encroach on I <br /> Countile N y on the �VV side of St. John Rd. approximately 580' <br /> -N of Catherine Ave. by performing the following work: (description of work). <br /> Exca'Vate a'x4'Bellhole to insert lealdn as service <br /> Work will commence on or about 5/26/09 <br /> for approximately----2 days <br /> the undersigned certify that I am the owner of the res ective prop <br /> I <br /> owner agree to do the work described above in accordance with hey,Or are qualified to represent the <br /> County and subject to inspection and approval, <br /> regulations of San Joaquin <br /> I <br /> ATURE OF APPLICANT-TITLE _52 f 1f Gq <br /> DATE <br /> 1 <br /> 1 <br /> f <br /> 1 <br /> I <br /> i <br />