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__ _ .- -- --.. .-.,•�••� . uv� i uri o I"fiUt CJl/bL <br /> APPI,XCATTON .FOR EI'cROA.� PTT <br /> PT,19AS P>!R �1T <br /> OFFICE <br /> ONLY <br /> Date <br /> To: San, L'oagtxi a County 2013 It 045 REQ' # <br /> Department of PuCR <br /> blic works A)'I`� ' <br /> G =15. MIT <br /> "'L'D. TO ARt xs <br /> (AppliCant Name) s ET _695�� AJC <br /> u <br /> S .l-e- AREA—rRACk - <br /> 3y 4A-A4 s eA ZN• TYPE Bop-1 <br /> (Tdaili ng Addrbse) FORMS. <br /> TOTE <br /> (city, 9tate, .zip Code) <br /> '7 . <br /> (Area Code - Telephone Number) . <br /> Sketch, (betailed pians may be sizbntitted) <br /> 5E_ElPh'cN <br /> I � , <br /> V <br /> The undersigned hereby applies forpermission to ,excavats, construct and/or <br /> otherwise-P�cxoa h on•County. Highway Right-of-Ift ••on-qe 0. T side.,.af <br /> � Alf. ST.approximately, 600 mile rEET <br /> .of 12 lu1.1,4 til . . , by' or orming the <br /> follpwing work (description of work) : So 0f►-AS <br /> F" �fLU�c J <br /> wox c wil ommenee on. or'about o a for approximately <br /> days. <br /> , If the undersigned certify that I am the ,owner of..the respective property, or am <br /> qualified to represent the owner and 4gree to do .the waxk described above in <br /> accordance with the rules, regulations of San Joaquin County and subject to <br /> inspection and approval. <br /> Sig�u7Cat a of Applicaati Title Date <br /> M/G7EH.P8\88RtlCimL (G/00) <br /> i <br />