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FROM :CALIFORNIA WATER SEROICE FAX NO. :2094640195 Tut. 06 2009 02:23RM R 2 <br /> A.PPLIXI &Tjow P'OR WCR0AC 'N•T PERMIT <br /> Date <br /> OFFICE VSE ONLY <br /> Tot Saxe �7oaquin County aTOB 0&V 77 <br /> Department of Public) T�orke <br /> AM # <br /> (4pliGant z�r `rpr,z� •30 eco ,�.10�.�.. DRxo UyS: <br /> s'i'r <br /> 1 ARS MKI Q= Es ,� — -----... <br /> Mailing Admdr* TYPE c t.(, pj„Ls <br /> FORMS ' <br /> 5^ - Q� NOS <br /> (city, State, -Zip Coal) <br /> cRR - IAb� w % <br /> (Area Code . xeYeph a Naunbez) <br /> Sketch {Detailed plaza tna be s$bmitted) <br /> The undersigned hereby app3.i far <br /> othezwase encroa.Ch•On Permissiort to.excavata, construct and/or <br /> Count 1,aghway 1?ig1x�-of� Sr:.o .the i43d�:.of <br /> _ approximately <br /> ofd - f <br /> £013 wing work (description f r woxk) : by perforg the <br /> Work will co=wzce on or'abo t <br /> •—�� days, for appxoximately <br /> r, the uaddrzigaed certfY• t Z am the 0wnez' of.the xespecti�re prc ext or <br /> qualified to represent the r agree to do the woxk described abava,�to <br /> aecoxdance wi the Che rel?e , r ations'of San <br /> inspection anti appvov�j J 0itgt n'c6=ty and 6!4b ji ect to <br /> Umw <br /> •1+-9natLlre of AApplicaant <br /> Date C� <br />