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FROM :CALIFORNIA WATER SERVICE FAX NO. :2094640195 Feb. 11J 200b 04.1'JH'I r <br /> APPLICATION FOR ENCROACEMENT PERMIT <br /> KOSH P. <br /> Date Q f 1 .Q y �•++tiJ `[� _ 01priCE USE ONLY <br /> TO: San aoaqui U County Jos # -73077- <br /> Department <br /> 73077-Department of Public Forks APS Cz # <br /> �.�1f 4 VAL*I W01 A� To d Dummys, <br /> (Applicant Name) S 'TaT " <br /> ARUs-c M?,3 QM0 E5 <br /> TYPE �J-t- 11oLE <br /> (Railing Addre0a) rows <br /> S9 OcM-QAA C\ '=v5 ao I ; <br /> (City, 9bate, .Siipr�Cod`e) <br /> (Area Code - Telephone V=ber), <br /> Sketch (Detailed plans may be su6i-tted) <br /> T6 undersigned hereby.applies for permission to.excavate, coastt and/ox'�Qk^k�\ <br /> otherwiae-encroa2h,on County ai-gbway the side„o . <br /> -qL+ approximately ea n4ie <br /> of vR , , boy'perforqj4g the <br /> £ollowizx work (desoz' tion of or ) <br /> t <br /> Rork '11 commence on or'about for approximately <br /> �1 da•YS. ' <br /> I, the =dersigaed certify that I ant the owner of the respective property, or am <br /> qualified to represent the owner and agree to do the work described above in , <br /> accordance with the rul s, regulat us'oi' San Joaquin County and aubject to <br /> i.nspecti= and approv�al,kC��;\TNSU <br /> Signature of Applicant - T3,t].e Data <br /> a <br />