Laserfiche WebLink
COUNTY OF SAN JOAQUIN Dater/ <br /> DEPARTMENT OF PUBLIC WORKS Received by <br /> CR# O <br /> DRIVEWAY AND PAVED FRONTAGES <br /> PERMIT APPLICATION <br /> APPLICANT OFFICE USE ONLY <br /> JOB#11005 ISSUE DATZ <br /> NameAPN47,03 _ 240. 04 FEE DUE lP0 <br /> Q ik o EXP.DATE_ _ DRIVEWAYS: <br /> Address STREET <br /> r T- AREA GDS/ QUAD il/E <br /> Cit§,State-Zip Code TYPE <br /> CA I r�p 3�L FORMS 77 <br /> '—(Area Code)Telephone NOTE —� <br /> S�rE INFORMATION <br /> D d n.e,.(cJ � Th a w��s 40 PIPG <br /> Parcel Owner's Name <br /> 7r cc J <br /> nI Site Address <br /> 1�s- DRIVEWAY <br /> City,State-Zip Code TYPE QUANTITY WIDTHS <br /> GRICULTURE @ FRONTAGE <br /> (Area Code)Telephone COMMERCIAL <br /> INDUSTRIAL @ R/W <br /> Z YJ--G�(- 7� lo l r <br /> SIDENCE 1/ <br /> CONTRACTOR PAVED FRONTAGE <br /> LENGTH: Ft. X WIDTH: Ft. <br /> Name <br /> Address The undersigned hereby�,hliesfformissionto encroach on County Highway <br /> Right-of-Way on theside of �j9,Q i� 2AAA <br /> City,State-Zip Code approximately / L- 1A.M137%1 of J'Aele Tt4*1 <br /> P-:t>• ,by installing <br /> (Area Code)Telephone <br /> Work <br /> will commence 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 /> Acce-Ter Apel —OrivewayPaved firo¢tage <br />