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APPLICATION FOR ENCROACHMENT PERMIT <br /> PLEASE PRINT: <br /> Date February 18, 2010 OFFICE USE ONLY <br /> To: San Joaquin County JOB# if REF# <br /> Department of Public Works APN CR# <br /> EXP. DATE r Zcip _ <br /> ATC Associates for Jay Mcllrath VALID /r Z6lo TOr Zoo DRIVEWAYS: <br /> (Applicant Name) STREET <br /> AREA S{ 6 QUAD <br /> 1117 Lone Palm Ave Suite 201 TYPE WhAAOhlm ( eta <br /> (Mailing Address) FORMS Ltl1A� <br /> NOTES <br /> Modesto, Ca 95351 <br /> (City, State, Zip Code) <br /> (209) 579-2221 <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans may be submitted) Proposed <br /> -MNA location of MaaoAi, , <br /> \ o j monitoring <br /> Masc A d <br /> � L vasa <br /> — – s Igo Pv�q X26 E <br /> MW7A 6 Sa\esk Sko&_35 <br /> Ma7c tiz Mao GP g52\ <br /> Male for 3 ,03 <br /> p919 <br /> VACANT LOT `Z <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on Countv Hiahwav Riaht-of-Way on <br /> the south side of 4126 E. Main Street approximately 15 feet <br /> of the intersection of E. Main with Annabelle Court , by performing the following work(description of work): <br /> ATC Associates is under contract to conduct a aroundwaterinvestLqation the result of an nd rground Storage Tan{ <br /> Leak at 4075 E. Main in Stockton Ca. This investigation is being directed by the San Joaquin County Environmental <br /> Health Department. Part of the current phase of this investigation involves installing a monitoring well in the sidewalk in <br /> county right-or-way in fr-ohlof f86 Auto Sales 4126 E Main St Stockton, CA 95215. <br /> Work will commence on or about- March 1. 2010 (subject to permitting) for approximately 3 days. <br /> I,the undersigned,certify that I am the owner of the respective property, or am qualified to represent the owner and agree to do the <br /> work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br /> Michael D. Sonke Project Manager ATC Assoc February 18, 2010 <br /> Signature of Applicant-Title Date <br /> ElPU&SVVWMMISTER.PSiENCROACHP&NTPERMTAPPL'CATION.DOC (Di=) <br />