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,APPLZCATIOX FOR ENCROACM=Y PERMIT <br /> Date <br /> 10-716-06 <br /> OrrXCE USX ONLY <br /> To: San, .Toaguiri County JOS � REF # <br /> Department of Public works, ARN CR # <br /> Matheson , Fast Freight RXV• DATR <br /> VALID, A0-//-0C-;, TO DRTVMAYS <br /> - <br /> (Applicant Nam) STR>aFFT 6Agr E1yyW„�,��sAG6 <br /> AREA, 416 <br /> Po Box 9,70 . TYPE ' A4 UL& <br /> (mailing Address) FORMS. 1 - <br /> NOTE <br /> (City, state. .Zip Coda) <br /> 916 685-2330 <br /> (Area Code - -Telephone Number) <br /> sketch (Detailed plans may be submitted) <br /> 'b See Detailed Site repair and photos attached. <br /> This . <br /> This permit request. is after the fact due to an after hours emerg ncy <br /> repair that was performed :on the East frontage road of Hy 99 , <br /> one quarter mile north of eight mile road, This repair was necessary <br /> due to a vehicle -accident and diesel sTill. <br /> The undersigned hereby applies for permispi.on to.excavat.e, gom—truct and./or <br /> otherwise era,otdach-ou•'Ca'c=y'Highway Right-of-Way'.,on the sidp.;af <br /> Hy. 99 fruntage rd. approximately 1/4 mile?-eet/mile north of 8 mile <br /> of , UL trid k. 1 .414On'MR..� hau1t <br /> fol.l.owi.ng work (description oi•:work) : ,c ame , •, <br /> work will commence on, or about Work Performed on 10-11-06 for approximately <br /> days. <br /> 1, the undereig:4ed certify that x am the owner of, the respective -property, or am <br /> qualified to represent the owner and agree to ria the work described above in <br /> accordance with the zules, regulations of San Joaquin County and subject to <br /> iaspecti.on an, ppxoval. <br /> Signature of .A.pPli.cant Title J Date <br /> . F1T.8'I'gti.P9\117�9CfIDL f6/00) ` <br />