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FROM PAC BELL/STOCKTON (MON) 10. 30' 06 9:31/ST. 9:31/NO. 4800000943 P <br /> Mati 13 OS 10: 41a Valued Customer 209 468-8324 p. 1 <br /> APPLICATION FOR ENCROA•CM4FXr PERMIT <br /> �- OFFICM USE ONLY <br /> L <br /> To: San Joaquin Cotin7w,?3 <br /> ty <br /> D�ticuc LcacuL ofPublic worx-, �N ---,-�-- REF 4. <br /> / - r_x # <br /> Exp_ DATB <br /> VALID TO DRIVEWAYS: <br /> } ( PlieaaC Name) — STREET !:C-ATTo ; qD i- <br /> f1/�LJfQrJ -' AREA STo%7at) ouAD N6 <br /> 'TYPE <br /> FORIMS <br /> (Mailing AeQ=ergg) <br /> 20 NOTE <br /> (C;.ty,' Stetter, zip Code) <br /> (Areal Cede - Telepxyane NUAIUex•) � ( - <br /> Sketch (Detailed Mara :,m4y bQ suhmi.ttcd) ` <br /> rill <br /> i <br /> -A I <br /> The Undersigned hereby applies for permi"iOu to excavate, construct and/or <br /> ath6rwise- encroach on q4 aunty Highway Right-Of Wer " • <br /> c f Yon ther_rr, k,, <br /> ��" d c�? <br /> !' appzc�ximaLGl <br /> �y pex formizag the <br /> Following work (@eser t�CIO,, of work) - - <br /> -tomes ACL t. -� ,' <br /> -r <br /> Lam}:' <br /> work w'11 ommeTlce on or <br /> days. -- <br /> _ = -�--- for approximately. <br /> Y, the undersigned cer.t.ity that I am the owner of the respective property, or am <br /> qualified to represeitt the owner and agree to do the work described above in <br /> accordanr.F w;.rh th rulatd, reg,,latiazk of Can Joacruin ti,utmLy and subjec4 to <br /> --- -ills C- - ai d c3D <br /> _oval. <br /> afurs a A?-plicant - Tir;.s <br /> �ST6fl.esl�r$s�, tc,oa, <br />