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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Feb. 05 2006 02:13PM P 2 <br /> APPLICAxTON FOR EgCR0ACMMV PEPMT <br /> � EAS MINT i <br /> Date 0\0 OFFXCS USE 01MY <br /> To. Sacs 10aqulz County JOB # RSF # <br /> Department of Public Works APN ( # <br /> vL TO . na�Ys <br /> (AppliCaat Name) STET Mou&QUAD 5F- <br /> E� <br /> (Hailing Address) FORMS �"01-JE <br /> �L-Zy �W <br /> (City, State, ,Zip Code) <br /> (Areal Code - Telephone Number) <br /> Sketch (Detailed plans may be submitted) <br /> The undersigned hereby.applies for permission to,excavate, c nat uct and/or <br /> o :Cwise-carr c on County Mghway Rfght-of�Wa ••o�x tba ,�. �, &4 dfs,.•o <br /> 129 WAIapproximately f e <br /> of t—, , by"aerforneing the <br /> following rk (description ok work) : <br /> ZAKI WA-mikknu • <br /> Work will commence on ox'about "� for approximately. <br /> Q days. <br /> I, the undersigned certify Chat X am the owner of the respective property, or am <br /> qualified to represent the owner and agree► to do the work described above in <br /> u], <br /> accordance with the rui s, regati Agree <br /> 'of Saxe YoaquAn county and subject to <br /> inspection and approval cO�k-06 <br /> Signature of Applicant Title Date <br />