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gstyt ? <br /> COUNTY OF SAN JOAQUIN Date: <br /> DEPARTMENT OF PULIC WORKS <br /> Received By: <br /> DRIVEWAYS AND PAVED FRONTAGES <br /> PERMIT APPLICATION CR#: d 394 <br /> APPLICANT OFFICE USE ONLY <br /> Name: <br /> Address: ' ,�%�g <br /> ,� - L Is_-r C, „r JOB#: 11005 ISSU E DATE: <br /> City,State,Zip Code: „ x c' ,-7- 5Pw>-j c7 APN 4707 t3•Lt 7 FEE DUE: <br /> Area Code -Telephone Number: ,.,o c _ k_7,!� , EXP.DATE: DRIVEWAYS: <br /> STREET: ALAYl 711 Am Z4z <br /> SITE INFORMATION: AREA: QUAD NE <br /> Parcel Owner's Name: 4 PE: <br /> Site Address:.2-jy FORMS: <br /> City, State,Zip Code: y a, c a NOTES: , <br /> Area Code -Telephone Number: <br /> DRIVEWAY <br /> CONTRACTOR TYPE: QUANTITY WIDTHS <br /> Name: AGRICULTURE: I @FRONTAGE <br /> Address: COMMERCIAL: <br /> City,State,Zip Code: INDUSTRIAL: @ RNV <br /> Area Code -Telephone Number: RESIDENCE: <br /> PAVED FRONTAGE <br /> LENGTH: Ft. X WIDTH: Ft. <br /> T undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highw Right-ot•Way the <br /> g�g side of N• t + approximately k2— fee i <br /> Of S by installing <br /> commence on or about for approximately days. Work will <br /> SKETCH(Separate sheet may be submitted) <br /> Will this proiect be self-installed? YES NO Contractor's License <br />