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10/2312006 13:55 209-848-0161 MOZINGO CONSTRUCTION PAGE 02/04 <br /> 1,q/17/7RRF <br /> 15!77 ?pgdp$44']d G,lnl PFR.MM_ PA(;F R1 Ip7 <br /> APPLICATION. OR FNCROA m PURTT <br /> ' •LEAS _PBT_: . <br /> Date "G omr <br /> To: Sac Joagttrin Co=ty :,TOS <br /> DeUartmatt of Public Works <br /> ` EXP. DA= T _ <br /> r-i C Z i,r lrW Co n'S-tY LkCt•%C'r`1 � VALZI} <br /> (ilgpiiaaat Mama) StTR=T w- TO <br /> AMML ESc-![off <br /> (hail g Address) k�O1ZNL9, - <br /> (A"& Code - Telephone Reber)., <br /> 8%at±ali (DO-tailed pIAns my be eii'bntfttsd) <br /> il°► S1'EUpt., G.oNbcTibNS H'rt-Ac.c�re.D yPi . <br /> The, uut:dersigned hereby•appljes fCax. peso dg'Riola to,eacavatsp coutruct and/or <br /> • oths�vise-eaa�ark�•an •C+ot>Fn�ySri,gh►ray Stit�ht-of•-4�Ir-•on.•tFb,e . ,. •:..-- ._ • , �ide,:b� •- - . <br /> t��t1t approximately � feet/mile <br /> of G. `' • ' by,' *J-f tmistg Zhu <br /> foiJ.owing work (dP3s=lpt•ion of;+Park) : <br /> r , <br /> Work millc�ence CM or•about 1 fCir a<pproacimate�y <br /> . , -. �. 1'�, days. •• • <br /> r, the ;.ul derstgred cdrtif'y thA Y ani the ,0=aV o� tha rasgective-propertyr az am <br /> eJtsa]3�i;ied to xepzesent tkte oavr�Or aixci agree to do•,the 'vmrk daeCxxbed-above is <br /> accordance with, the rules, regadticam-of Bart Joagtt� Coizntji► and subject toi»�seati.on attd approiral. <br /> Sf,yaa b=Q e£ t - Tit e ` <br /> - Date <br />