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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Jun. 01 2009 04:05PM P <br /> APPLICATION FOR EWCXOACMM= PERMIT <br /> P ika PRINT• C�Q <br /> Date Y �. DIME E OFFICE USE ONLY <br /> TO: san Joaquin County �O8 �� REF # <br /> Department Of Public works APN Cit i <br /> . DATE 1945.02 . _ - <br /> �3 R�1 vnt4 To 9'/So9 nxrvXwnYs: <br /> <App cant Name) STREET . :iz <br /> ARBA 1!2 c Qm ss - <br /> lMa3I 3.ag Addroaa) <br /> FORMS 5s .� y <br /> o� rear t <br /> (City" sbate. .Zip Code) <br /> (Area i_�%_ <br /> eYep L mD mmbex) <br /> Sketch (Detailed plWw may be $,sbmitted) <br /> The udersi.gne+d hereby applies for <br /> otherwiQe-eucroach,OU Count •. permission to.excavate, conatzuct anti/or <br /> 1W X Highway Right-of-Way.•oA.the 83d <br /> e:.4f <br /> of ,F'RA1�1C�.� aPProxiinately _fir /mike =t�14� 1 <br /> following work {description o£: � 1>Y Performing the <br /> ' ' -1•• • .. '• ' <br /> \\ h <br /> Work will commence on ox'about <br /> days•' for approximately <br /> z, the undersigned certify, that <br /> qualified to Y am the owuex of•the respective •prolert�', or am <br /> represent the owner and agree to do the work described above in <br /> accordance with the rule regvtatiarss'of San :7oa <br /> inspection and approval. C17 Ccwnty and subject to <br /> Signature Of applicant - WzLt2a <br /> Date <br />