Laserfiche WebLink
DEPARTMENT OF PUBLIC WORKS <br /> DRIVEWAY AND PAVED FRONTAGES <br /> PERMIT APPLICATION <br /> APPLICANT OFFICE USE ONLY <br /> JOB#11005 ISSUE DATE <br /> Name APN j _Qc,Lp - p rj FEE DUEil80 <br /> EXP.DATE DRIVEWAYS: <br /> Address STREET M <br /> c City,State-Zip Code TYPE <br /> G tc h C-q. FORMS <br /> (Area )Telephone OTE <br /> SITE INFORMATION <br /> Farcol Ownces Name <br /> Ji <br /> Site Address RIVEWAY <br /> Z g TYPE QUANTITY_ WIDTHS <br /> City,StE Zip Code GRICULTURE @ FRONTAGE <br /> C fi (SCF COMMERCIAL <br /> ( Coda)Telephone11DUSTRJAL R/W <br /> D <br /> CONTRACTOR PAVED FRONTAGE <br /> LEN <br /> GTIL Ft. X WIDTH:. Ft <br /> Name <br /> Address The undersigned hereby apnlios for permission to encroach On County Highway <br /> Right-of-Way on the_ Of ft4A)AJ %7 <br /> City,State-Zip Code Y y2 E A-s'1' of <br /> by installing <br /> (Area Code)Telephmw <br /> Werk <br /> will eon=ence on or about for approximately days. <br /> SKETCH(Separate sheet may be submitted) <br /> Will this project be self-installed? NO YES Contractor's License <br /> AeomWer AW\FormUkiveway2sved ff a tag, <br /> ,y <br />