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FROM :CALIFORNIA WATER SERUICE FAX N0. :2094640195 Jul. 28 2809 12:0-3RM P 2 <br /> APPLICATION FOP. BUCp.OAC mb T PERMIT <br /> PL AS 1?RINT:" <br /> Date OFFZCs IISB 4Y <br /> TO: San Joagain Comty JOB # <br /> Depxrtment of Public Works APN a <br /> CALFS F.�11 P� 7EXJP. DATEA"•�oS� <br /> VAZ3,b• • .V <br /> /O• •,9I�RN8i4AYS; <br /> {APpliCa►ut Naze) gTDw.V.,j <br /> \ffic)VA Sir <br /> TYPE -4=t <br /> 2 � <br /> (Mai,lj►g Addrose) FORMS <br /> NOTE <br /> (City, State, .Sip Code) <br /> (Area Code - Telephone DTumber) <br /> Sketch (Detailed pilaris may be sisbmi.tted) <br /> The undersa gnad hereby apples for permission to.axcavate; Construct and/or <br /> otherwise-eszcroach on •Co=byr,Fighway Right-of-Wa on the <br /> y- <br /> of R3]1 1P� AVS aPProximately 1' +l. ( e /fie _ <br /> , <br /> follawiag work (description ofby'Pexfoxrazng• the <br /> ;work) : <br /> r <br /> 'Rork will +commence oa or'about � <br /> days. Wl ' for approximately <br /> r, the umdtirsigued certify. that I am the owner of.the re spective •property, or am <br /> qualified to represent the owner and'agraccor4ee to c10 the urark described above in <br /> inSpec ionzxce with the rule , regsilations'of San Jaac,�uin Cauaty and subject to <br /> inspection and approvaal,. r' <br /> as s acture of AffP33caczt - Txt .0 t ' �`•� " 09, <br /> Date <br /> �sz$r.aiutsccc�n ww) . <br />