Laserfiche WebLink
COUNTY OF SAN JOAQUIN Date: /' l g l 0C� <br /> Received by <br /> DEPART N ENT OF PUBLIC WORKS CR# L)3 0 9 3 2n, <br /> DRIVEWAY AND PAVED FRONTAGES <br /> PERMIT APPLICATION <br /> OFFICE USE ONLY <br /> APPLICANT ISSUE DATE 1 / <br /> JOB#11005 �.� FEE DUE <br /> Name APN 2 g -��� -�_ <br /> [� EXP.DATE DRIVEWAYS: <br /> C` ( / STREET �lyf : <br /> a+ �TQUAD <br /> / 7 SrJ i D� s <br /> City,State-Zip Code <br /> TYPE <br /> FORMS <br /> (Area Code)Telephone NOTE <br /> SITE INFORMATION <br /> p 1 Os Ne <br /> e `� <br /> _ ite Addrf gs DRIVEWAY <br /> cZ 3 ©l L UY V TYPE QUANTITY WIDTHS <br /> Ci ,State-Zip Code G AGRICULTURE @FRONTAGE <br /> ©� r^ `J' 3 COMMERCIAL <br /> (Area Code)Telephone INDUSTRIAL @ R/W <br /> SIDENCE <br /> PAVED FRONTAGE <br /> CONTRACTOR GTH: Ft. X WIDTH: Ft. <br /> LEN <br /> Name <br /> The undersigned hereby applies for permission to encroach on County Highway <br /> Address Right-of-Way on the Vlo!a sideof (}l+ye- Ave. <br /> approximately--Q-,LZ— <br /> City, <br /> .9 Z feet/� 8A9%—of St. <br /> City,State-Zip Code99 meal ing ur <br /> (Area Code)Telephone T` <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 <br /> YES Contractor's License <br /> AccessTer Apff orm\DrivewayPaved frontage <br />