Laserfiche WebLink
P5-c?o 2 7a <br /> COUNTY OF SAN JOAQUIN Date: <br /> DEPARTMENT OF PULIC WORKS <br /> Received By: SCS <br /> DRIVEWAYS AND PAVED FRONTAGES <br /> PERMIT APPLICATION CR#: e .3940o'L? <br /> APPLICANT OFFICE USE ONLY <br /> Name: <br /> j' Address: 1.2 <br /> 2 C) JOB#: 11005 ISSUE DATE: <br /> 1 <br /> City,State.Zip Code: -- r ' to APN FEE DUE: f2o7 — <br /> Area Code -Telephone Number: EXP. DATE: DRIVEWAYS: <br /> STREET: Vc-a,-rAS Ayr, x <br /> SITE INFORMATION: AREA: yyl�q �,q QUAD <br /> Parcel Owner's Name: TYPE: �LLJ <br /> j' Site Address: 7 "_' FORMS: <br /> City, State,Zip Code: NOTES: <br /> Area Code -Telephone Number: <br /> DRIVEWAY <br /> CONTRACTOR TYPE: QUANTITY WIDTHS <br /> Name: AGRICULTURE: @FRONTAGE <br /> Address: COMMERCIAL: A PTioa.) <br /> City,State,Zip Code: INDUSTRIAL: @ R/W <br /> Area Code -Telephone Number: RESIDENCE: <br /> PAVED FRONTAGE <br /> LENGTH: Ft. X WIDTH: Ft. <br /> The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on the <br /> _ side of approximately feet/mile <br /> of by installing <br /> Work will <br /> commence on or about for approximately days. <br /> SKETCH(Separate sheet may be submitted) <br /> Will this project be self-installed? YES NO Contractor's License <br /> M.,SENTRALSERVICES CLERICAL'PUB-5V.'/VK/MASTER PS�ENCROACHMENT PERMIT DRIVEWAY.DOC (10/09) Page'of 2 <br />