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0q/13/2006 16: 07 2094689324 SJCO PERMITS PAGE 01/02 <br /> APPLICATION FOR ENCROACMaNT PERMIT <br /> 1iLEAS9 0 19T <br /> Date w 15 September 2006 OFFICE. USE ONLY <br /> xo: San Joaquin County :JOB # 11 o Q 'REF # <br /> Department of Public Works APN CR # <br /> Mlke McLeod of Kennedq/Jenks Cons. EXP. DATE --f 0 <br /> Inc. vALiD STC -/QZ DR2VIWAYS <br /> (Applicant Name) STREET <br /> AREA ESct/cotiJ QUAD SE <br /> 622 Folsom St. TYPE <br /> (Mailing Addreee) F0RMS 61 l&W <br /> 'NOTE <br /> _San Francisco, CA 94107 ALBAA�RtHU <br /> (City, Sbate, .Sip Code) o <br /> • E <br /> 415-243-2508 <br /> (Area Code - Telephone Number) VAN <br /> Sketch (Retailed plan.® may be submitted) <br /> Hwy 120 - Van Allen Road - Sexton Road -area se 0. <br /> See Attached Figure <br /> The Undersigned hereby applies for. permission. t'o .excavate, coas.truct and/or <br /> otherwise-encroach on -County•Highway Right-of_way-gn•the eide,.bf­ <br /> see attached approximately see attache feet/mile <br /> of see attached by'par€orming the <br /> following work (description of:work) : Cone Penetrometer tests at designated locations. <br /> Probe will be advance on shoulder .next to• avement:_ Two, 2-in, diameter boreholes to. <br /> be advance at each location. Upon .completion each borehole will bd groUted to. ground <br /> surface with neat cement grout. <br /> Traffic plan attached. <br /> Work will commence on or'about6' <br /> five day, . for approximately <br /> PSK J O+� ��0 <br /> Z, the .,undersigned certify that I am' thevowner' of: the respective property, or am <br /> CSU <br /> alifi.ed to represent the owner and, agree to do .the work described above in <br /> a,ccordanco with the rules, re. <br /> gulations 'of San Joaquin County and subject to <br /> inspection and app:rova,].. <br /> dature of Applicant Title Dare <br /> M1C1'SR•R9\1!0S913mL (6/00 . <br /> ..y <br />